CHIP State Plan Amendments
As part of a strategy to increase transparency, enhance efficiency, and reduce burden for states in the review and approval process of state plan amendments (SPA), CMS committed to providing a tool kit to assist states in the development of complete submissions, and facilitate quicker adjudication of SPA submissions. This page provides a collection of existing CHIP SPA templates for completing the templates that will be enhanced as more tools are developed.
States apply for changes to their CHIP state plan using the CHIP State Plan Template (DOCX, 206.04 KB). Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
CHIP State Program Information
In order to be eligible for payment under this statute, each State must submit a Title XXI plan for approval by the Secretary that details how the State intends to use the funds and fulfill other requirements under the law and regulations at 42 CFR Part 457.
States can design their CHIP program in one of three ways:
1. Separate CHIP: a program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of section 2103 of the Social Security Act.
2. Medicaid expansion CHIP: a program under which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act.
3. Both Separate CHIP and Medicaid expansion: a program under which a state receives federal funding to implement both a Medicaid expansion and a separate CHIP.
CHIP Program by State (PDF, 350.84 KB) has more information about how each state has implemented its program.
To see CHIP information by state, select a state on the map to find details about enrollment and dental providers. Click here for the CHIP Annual Reports.
CHIPRA creates a broad quality mandate for children's health care and authorizes health care quality initiatives for both the Children's Health Insurance Program (CHIP) and Medicaid programs. Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
Results
Transmittal Number: UT-23-0030
This SPA provides Utah with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its CHIP program.
- Benefits
- Eligibility
- Medicaid and CHIP Program (MACPro)
Transmittal Number: GA-24-0037
Through this SPA, Georgia updates its process for health services matters reviews to be consistent with the state's managed care appeals process and for the state’s CHIP review process to demonstrate compliance with requirements at 42 CFR §§ 457.1120 – 457.1180.
- Managed Care
Transmittal Number: VA-23-0027
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Benefits
Transmittal Number: WI-23-0023-CHIP
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Benefits
Transmittal Number: MS-23-0017-CHIP
Through this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Benefits
Transmittal Number: ME-23-0025
This SPA establishes a Health Services Initiative (HSI) to provide comprehensive coverage during the 12-month postpartum period for individuals whose newborns had been eligible as targeted low-income children under the from-conception-to-end-of-pregnancy (FCEP) option. The benefits provided during this postpartum period are identical to the benefits provided to pregnant individuals enrolled in Medicaid.
- Benefits
Transmittal Number: SD-23-0020
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Benefits
Transmittal Number: TX-23-0029
This SPA provides Texas with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its CHIP program.
- Benefits
- Eligibility
- Medicaid and CHIP Program (MACPro)
Transmittal Number: NY-23-0034-CHIP and NY-23-0034A-CHIP
Through these SPAs, New York extends CHIP eligibility for children from-conception-to-end-of-pregnancy (FCEP) with family incomes up to and including 218 percent of the federal poverty level (FPL) whose birth parents are not otherwise eligible for Medicaid or CHIP. Coverage for the FCEP population is identical to the benefit package provided to pregnant individuals in Medicaid.
- Eligibility
Transmittal Number: AR-23-0027
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Benefits