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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 9 of 9 results
Transmittal Number: VT-24-0003
State: Vermont
Summary: This SPA is to update the 2024 Base Benchmark.
Approval Date:
Effective Date:
Topics:
  • Alternative Benefit Plan
  • Inpatient
  • Other Licensed Practitioners
  • Home Health
  • Prior Authorization
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NH-24-0002
State: New Hampshire
Summary: This amendment allows a child to remain eligible and enrolled for a full year without consideration of changes in circumstances in accordance with the 2023 Consolidated Appropriations Act.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Inpatient
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: DC-23-0016
State: District of Columbia
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
Approval Date:
Effective Date:
Topics:
  • Value Based Purchasing
  • Prescribed Drugs
  • Covered Outpatient Drug
  • Over-the-Counter Drugs
  • Non-prescription Drugs
  • Fertility Drugs
  • Excluded Drug Coverage
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-23-0048
State: North Carolina
Summary: This amendment increases the personal needs allowance for individual Medicaid recipients institutionalized from $30 to $70 and from $60 to $140 for married couples.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Inpatient
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: TN-23-0004
State: Tennessee
Summary: This amendment is to update the state plan to reflect the current Preadmission Screening and Annual Resident Review process.
Approval Date:
Effective Date:
Topics:
  • Inpatient
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-22-0024
State: Maryland
Summary: Removes the reference to “psychiatric hospitals” on the inpatient hospital coverage state plan page.
Approval Date:
Effective Date:
Topics:
  • Inpatient
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: NC-21-0013
State: North Carolina
Summary: The Pregnancy Medical Home program will be replaced by the Pregnancy Management Program.
Approval Date:
Effective Date:
Topics:
  • Inpatient
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MD-22-0002
State: Maryland
Summary: To update the State Plan language regarding the guidance on in-patient delivery hospital stays, clarifying the authorization requirements for both vaginal and cesarean deliveries.
Approval Date:
Effective Date:
Topics:
  • Inpatient
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: MS-21-0007
State: Mississippi
Summary: This amendment proposes to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims with last dates of service on or after July 1, 2021, and 3) remove language that intensive outpatient programs and partial hospitalization programs are not covered in the outpatient hospital setting.
Approval Date:
Effective Date:
Topics:
  • Inpatient
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT