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.

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New York

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.

Approval Date: February 14, 2017

Effective Date: April 1, 2015

Links:

Approval Package

Topics: Benefits Health Services Initiatives Program Administration

South Dakota

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.

Approval Date: December 15, 2016

Effective Date: July 1, 2016

Links:

Approval Package

Topics: Eligibility Program Administration

Arkansas

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.

Approval Date: December 8, 2016

Effective Date: January 1, 2017

Links:

Approval Package

Topics: Benefits

Nevada

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.

Approval Date: November 23, 2016

Effective Date: October 1, 2016

Links:

Approval Package

Topics: Benefits

Wisconsin

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.

Approval Date: November 22, 2016

Effective Date: January 1, 2014

Links:

Approval Package

Topics: Eligibility

Michigan

This SPA permits Michigan to implement a new health services initiative (HSI) for the enhancement and expansion of its current lead abatement program. As part of this expansion, the state will provide coordinated and targeted lead abatement services to eligible properties in the impacted areas of Flint, Michigan and other areas within the state of Michigan.

Approval Date: November 14, 2016

Effective Date: January 1, 2017

Links:

Approval Package

Topics: Program Administration

New Jersey

This SPA implements four health services initiatives (HSis) to improve the health of children by providing title XXI funding for nurses in non-public schools, assisting families with unpaid medical expenses for children with catastrophic illnesses through the state's current program the Catastrophic Illness in Children Relief Fund, respite care services for children with developmental disabilities, and State poison control centers.

Approval Date: October 31, 2016

Effective Date: July 1, 2015

Links:

Approval Package

Topics: Benefits Health Services Initiatives Program Administration

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:

Approval Package

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:

Approval Package

Topics: Financing & Reimbursement

Tennessee

Cost Sharing Changes.

Approval Date: September 16, 2016

Effective Date: April 1, 2016

Links:

Approval Package

Topics: Cost Sharing

CHIP State Plan Amendments

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Transmittal Number: NY-16-0022-CA

Transmittal Number: SD-16-0006

Transmittal Number: AR-16-0002-CHIP

Transmittal Number: NV-16-0012-A

Transmittal Number: WI-13-0032-MC5

Transmittal Number: MI-16-0017

Transmittal Number: NJ-16-0024

Transmittal Number: GA-16-0022

Transmittal Number: IL-15-00012-0XXI

Transmittal Number: TN-16-0015