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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 update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment establishes a Coordinating, Aligned, Relationship-centered, Enhanced Support (CARES) Targeted Case Management (TCM) benefit for children. This new CARES TCM will provide intensive support in care planning and coordination of services for eligible medically complex MassHealth members younger than 21.
Summary: This amendment proposed to eliminate the resource test for the following eligibility groups: Qualified Medicare Beneficiaries; Specified Low-Income Medicare Beneficiaries; and Qualifying Individuals.
Summary: This SPA adds mandatory coverage of COVID-19 vaccine and administration, testing, and treatment benefits as required by Section 9811 of the American Rescue Plan Act.
Summary: This SPA provides Massachusetts with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.