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A Medicaid and CHIP state plan is an agreement between a state and the Federal government describing how that state administers its Medicaid and CHIP programs. It gives an assurance that a state will abide by Federal rules and may claim Federal matching funds for its program activities. The state plan sets out groups of individuals to be covered, services to be provided, methodologies for providers to be reimbursed and the administrative activities that are underway in the state.
When a state is planning to make a change to its program policies or operational approach, states send state plan amendments (SPAs) to the Centers for Medicare & Medicaid Services (CMS) for review and approval. States also submit SPAs to request permissible program changes, make corrections, or update their Medicaid or CHIP state plan with new information.
Persons with disabilities having problems accessing the SPA PDF files may call 410-786-0429 for assistance.
Summary: Revising the Community First Choice (K-Plan) option which increases the local case management benefit limit on assistive technology, implements an enhanced Foster Care model which would allow for some children with intellectual and developmental disabilities to be diverted from children's residential placement to less costly and restrictive placements, adds Support Technology where advanced supervision is necessary.
Summary: Clarifying the maximum amount paid for Medicare Part B coinsurance and deductibles for services provided by the Indian Health Services and tribal providers operating under 638 agreements.
Summary: Expands Health Homes into 8 additional counties with 7 providers. Will pilot a high fidelity wraparound model with 2 providers for children/adolescents. One provider will be first Tribal Health Home.
Summary: This amendment implements policy that health care facilities operated by Indian Health Service/Tribally-Operated 638 Health Programs/Urban Indian Health Programs (ITU) providers are designated as Federally Qualified Health Centers (FQHC).
Summary: This amendment clarified and simplified the rules for when the Indian Health Service (IHS) encounter rate is paid to IHS and triba facilities.
Summary: This amendment gives the Blackfeet Tribe of the Blackfeet Reservation, and the Gros Ventre and Assiniboine Tribes of the Ft. Belknap Reservation, authority to determine Medicaid eligibility. A2 has been amended to add this authority.
Summary: The Tribal Leadership Advisory Council was established through an internal Wyoming Department of Health policy to seek advice on a regular, ongoing basis from the federally recognized Wyoming Tribes and Indian Health Services on matters related to Medicaid and/ or Kid Care CHIP. The wording for this policy was added to the Tribal Consultation SPA.
