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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: To raise the Federal Poverty Level (FPL) for Qualified Medicare Beneficiaries from 100 percent to 138 percent and the Qualified Individual's eligibility level to greater than 138 percent FPL to 186 percent FPL.
Summary: To adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORD Act, Pub. L. No. 115-217, section 1002.
Summary: Revises the Medically Needy Income Levels, effective January 1, 2021. For Medically Needy households of 1 and 2, levels are calculated using the SSI standards. To arrive at uniform levels for households of 3 and higher, 15% per additional household member is added to the standard for a household of 2. Thus, the standard for a
household of 3 would be 115% of the standard for a household of 2; the standard for a household of 4 would be 130% of the standard of for a household of 2, etc.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
