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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.
To provide 12 months of continuous eligibility (CE) for children under the age of 19 to comply with Section 5112 of the Consolidated Appropriations Act, 2023.
This amendment streamlines the process of integrating the state's compliance with continuous eligibility (CE) authority into the Medicaid and Chip Program (MACPro) Portal.
Summary: This amendment expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast
and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
Summary: 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: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily implement a disregard of income that would have otherwise been part of an individual’s liability for institutional or home and community-based waiver services based on application of the post-eligibility treatment-of income (PETI) rules, but which became countable resources on or after March 18, 2020.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the authorities regarding Presumptive Eligibility (PE) authorized in sections B.1, B.2, and B.3 of DR SPA KS-20-0012. This will revert the State back to the practice of one PE period for parents or caretaker relatives, children, former foster care children; one PE period per pregnancy per a 12-month period; remove the state as a qualified entity; and eliminate the ability for qualified providers to determine eligibility for Parents/Caretaker Relatives and Former Foster Care Children.