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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 is to adjust the premium scale per 441 IAC 75.1(39)”b”. The maximum premium amount is based on the avg. state employee health insurance premium which is, for a single person, $958.50 effective January 1, 2024.
Summary: This amendment complies with the federal requirement that the state implement a tracking system that ensures that cost sharing and premiums of a Medicaid beneficiary will not exceed five percent of the family income.
Summary: Increase the premiums assessed to individuals enrolled in the eligibility group under section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act beginning on August 1, 2020
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, allow for flexibility in hospital presumptive eligibility, suspend cost sharing and premiums for all services for all beneficiaries, add new services under 1915(i), and allow for other flexibilities in the 1915(i) program.
Summary: Required due to a premium scale adjustment per 441 IAC 75.1(39). The maximum preium amount is based on avg. state employee health insurance premium, & that amount increased. Therefore, premiums for MEPD have increased.
