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The 1115 Waiver and State Plan are the two policy documents the state uses to determine how Medicaid serves the people of Arizona. The State Plan is an agreement between Arizona and the federal government that describes how the state runs its Medicaid program, including how it determines eligibility, which benefits and services it provides, and how providers are paid for services. As needed, AHCCCS amends the State Plan to add or change parts of Arizonas Medicaid program. These changes are called State Plan Amendments (we call them SPAs for short). Every SPA must meet federal Medicaid requirements, and be approved by the Centers for Medicare and Medicaid Services (the federal agency known as C-M-S). SPAs are negotiated with CMS and approved on a case-by-case basis. Once CMS approves a SPA, it is a permanent change to the Arizona Medicaid program. Each SPA takes effect on its unique start date. The US government created the Medicaid program in 1965 to provi
