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.
Results
Transmittal Number: MD-24-0005-CHIP
Through this SPA, the state makes several technical updates and updates their strategic objectives and performance goals.
- Program Administration
Transmittal Number: WV-24-0003
Through this SPA, the state amends the benefit package for children under the CHIP state plan from benchmark to Secretary-approved coverage that mirrors the Medicaid state plan benefit package for children. CHIP medical, dental, and behavioral health benefits align with West Virginia Medicaid benefits for children and pregnant women in respect to amount, duration, and scope of services, as well as exclusions and limitations. Pharmacy is the one exception to full alignment with Medicaid.
- Benefits
Transmittal Number: MA-24-0024
Through this SPA, the state makes several updates to benefits under the CHIP state plan and updates its strategic objective goals related to CHIP enrollment and removes an outdated performance goal.
Additionally, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. This SPA also 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
- Program Administration
Transmittal Number: WV-24-0007
Through this SPA, West Virginia deactivates the Kids First Health Services Initiative (HSI) in the CHIP state plan, due to inactivity.
- Health Service Initiative
Transmittal Number: HI-24-0004
This amendment implements a health services initiative (HSI) to improve the health of low-income children by increasing their access to needed hearing screenings and follow up services, such as exams and referrals for hearing devices, through a targeted, school-based initiative.
- Benefits
- Health Services Initiatives
Transmittal Number: DE-24-0003 and DE-24-0003-CHIP
Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023). Additionally, through this SPA the state removes all premiums from the CHIP state plan effective July 1, 2024.
- Eligibility
Transmittal Number: TN-24-0024
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.
Also, through this SPA the state adds coverage of lactation supports services and updates their strategic objectives and performance goals to align with those reported
in the state’s CHIP annual report.
- Program Administration
Transmittal Number: VA-24-0012
Through this SPA, the state makes several benefit changes to their CHIP state plan.
- Benefits
Transmittal Number: ME-24-0025
Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023).
- Eligibility
Transmittal Number: NY-24-0038-CHIP and NY-24-0040-CHIP
Through SPA, the state makes technical updates to remove outdated references and clarify current practices in their CHIP state plan. Additionally, through this SPA the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023). Furthermore, the state confirms they no longer disenroll children from coverage due to late premium payments during or at the end of the CE period.
- Cost Sharing
- Eligibility
- Program Administration