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Table of Contents State/Territory Name: AZ State Plan Amendment (SPA) #: 200016 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 Form/Summary Form (with
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Obtain a copy of the AZ State Plan Amendment form.
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Who needs az state plan amendment?

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Healthcare providers or organizations in Arizona who are part of the Medicaid program may need to fill out an AZ State Plan Amendment if they want to make changes to their Medicaid services or coverage.
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Az state plan amendment is a formal proposal submitted to the state Medicaid agency outlining changes to the state's Medicaid program.
State Medicaid agencies are required to file az state plan amendments to make changes to their Medicaid programs.
Az state plan amendments can be filled out by state Medicaid agencies in accordance with federal guidelines and requirements.
The purpose of az state plan amendment is to seek approval for changes to the state's Medicaid program in order to comply with federal regulations and requirements.
Az state plan amendments must include details of the proposed changes to the Medicaid program, including the reason for the change and the impact on beneficiaries.
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