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 (PDF, 54.75 KB)
- Fee For Service SPA Submission Package Completeness Checklist (DOCX, 20.04 KB)
- Federal Requirements for Comprehensive State Plan Payment Methodologies (DOCX, 23.58 KB)
- Quality Incentive Payments in the State Plan (DOCX, 18.33 KB)
- Guidance on Annual Upper Payment Limit Demonstrations Public Notice and Public Process Requirements for Changes to Medicaid
- Public Notice and Process (PDF, 95.59 KB)
- Bundled Rate Payment Methodology (PDF, 633.17 KB)
- Clinic Payment Methodology (PDF, 76.15 KB)
Eligibility and Administration SPA Tools
- Eligibility and Administration SPA Implementation Guides (ZIP, 3.6 MB)
Premiums and Cost-Sharing SPA Tools
- SPA Templates
- Implementation Guides (ZIP, 172.09 KB)
Pharmacy SPA Tools
- Summary Sheet - Reimbursement Requirements in the Covered Outpatient Drug final rule with comment (DOCX, 24.58 KB)
- 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 (PDF, 1.02 MB)
- 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) (DOCX, 23.53 KB)
- HCBS Authorities
- Toolkit for HCBS Settings Requirements
- HCBS Training on a Variety of Subjects
Benefits and Coverage SPA Tools
Mandatory MAT Tools-SUPPORT Act Section 1006(b)
- SPA Template: Supplement to Attachment 3.1-A for 1905(a)(29) Medication-Assisted Treatment (MAT) (DOCX, 39.97 KB)
- SPA Template: Supplement to Attachment 3.1-B for 1905(a)(29) Medication-Assisted Treatment (MAT) (DOCX, 33.41 KB)
Alternate Benefit Plan Tools
Other Benefit SPA Tools
- TCM Pre-Print (PDF, 51.26 KB)
- Hospice Pre-Print (PDF, 18.72 KB)
Integrated Care SPA Tools (Managed Care, PACE and Health Homes)
- 1932(a) Pre-Print (PDF, 412.8 KB)
- PACE SPA Template (PDF, 47.82 KB)
- Health Homes Tools