CMS Issues Letter Revising SPA Process - October 12, 2010

On October 1, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director and State Health Official Letter informing states of changes to the state plan amendment (SPA) application and review process. The changes are intended to make the review of proposed modifications of SPAs more efficient. Specifically, CMS has announced that it will no longer require states to resolve issues that are not integral to the provision modified by their SPA prior to gaining approval of the new SPA application. Under the new guidelines, if CMS identifies state plan provisions that do not comply with federal rules, states will now be given the option to resolve all issues submitted during review of their SPA or to focus only on the modified SPA and to resolve peripheral issues through a separate process. States will be required to assist CMS in resolving the issues identified, but the SPA will not be delayed.