Medicaid SPA Processing Tools for States
As part of a strategy to increase transparency, enhance efficiency, and reduce burden for States in the review and approval process of State Plan Amendments, CMS committed to providing a tool kit to assist States in the development of complete submissions, and facilitate quicker adjudication of SPAs. This page provides a collection of existing preprints, templates, checklists and other existing guidance that will be enhanced as more tools are developed.
Payment SPA Tools
- Medicaid Funding Questions
- Fee For Service SPA Submission Package Completeness Checklist
- Federal Requirements for Comprehensive State Plan Payment Methodologies
- Quality Incentive Payments in the State Plan
- Guidance on Annual Upper Payment Limit Demonstrations Public Notice and Public Process Requirements for Changes to Medicaid
- Public Notice and Process
- Bundled Rate Payment Methodology
- Clinic Payment Methodology
Eligibility and Administration SPA Tools
Premiums and Cost-Sharing SPA Tools
Pharmacy SPA Tools
- Summary Sheet - Reimbursement Requirements in the Covered Outpatient Drug final rule with comment
- Cures Act
- Smoking Cessation and Benzo/Barbs
Home and Community Based Services SPA Tools
- 1915 (i) Pre-Print – State Plan Home and Community Based Services
- Technical Guide for 1915(c) Waivers including Instructions and Review Criteria
- 1915 (j) Pre-Print – Self Directed Personal Assistance Services Under the State Plan
- 1915(k) Template and Technical Guide – Community First Choice (CFC)
- HCBS Standard Review Qs (CFC)
- HCBS Authorities
- Toolkit for HCBS Settings Requirements
- HCBS Training on a Variety of Subjects