As part of a strategy to increase transparency, enhance efficiency, and reduce burden for states in the review and approval process of state plan amendments (SPA), CMS committed to providing a tool kit to assist states in the development of complete submissions, and facilitate quicker adjudication of SPA submissions. This page provides a collection of existing CHIP SPA templates for completing the templates that will be enhanced as more tools are developed.
States apply for changes to their CHIP state plan using the CHIP State Plan Template (DOCX, 206.04 KB). Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
CHIP State Program Information
In order to be eligible for payment under this statute, each State must submit a Title XXI plan for approval by the Secretary that details how the State intends to use the funds and fulfill other requirements under the law and regulations at 42 CFR Part 457.
States can design their CHIP program in one of three ways:
1. Separate CHIP: a program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of section 2103 of the Social Security Act.
2. Medicaid expansion CHIP: a program under which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act.
3. Both Separate CHIP and Medicaid expansion: a program under which a state receives federal funding to implement both a Medicaid expansion and a separate CHIP.
CHIP Program by State (PDF, 350.84 KB) has more information about how each state has implemented its program.
To see CHIP information by state, select a state on the map to find details about enrollment and dental providers. Click here for the CHIP Annual Reports.
CHIPRA creates a broad quality mandate for children's health care and authorizes health care quality initiatives for both the Children's Health Insurance Program (CHIP) and Medicaid programs. Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
Results
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Transmittal Number: CO-20-0032
This SPA demonstrates the state’s compliance with section 5022 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
- Benefits
Transmittal Number: NC-23-0008 and NC-23-0010
Through these SPAs, the state transitions all children from the state’s separate CHIP to a Medicaid expansion CHIP.
- Benefits
Transmittal Number: MD-23-0002-0003-0004-CHIP
Collectively, these SPAs create a separate CHIP for the from-to-conception-to-end-of-pregnancy population (FCEP, otherwise known as the "unborn" option)
Collectively, with household incomes up to 259 percent of the federal poverty level (FPL), for birth parents that are not otherwise eligible for Medicaid or CHIP. Specifically, MD-23-0003-CHIP and MD-23-0004 establishes financial eligibility and residency requirements respectively for the new separate CHIP FCEP population. In addition, MD-23-0002-CHIP creates a new Health Services Initiative (HSI) program to cover postpartum services to birth parents from the same population through the end of the month in which the 120th postpartum day occurs.
- Benefits
Transmittal Number: OR-23-0137
This SPA updates the state's performance goals and strategic objectives to align with their CHIP annual report.
- Program Administration
Transmittal Number: DE-23-0001-DRAL
This letter extends Delaware's approved Evergreen Disaster Relief State Plan Amendment to include the following flexibilities: state will continue to provide continuous eligibility to CHIP enrollees, waive all premiums for CHIP enrollees, and not disenroll beneficiaries for failure to pay premiums. These flexibilities are effective through June 30, 2024.
- Cost Sharing
- Disaster Relief
Transmittal Number: IA-23-0001-DRAL
This letter reactivates Iowa's approved Evergreen Disaster Relief State Plan Amendment. The state will be waiving the collection of premiums for all CHIP beneficiaries through December 31, 2023. The state will then resume the standard premium and cost sharing policies for individuals who have completed a full renewal in the last 12 months. The state will resume the collection of premiums on a rolling basis as renewals are conducted through the state's COVID-19 PHE unwinding period, scheduled to end June 1, 2024.
- Cost Sharing
- Disaster Relief
Transmittal Number: MD-23-0001-LEAD
Through SPA MD-23-0001-LEAD, the state updates its two existing CHIP Health Services Initiative (HSI) programs; Healthy Homes for Healthy Kids and Childhood Lead Positioning & Asthma Prevention and Environmental Case Management.
- Benefits
- Health Services Initiatives
Transmittal Number: WV-23-0001-DRAL
This letter reactivates West Virginia's approved Evergreen Disaster Relief State Plan Amendment to include the following flexibilities: waiving the collection of premiums (through 3/1/24) and waiving copayments for services related to COVID-19 (through 9/30/24).
- Cost Sharing
- Disaster Relief
Transmittal Number: PA-23-0001-DRAL
This letter reactivates Pennsylvania's approved Evergreen Disaster Relief State Plan Amendment to include the following flexibilities: waiving the collection of premiums for all CHIP beneficiaries through July 31, 2023. The state will resume the standard premium and cost sharing policies for individuals who have completed a full renewal in the last 12 months. The state will resume the collection of premiums on a rolling basis as renewals are conducted through the state’s COVID-19 PHE unwinding period, scheduled to end February 29, 2024.
- Cost Sharing
- Disaster Relief
Transmittal Number: IN-20-0002-CHIP
This SPA demonstrates the state’s compliance with section 5022 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act.
- Benefits