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: ND-24-0101
Through this SPA, the state increases the upper income standards for the state’s title XXI funded Medicaid expansion from 170 to 200 percent of the federal poverty level. SPA ND-24-0101 is a companion to the Medicaid eligibility expansion SPA, ND-24-0007.
- Eligibility
Transmittal Number: NE-24-0007
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: MT-24-0029
Through this SPA, the state 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: SD-24-0006
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
- Enrollment
Transmittal Number: RI-24-0005
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.
- Benefits
Transmittal Number: MI-24-0025-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: MO-23-0011
This SPA updates the CHIP state plan to remove the state’s premium assistance program as of January 1, 2023. The state also makes non-substantive updates to its CHIP state plan to more clearly reflect existing policies. The updates are effective September 1, 2023.
- Cost Sharing
- Current State Plan
Transmittal Number: UT-22-0027
Through this SPA, Utah updates its CHIP reimbursement methodologies for Federally Qualified Health Centers and Rural Health Clinics and clarifies the Prospective Payment System and Alternative Payment Methodologies used by the state. Also, the state also updates reimbursement methodologies for Indian Health Services and 638 Tribal Health Facilities.
- Financing & Reimbursement
Transmittal Number: IN-24-0002-CHIP
Through this SPA, the state adds mobile crisis services to the state's behavioral health benefits.
- Benefits
Transmittal Number: AZ-24-0003
Through this SPA, the state 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