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CHIP State Plan Amendments

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.  Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance. To request a Word version of the CHIP State Plan, please contact your CHIP Project Officer.

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 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.

Results

Displaying 1 - 10 of 972

Alabama

Through this SPA, Alabama reactivates its Reach Out and Read Health Services Initiative (HSI) for an additional three years and modifies it to operate statewide. The state also removes its time-limited Infant and Early Childhood Mental Health Services HSI from the state plan as it expired on September 30, 2023.

Approval Date: September 18, 2025
Effective Date: October 1, 2025
Topics: Benefits Health Services Initiatives

Arizona

Through SPA AZ-25-0007, effective August 23, 2024, the state removes the premium lock out period, in accordance with 42 CFR 457.570(c). Through SPA AZ-25-0009, effective July 1, 2025, the state provides the corresponding technical edits in the CHIP state plan to reflect the removal of the premium lock out period.

Approval Date: September 18, 2025
Effective Date: July 1, 2025

Nebraska

Through this SPA, the state revises the strategic objectives and performance goals in section 9 of the CHIP state plan with the state’s CHIP Annual Report and also removes outdated strategic objectives and performance goals from the state plan that the state no longer includes in the CHIP Annual Report.

Approval Date: September 18, 2025
Effective Date: December 31, 2024

Virginia

Through this amendment, the state makes a number of technical updates to the state's previously approved Poison Control Health Services Initiative, as well as update the program's budget.

Approval Date: September 12, 2025
Effective Date: July 1, 2024

Utah

Through these SPAs, the state permanently eliminates premiums and adds a new managed care vendor. The state updates their CS21 to reflect the removal of CHIP premiums.

Approval Date: September 12, 2025
Effective Date: July 1, 2024

Arizona

Through these SPAs, Arizona removes the state's waiting period in CHIP and describes the state's substitution of coverage monitoring strategy.

Approval Date: September 4, 2025
Effective Date: August 6, 2024

Colorado

Through this SPA, the state amends it's existing Continuing Care Services benefit requires that a demonstrate that a CHP+ member receives continued care with the member’s same health care provider or health care facility under the member’s new MCO plan as if the provider or facility are in network, for up to ninety days.

Approval Date: September 4, 2025
Effective Date: January 1, 2025

South Dakota

Through this SPA, South Dakota adds coverage for pregnancy-related doula services, community health worker services, and peer support services to its CHIP state plan to align these services with Medicaid.

Approval Date: September 4, 2025
Effective Date: January 1, 2025

Kansas

Through this SPA, the state eliminates the CHIP waiting period, consistent with requirements of 42 CFR § 457.805(b).

Approval Date: September 3, 2025
Effective Date: June 1, 2025

Indiana

Through these SPAs, the removes the CHIP waiting period and describes the
substitution of coverage monitoring strategy.

Approval Date: September 3, 2025
Effective Date: April 1, 2025