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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 10 results
Transmittal Number: MN-24-0011
State: Minnesota
Summary: This amendment proposes to expand coverage for prescription contraceptives to up to a 12-month supply.
Approval Date:
Effective Date:
Topics:
  • Contraceptive Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-23-0038
State: North Carolina
Summary: This amendment adds a tribal consultation process for Indian Health Services Facilities and Urban Indian Organizations.
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
  • Tribal/Indian Health Issues
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-21-0011
State: North Carolina
Summary: Adds a tribal Primary Care Case Management Program to the State Plan
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
Links:
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Transmittal Number: MI-21-0009
State: Michigan
Summary: Provides authority to allow Tribal 638 pharmacies to be reimbursed at the Indian Health Services outpatient all-inclusive rate (A.I.R.) per visit
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
  • Financing & Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: VA-21-0014
State: Virginia
Summary: Effective July 1, 2021, this amendment allows for 12-month contraception dispensing and participation in the National Medicaid Pooling Initiative (NMPI). 
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Contraceptive Drugs
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: WA-20-0034
State: Washington
Summary: Creates a new, cost-based per diem rate for substance use disorder (SUD) residential treatment facilities (RTF) operated by the Indian Health Service (IHS) or Tribes to IHS-eligible American Indian/Alaska Native (AI/AN) Medicaid beneficiaries. 
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NM-20-0022
State: New Mexico
Summary: Effective January 31, 2021, this amendment modifies rates payable to Indian Health Services and eligible tribal health facilities operating under Public Law (P.L.) 93-638.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Indian Health Services
Links:
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Transmittal Number: OR-21-0001
State: Oregon
Summary: Effective January 7, 2021, this amendment increases the daily encounter limit from one encounter per day to five encounters per day. This change applies to Indian Health Service and Tribal 638 clinics.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Indian Health Services
  • Program Administration
Links:
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Transmittal Number: CA-20-0044
State: California
Summary: Establishes the Tribal Federally Qualified Health Centers (FQHC) provider type in Medi-Cal and establishes an Alternative Payment Methodology (APM) at the Indian Health Services All-Inclusive Rate for Tribal FQHCs 
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: AZ-20-0013
State: Arizona
Summary: Proposes inpatient hospital and outpatient hospital differential adjusted payments to facilities owned or operated by the Indian Health Services (IHS) or tribes under PL 93-638
Approval Date:
Effective Date:
Topics:
  • Indian Health Services
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT