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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 is to provide 12 months continuous eligibility for children under the age of 19 in Medicaid, including children eligible with a Medically Needy spenddown.
This amendment is to temporarily limit otherwise covered benefits for adult beneficiaries for the period June 1, 2023 through September 30, 2023 in response to the territory’s federal funding shortfall.
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 extend the increased eligibility income limit at 180% of the SSI Federal Benefit Rate.
Summary: This SPA provides coverage for COVID-19 vaccines and vaccine administration, testing, and treatment in accordance with section 9811 of the American Rescue Plan (ARP).
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: Effective October 1, 2022, this amendment
adds reimbursement methodology to Attachment 4.19-A of the state plan for off-island inpatient
hospital services.
Summary: Effective October 1, 2022, this amendment adds reimbursement methodology to Attachment 4.19-D of the state plan for off-island nursing facility services.
This SPA waives Northern Mariana from participation in the Medicaid Drug Rebate Program (MDRP) under the authority of 1902(j) of the Social Security Act.
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 authorize a temporary income disregard of $1000 monthly income in excess of 180% of the SSI Federal Benefit Rate (FBR) for individuals to whom a spenddown applies.
Summary: Effective January 1, 2021, this amendment adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in the Commonwealth of the Northern Mariana Islands in accordance with the Compacts of Free Association (COFA) between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau.
