Due to the government shutdown, updates to information on this website may be limited or delayed. State Medicaid and Children’s Health Insurance Programs (CHIP) continue to operate. Continue to work with the programs in your state to access coverage. For more information about government operating status, visit OPM.gov.
CHIP State Amendment Plans
Georgia
Describes the payment methodologies used to ensure that Federally Qualified Health Centers (FQHC) and Rural Health Clinics (RHC) receive reimbursement equivalent in aggregate by federal fiscal year to the amounts of reimbursement each FQHC\/RHC would have received under the Medicaid Prospective Payment System, as required under section 2107(e)(l)(G) of the Social Security Act.
Approval Date: October 27, 2016
Effective Date: January 1, 2016
Links:
Topics:
Financing & Reimbursement
Program Administration
Illinois
Updates the federal poverty levels of the premium and copayment bands to the equivalent Modified Adjusted Gross Income (MAGI) eligibility standards. This SPA is consistent with the state's approved MAGI Conversion Plan and the state's implementation of MAGI, effective January 1, 2014, through Illinois CHIP SPA IL-14-0006. CHIP families are required to pay monthly premiums according to federal poverty levels as detailed in the following table:.
Approval Date: October 7, 2016
Effective Date: July 1, 2014
Links:
Topics:
Financing & Reimbursement
Tennessee
Cost Sharing Changes.
Approval Date: September 16, 2016
Effective Date: April 1, 2016
Links:
Topics:
Cost Sharing
North Carolina
North Carolina updates the federal poverty levels (FPL) of the eligibility and enrollment fee bands to be consistent with the Modified Adjusted Gross Income (MAGI) eligibility levels:.
Approval Date: August 23, 2016
Effective Date: October 1, 2015
Links:
Topics:
Financing & Reimbursement
Virginia
Under this SPA, Virginia adds behavioral therapy services, including applied behavioral analysis, to its CHIP benefit package, with an effective date of September 1, 2016.
Approval Date: August 18, 2016
Effective Date: September 1, 2016
Links:
Topics:
Benefits
Idaho
This SPA modifies the state's delivery system by creating a new tier-based primary care case management fee structure for providers based on the complexity of the patient's health care needs and capabilities of the provider's ability to meet those needs.
Approval Date: August 11, 2016
Effective Date: February 1, 2016
Links:
Topics:
Financing & Reimbursement
Program Administration
Illinois
To clarify the state's non-financial eligibility policies on residency; citizenship; social security numbers; substitution of coverage; non-payment of premiums; continuous eligibility and presumptive eligibility.
Approval Date: August 10, 2016
Effective Date: January 1, 2014
Links:
Topics:
Eligibility
Arizona
Lifts the state's existing enrollment freeze enabling children ages birth through age 19 with income above 133 percent up to and including 200 percent of the federal poverty level (FPL) to enroll in the state's CHIP, known as "KidsCare. ".
Approval Date: July 22, 2016
Effective Date: July 26, 2016
Links:
Topics:
Program Administration
Arizona
Lifts the state's existing enrollment freeze enabling children ages birth through age 19 with income above 133 percent up to and including 200 percent of the federal poverty level (FPL) to enroll in the state's CHIP, known as "KidsCare.".
Approval Date: July 22, 2016
Effective Date: July 26, 2016
Links:
Topics:
Benefits
Eligibility
Program Administration
Wisconsin
Through this SPA, Wisconsin updates its CHIP family premium cost sharing amounts to reflect the conversion to the Modified Adjusted Gross Income equivalent standards. CHIP families are required to pay monthly premiums according to federal poverty levels (FPL).
Approval Date: July 21, 2016
Effective Date: July 1, 2014
Links:
Topics:
Financing & Reimbursement