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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 proposed to adopt the 12-month continuous eligibility mandate for children, extend the initial transitional medical assistance (TMA) period from six months to 12, and elect the option to require less than three months of eligibility or enrollment in the parent/caretaker relative eligibility group for TMA eligibility.
Summary: This amendment proposed to document the new income standards for its optional state supplement program, beneficiaries of which are eligible for Medicaid under Vermont's State Plan.
Summary: This amendment streamlines the process of integrating the state's compliance with continuous eligibility (CE) authority into the Medicaid and Chip Program (MACPro) Portal.
Summary: This amendment expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast
and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
Summary: This amendment proposes to change the eligibility rules for the Former Foster Care Children eligibility groups, as enacted by the Substance Use-Disorder Prevention that Promotes Opiod Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind premiums and cost-sharing. It reverts to co-pay amounts prior to the public health emergency (PHE) with exception of services, drugs, test and vaccines for treatment of COVID-19.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily implement a disregard of income that would have otherwise been part of an individual’s liability for institutional or home and community-based waiver services based on application of the post-eligibility treatment-of income (PETI) rules, but which became countable resources on or after March 18, 2020.
Summary: disregard two sources of income/resources: 1) any refundable credit against taxes made pursuant to Vermont's child tax credit or pursuant to a similar tax credit enacted by the State and intended by legislation to not be considered as countable income or resources for benefit programs; and 2) any wages that are made pursuant to Vermont's Premium Pay for Workforce Recruitment and Retention Program or a similar workforce recruitment and retention program enacted in Vermont and intended by the legislature to not be considered as countable income or resources in determining eligibility for benefit programs.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the authorities regarding Presumptive Eligibility (PE) authorized in sections B.1, B.2, and B.3 of DR SPA KS-20-0012. This will revert the State back to the practice of one PE period for parents or caretaker relatives, children, former foster care children; one PE period per pregnancy per a 12-month period; remove the state as a qualified entity; and eliminate the ability for qualified providers to determine eligibility for Parents/Caretaker Relatives and Former Foster Care Children.
