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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: This amendment implements policy that health care facilities operated by Indian Health Service/Tribally-Operated 638 Health Programs/Urban Indian Health Programs (ITU) providers are designated as Federally Qualified Health Centers (FQHC).
Summary: This amendment clarified and simplified the rules for when the Indian Health Service (IHS) encounter rate is paid to IHS and triba facilities.
Summary: This amendment gives the Blackfeet Tribe of the Blackfeet Reservation, and the Gros Ventre and Assiniboine Tribes of the Ft. Belknap Reservation, authority to determine Medicaid eligibility. A2 has been amended to add this authority.
Summary: The Tribal Leadership Advisory Council was established through an internal Wyoming Department of Health policy to seek advice on a regular, ongoing basis from the federally recognized Wyoming Tribes and Indian Health Services on matters related to Medicaid and/ or Kid Care CHIP. The wording for this policy was added to the Tribal Consultation SPA.
Summary: Including references to the federally recognized tribes (Eastern Band of Cherokee Indians), where appropriate, to ensure all duties, roles and responsibilities previously assigned to county divisions of social services are shared with the tribe for individuals living within the tribal boundary.
Summary: Revises the provisions governing the tribal consultation process in the Medicaid program, specifically to clarify language pertaining to waiver amendments.