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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.

Results

Displaying 1 - 10 of 15719

Louisiana

This plan amendment proposes an increase to FQHCs by $50 per encounter and shall be reimbursed through an APM.

Approval Date: May 29, 2025
Effective Date: July 1, 2025

Washington

This amendment adds Certified Anesthesiologist Assistants and Dental Therapists to Other Licensed Providers section in the State Plan.

Approval Date: May 28, 2025
Effective Date: July 1, 2025

Florida

This plan amendment updates buy-back provisions for Intermediate Care Facilities for Individuals with Developmental Disabilities outlined within the State Plan.

Approval Date: May 27, 2025
Effective Date: July 1, 2024

Rhode Island

This amendment authorizes the state to enter into value-based supplemental drug rebate agreements on a voluntary basis.

Approval Date: May 27, 2025
Effective Date: January 1, 2025
Topics: Value Based Purchasing

Utah

This plan amendment updates the bed hold days methodology.

Approval Date: May 27, 2025
Effective Date: January 1, 2025

Illinois

This SPA updates the state plan to clarify Illinois’ compliance with federal requirements as they pertain travel-related expenses for long-distance transportation funded by Medicaid.

Approval Date: May 27, 2025
Effective Date: March 1, 2025
Topics: Coverage and Reimbursement

New York

This plan amendment updates the quality incentive program for non-specialty nursing homes will continue to recognize improvement in performance and provide for other minor modifications.

Approval Date: May 27, 2025
Effective Date: January 1, 2025

New York

This amendment proposed to increase its resource standards for the Medically Needy, Ticket to Work Basic, and Ticket to Work Medical Improvement eligibility groups.

Approval Date: May 23, 2025
Effective Date: January 1, 2025
Topics: Coverage Eligibility Medicaid and CHIP Program (MACPro)

Georgia

This SPA proposes to establish coverage of Certified Community Behavioral Health Clinics (CCBHC) and reimbursement of CCBHC services.

Approval Date: May 22, 2025
Effective Date: July 1, 2024
Topics: Coverage and Reimbursement

Oregon

This plan amendment adds neonatal procedure codes to the conversion factors inadvertently omitted by the state in OR-22-0005.

Approval Date: May 21, 2025
Effective Date: January 1, 2025