Back to Approved State Plan Amendments by Year 

The following attachments are amendments to the California State Plan that were recently approved by the Centers for Medicare and Medicaid Services (CMS). Stakeholders can update their copies by following the links and instructions attached to the documents.

17-002 Modifies the Reimbursement Methodology for Covered Outpatient Drugs

17-004 Supplemental Payments for Hospital Inpatient Services

17-005 Supplemental Payments for Hospital Outpatient Services 

17-006Creates a One-Time, Supplemental Payment Pool for Eligible Providers within Specific Service Categories

17-009 Graduate Medical Education Payments to Designated Public Hospitals

17-012 Physician Prescriptions for Medical Supplies

17-014 Medi-Cal reimbursement rates for Radiology Services

17-015 Inpatient Hospital APR-DRG Updates for State Fiscal Year 2017-18

17-016 Compliance with CMS Final Rule to No Longer Cover Out-of-State Former Foster Youth under Current State Plan

17-017 Removes outdated transportation pages and clarifies services surrounding Nonemergency Medical Transportation (NEMT)

17-018 Adds nonmedical transportation services in the Alternative Benefit Plan

17-019 Supplemental Payments for Emergency Air Medical Transportation Services

17-020 Specifies Statewide Weighted-Average Rate Increase for Skilled Nursing Facilities

17-023 Proposed Increase to the Cap for Supplemental Payments Made to the Martin Luther King, Jr. – Los Angeles Healthcare Corporation

17-024 Extends the Quality and Accountability Supplemental Payment program

17-025 Changes the provider type name from Christian Science to Religious Non-Medical Health Care Institutions (RNHCIs)

17-026 Provides Updates Requested by CMS to Pages that Describe Personal Care Services

17-027 Proposes to restore adult optional dental benefits for beneficiaries ages 21 and older with full-scope dental coverage

17-028 Provides for a Time-Limited Supplemental Payment Program for Intermediate Care Facilities for the Developmentally-Disabled

17-029 Allows for Time-Limited Supplemental Reimbursements under the Family Planning, Access, Care, and Treatment (Family PACT) program for the Evaluation and Management Portion of Office Visits Rendered for the Purpose of Comprehensive Family Planning Services

17-030 Provides for a Supplemental Payment Program for Certain Physician Services Rendered during the July 1, 2017 to June 30, 2018 Period

17-031 One-Year Supplemental Payment for Certain Dental Services using California Healthcare, Research, and Prevention Tobacco Tax Act Funds

17-032 Inpatient Hospital- All Patient Refined – Diagnosis Related Groups updates for SFY 2017-18

17-034 Updates the Geographic Area offering Targeted Case Management Services for the “Children Under the Age of 21” Group

17-035 Updates the Geographic Area offering Targeted Case Management Services for the “Medically Fragile Individuals” Group

17-036 Updates the Geographic Area offering Targeted Case Management Services for the “Individuals at Risk for Institutionalization” Group

17-037 Updates the Geographic Area offering Targeted Case Management Services for the “Individuals in Jeopardy of Negative Health or Psycho-Social Outcomes” Group

17-038 Updates the Geographic Area offering Targeted Case Management Services for the “Individuals with a Communicable Disease” Group

17-039 Revises the Medi-Cal Fee-for-Service Reimbursement Methodology for All-Inclusive Birth Services Provided in Alternative Birth Centers

17-0041 Amends the Alternative Benefits Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. 

17-044 Allows the State to waive premium charges for OTLICP beneficiaries affected by recent wildfires in California

Contact Us

You may email your questions and concerns regarding State Plan Amendments (SPAs) to Publicinput@dhcs.ca.gov.  In your email, please include the SPA number in question. 

Resources

CMS Minimum Essential Coverage Determination (PDF)

NOTE: Links on this page are documents in Adobe Acrobat Document Format (PDF); unless indicated are smaller than 2MB. PDF documents require Adobe Reader. Install or upgrade to the latest version of Adobe Reader.