CHIP State Amendment Plans

Through this SPA, Missouri will accept CHIP eligibility determinations made by the Federally Facilitated Exchange (FFE), pursuant to section 2107(e)(1)(U) of the Social Security Act and 42 CFR 457.348, which requires states to have procedures in place for enrollment simplification and coordination with Exchanges and Medicaid.

This amendment implements a health services initiative (HSI) to support the Oklahoma Child and Adolescent Psychiatry Access Program (OKCAPMAP).

Through this SPA, the state transitions their delivery system for dental benefits from the Healthy Smiles managed care program to the fee-for-service system administered by the Division of Medical Services.

Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023).

Through this SPA, the state adds coverage in CHIP for home and community-based services that are identical to those provided under section 1915(i) of the Social Security Act (the Act) and home and community-based attendant services and supports under section 1915(k) of the Act, in the Medicaid state plan.

This SPA demonstrates compliance with CHIP mental health parity regulations.

Through this SPA, the state makes several technical updates and updates their strategic objectives and performance goals.

Through this SPA, the state amends the benefit package for children under the CHIP state plan from benchmark to Secretary-approved coverage that mirrors the Medicaid state plan benefit package for children. CHIP medical, dental, and behavioral health benefits align with West Virginia Medicaid benefits for children and pregnant women in respect to amount, duration, and scope of services, as well as exclusions and limitations. Pharmacy is the one exception to full alignment with Medicaid.

Through this SPA, the state makes several updates to benefits under the CHIP state plan and updates its strategic objective goals related to CHIP enrollment and removes an outdated performance goal.

Additionally, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. This SPA also documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.

Through this SPA, the state amends its CS21 state plan page to demonstrate that it no longer disenrolls children from coverage due to non-payment of premiums during, or at the end of the continuous eligibility period. In addition, the SPA eliminates the state’s premium lock-out period.