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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: Elimination of an income test for individuals for whom public agencies are assuming full or partial financial responsibility and children for whom there is in effect a State adoption assistance agreement.
Summary: Eliminates coverage for medically needy caretakers relatives, adjust assignments of rights, and changes methodology related to treatment of resources.
Summary: The proposed amendments to the State Plan would implement provisions of the Patient Protection and Affordable Care Act of 2010 and the Health Care and Education Reconciliation Act of 2010. The proposed amendments implements the following: 1) New Medicaid eligibility groups; 2) Establishes financial methodologies for determining Medicaid eligibility based on modified adjust gross income (MAGI); 3) Establish simplified and date-driven renewal polices for individuals who eligibility is based on MAGI; 4) Simplifies residency, citizenship and immigration status; and 5) Allows presumptive eligibility conducted by hospitals for certain Medicaid eligibility groups.
