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2013 Approved State Plan Amendments (SPA)

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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.  All documents are in PDF format.

​13-001 Amendments to Conform to MIPPA Provisions Related to Medicaid Outpatient Drug Coverage (PDF, Approved 5/10/2013)
13-002 Private Hospital Supplemental Fund Program (Approved 12/11/2013)
13-003 Increase Payments for Primary Care Services Provided by Eligible Physicians (PDF, Approved 10/24/2013)
13-004 Diagnosis Related Group (DRG) Reimbursement Methodology for Private General Acute Care Hospitals (PDF, Approved 5/31/13)
13-005 Coverage For Optional Targeted Low-Income Children (PDF, Approved on 12/20/13)
13-006Updates the Service Descriptions for the Program of All-Inclusive Care for the Elderly (PACE) (PDF)
13-007 Community First Choice Option (PDF, Approved on 7/31/2013)
13-008 Expand Psychology Services to All Beneficiaries and Remove Two-Visit Limit from Psychology Services (PDF, Approved 12/19/13)
13-011 Construction Renovation Reimbursement Program (Approved 12/11/2013)
13-014 Implements ACA Section 4106 - Establishes One Percentage Point Increase in FMAP for Adult Vaccines (Approved 11/07/2013)
13-015 To Exempt Dental Pediatric Surgery Centers from the Medi-Cal 10% Provider Payment Reduction (PDF Approved 3/4/2014)
13-018 Adult Dental Benefits (PDF) (Approved 4/29/2014)
13-019 Audit Selection for Intermediate Care Facilities for the Developmentally Disabled (Approved 12/04/2013)
13-020 Update the Effective Date of the Fee Schedule for Alternative Birth Center Reimbursement Rates (Approved 9/06/2013)
13-021 ​MAGI-Based Eligibility Groups (S33, S25, S28, S30, S32, S50, S51, S52, S53, S54, S55, S57, S14 Forms)
13-022 -Incorporates MAGI-Based Eligibility Process Requirements, Including the Single Streamlined Application (Approved 12/10/2013)
13-023 Incorporates MAGI-Based Income Methodologies into CA Medicaid State Plan in accordance with ACA (Approved 09/30/2013)
13-024 Single State Agency (MAGI) - A1, A2, A3 Forms (Approved 05/14/2014)
13-025 Incorporates Residency Requirements into CA Medicaid State Plan (PDF, Approved 11/6/2013)
13-026 Incorporates Citizenship and Non-Citizenship Eligibility Requirements - S89 (PDF, Approved 11/18/2013)
13-027 Hospital Presumptive Eligibility (Approved 2/27/2015)
13-028 New Adults 133% Eligibility Group (Approved, 12/13/2013)
13-029​ Parental Income Disregard: Pregnant Women Under Age 21 (PDF)
13-033 Diagnosis Related Group - Reimbursement for Inpatient Hospital Services by Non-Designated Public Hospitals(Approved, 12/5/13)
13-034 Exemption to Designated Rural or Frontier Distinct Part Nursing Facilities - Level B (PDF, Approved 12/20/13)
13-035 ACA Alternative Benefit Plan (PDF, Approved 3/28/14)
13-036 Targeted Case Management - Individuals With A Communicable Disease (Approved 11/19/2013)
13-037 Targeted Case Management - Medically Fragile Individuals (Approved 09/17/2013)
13-038 Substance Use Disorder Services Expansion (PDF)​
13-039 Exempt Non-Profit Dental Pediatric Surgery Centers from the Provider Payment Reduction Imposed by AB 97 (Approved 12/20/13)
13-040 Quality and Accountability Supplemental Paymen​t (QASP) Program, Freestanding SNF Reimbursement Rates (PDF, Approved 4/2/14)
13-041 Reasonable Classification Under 21 Non-Title-IV-E and 2101(f)-Like Children (PDF, Approved 3/6/14)
13-042 Acquisition and Maintenance of Physical, Occupational, and Speech Therapy Services (PDF, Approved 12/31/2013)
13-044 Increased Federal Medical Assistance Percentage (FMAP) for New Adult Group (PDF)​ Approved 3/11/2015



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Last modified on: 7/19/2018 4:36 PM