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Medicaid State Plan Amendments

A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.

When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.

Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.

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Showing 1 to 10 of 65 results
Transmittal Number: ID-24-0004
State: Idaho
Summary: This plan amendment updates fee schedules language for service rehabilitation benefits section to comply with federal requirements and updates outdated language.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-24-0026
State: New Jersey
Summary: This plan amendment updates rates for COVID-19 Vaccine Administration.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-24-0023
State: New Jersey
Summary: This SPA allows coverage of select prescribed drugs that do not meet the definition of covered outpatient drugs. Additionally, this SPA also allows reimbursement of prescribed drugs with the same reimbursement methodologies as covered outpatient drugs.
Approval Date:
Effective Date:
Topics:
  • Prescribed Drugs
  • Reimbursement
  • Covered Outpatient Drug
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NJ-24-0004
State: New Jersey
Summary: This plan amendment authorizes indirect medical education for HEALS in both fee-for-service and managed care delivery systems.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: ID-23-0014
State: Idaho
Summary: This plan amendment creates a reimbursement methodology for supplemental payment for ground emergency medical transportation services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NJ-24-0011
State: New Jersey
Summary: This amendment revises the distribution of Graduate Medical Education Trauma payments for the State Fiscal Year 2025.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NJ-24-0010
State: New Jersey
Summary: This amendment revises the distribution of Graduate Medical Education (GME) and Indirect Medical Education (IME) supplemental payments for the State Fiscal Year 2025.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: ID-21-0002
State: Idaho
Summary: This plan amendment modifies the reimbursement for the Primary Care Case Management Program and aligns it with the Healthy Connections Value Care Program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: NJ-24-0009
State: New Jersey
Summary: This amendment revises the distribution of Graduate Medical Education (GME) and Indirect Medical Education (IME) payments for State Fiscal Year 2025.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NJ-24-0008
State: New Jersey
Summary: This amendment updates the methodology for the distribution of charity care subsidy payments for disproportionate share hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT