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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.
This amendment proposes to expand Express Lane Eligibility to include Childcare and Parental Services (CAPS), Refugee Cash Assistance, and the Supplemental Nutrition Program for Women, Infants, and Children (WIC) and is being submitted pursuant to Georgia's amended State Fiscal Year 2023 Appropriations Act.
The purpose of this amendment is to comply with Section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023) amended Titles XIX to require that states provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid.
This amendment is to provide full coverage of Medicaid benefits for lawfully present non-citizen pregnant individuals and children under 19, effective January 1, 2024.
This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA establishes a new eligibility category of assistance for parents, caretakers, or guardians with household incomes from 35% to 100% of the FPL who are not currently eligible for Medicaid and adults without dependent children with household incomes up to 100% of the FPL who are not currently eligible for Medicaid. Individuals must be between the ages of 19 and 64. To be determined eligible for Pathways, an individual must meet the required hours and activities threshold of 80 hours per month and meet the income eligibility requirement described above.
Summary: Revised the alternative paper application used for multiple human services program, and the alternative single, streamlined online application.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to provide flexibilities for presumptive eligibility, suspend all copayments, allow telehealth and provide an associated payment methodology, allow brand name products if generic prescription drugs are unavailable from the preferred drug list, and make interim payments to skilled nursing facilities.
Summary: Removes from the state plan the eligibility of former foster care youth under age 26 who were in foster care under the responsibility of another state, and enrolled in Medicaid at the time they turned 18 or aged out of the foster care system in the other state.
Summary: This SPA adds coverage of Autism Spectrum Disorder (ASD) services, and enrollment and reimbursement of Board Certified Behavior Analysts for providing ASD services.
