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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: Implements a resource disregard of earnings accumulated in a separate account during an individual's enrollment in a working disability eligibility group when determining the individual's subsequent eligibility for other eligibility groups covered under Washington’s state plan
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 following parts of Section 7.4 of the existing state plan: 1) Election A.1 to furnish medical assistance to uninsured group under 1902(a)(10)(A)(ii)(XXIII) and 1902(ss) of the Act; and 2) Election of B.1. to allow hospitals to make presumptive eligibility determinations for uninsured individuals described at section 1902(a)(10)(A)(ii)(XXIII) of the Social Security Act.
Summary: Adopts the eligibility group described in section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act (the “Work Incentives” eligibility group).
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow cover the new optional group for COVID testing; apply less strict resource and income methods when determining eligibility for certain individuals; consider individuals evacuated from the state due to the emergency to continue to be residents; provide medical coverage to non-residents who are quarantined in the state due to COVID-19; allow hospitals to make presumptive eligibility decisions for certain individuals; suspend enrollment fees and premiums for all individuals; expand telehealth; add certain benefits and increase some payment rates related to the COVID-19 national emergency.
Summary: This SPA specifies options for presumptive eligibility conducted by hospitals into the Medicaid State Plan in accordance with the Affordable Care Act.
Summary: It accomplishes several substantive revisions including changing the program name to "Apple Health;" adding a "low birth weight baby case payment;" making enrollmentmandatory; expanding the eligibility groups to include pregnant women (mandatory), the new adult expansion group (mandatory), and SSI/foster kids (voluntary); and adding a new description of the MCO assignment process.