CHIP State Amendment Plans

This SPA clarifies the state's policy on household composition under 42 CFR 457.315. Married couples who are living separately will be treated as individual households, even when filing a joint tax return.

Relates to the Modified Adjusted Gross Income eligibility and methodology.

This SPA changes the administration of CHIP from the Pennsylvania Insurance Department to the Pennsylvania Department of Human Services, and updates the number of contracts with managed care organizations from ten to nine.

This SPA authorizes its federally recognized tribes to share all of the duties, roles, and responsibilities related to administration of the state's CHIP program with the county divisions of social services, including screening applicants for CHIP eligibility and processing enrollments and renewals.

Proposing eliminating managed care and implementing FFS under purview of ASO.

Adds ostomy supplies as a state plan benefit and implements a CHIP Health Services Initiative (HSI) to support the activities of two regional poison control centers and an HSI to support sickle cell screening and transition services to prepare young adults to transition them from parental care to self-care for their sickle cell or other hemoglobinopathy conditions, as well as prepare children for the transition from pediatric to adult medicine in four contracted New York City hospitals.

South Dakota's SPAs SD-16-0002 and SD-16-0006 allows the state to expand eligibility to include unborn children whose pregnant mothers are not otherwise eligible for Medicaid and whose family incomes are up to, and including 133 percent of the federal poverty level (FPL). Coverage will include pregnancy-related services, such as prenatal care for children from conception to birth. SPA SD-16-0007 specifies that this population will be excluded from the state's 90-day waiting period. A copy of the approved CS9 is attached and incorporated into section 4.1.9 of the state's current CHIP state plan. A copy of the approved CS20 state plan page is attached and supersedes section 4.4.4.1 of the current CHIP state plan.

The goals of this HSI are to prevent the removal of children from the home, prevent a recurrence of maltreatment and improve the overall health and well-being of young children and their families. The state will implement the SafeCareevidence-based home visitation program that has been shown to reduce child maltreatment among families with a history of maltreatment or with risk factors for maltreatment among families with a history of maltreatment or with risk factors for maltreatment.

This SPA permits Nevada to implement a new health services initiative (HSI) to integrate the Resources for the Early Advancement of Child Health (REACH) program into after school programs serving the highest risk populations of children in Nevada public schools.

To clarify the state's non-financial eligibility policies on residency; citizenship; social security numbers; substitution of coverage; non-payment of premiums and other eligibility standards.