2016 Approved State Plan Amendments
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.
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Questions and/or concerns regarding any State Plan Amendment can be submitted via e-mail to
. Please reference the SPA number in question.
16-001 Amends the Medicaid-eligible beneficiary population for the Targeted Case Management (TCM) services in Local Educational Agency (LEA) Medi-Cal Billing Option Program.
16-002 Corrects error in State Plan
16-007 CA Health Homes Program
16-008 Provides technical updates for comprehensive perinatal service program providers
Transfers the authority for Disproportionate Share Hospital replacement payments
16-011 Updates Year 4 Diagnosis Related Group (DRG) payment parameters
16-012 Increases reimbursement for Intermediate Care Facilities for the Developmentally Disabled (ICF/DD)
16-013 Revision to current language regarding Nursing Facilities
16-014 Supplemental Reimbursement for Qualified Private Hospitals program
16-015 Supplemental Reimbursement for Inpatient Hospital Services
16-016 Proposes to renew the 1915(i) State Plan Home and Community-Based Services (HCBS) benefit for individuals with developmental disabilities
16-017 Supplemental Reimbursement to MLK-LA
16-018 Provides updates to the Home Health Services section of the State Plan to align with revisions to Title 42
Public Hospital Outpatient Services Supplemental Reimbursement Program
Reimbursement to Specified Government-Operated Providers for Costs of Professional Services.
16-021 Supplemental reimbursement for services provided by public freestanding, non hospital-based clinics
16-022 Proposes to reduce payments to St. Rose Hospital, located in Alameda County
16-023 Updates the names of hospitals deemed as government-operated
16-025 Restores acupuncture services
16-027 Restores acupuncture as a covered service under the Alternative Benefit Plan.
16-028 Allows reimbursement for three visits per day for Indian Health Service/Centers
16-029 Kern County Medical Center
16-030 Revisions to Estate Recovery (ER) program
16-031 Non-Designated Public Hospital Supplemental Fund (NDPHSF) Program
16-032 Adds Alameda Hospital and San Leandro Hospital to the list of government-operated hospitals
16-035 Provides for an additional year, augmentation payments to emergency medical air transportation providers
16-036 New Provider Rates for 1915(i) State Plan
Extends the Quality and Accountability Supplemental Payment program from through July 31, 2020
16-038 Updates the geographic area offering Targeted Case Management services for the “Children Under the Age of 21” group
16-039 Updates the geographic area offering Targeted Case Management services for the “Medically Fragile Individuals” group
16-040 Updates the geographic area offering Targeted Case Management services for the “Individuals at Risk of Institutionalization” group
16-041 Updates the geographic area offering Targeted Case Management services for the “Individuals in Jeopardy of Negative Health of Psycho-Social Outcomes” group
16-042 Updates the geographic area offering Targeted Case Management services for the “Individuals with a Communicable Disease” group
Recovery Audit Contractor (RAC) Program
Adds a median rate methodology for Licensed/Certified Residential Services
CMS Minimum Essential Coverage Determination (PDF)