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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: Reflects Changes in Pharmacy Coverage Required by Section 175 of the Medicare Improvement for Patients and Providers Act of 2008 to Include Barbiturates "Used in the Treatment of Epilepsy, Cancer, or Chronic Mental Health Disorder" and Benzodiazepines in Part D Drug Coverage.
Summary: Describes New Medicaid Eligibility Group (The Adult Group) for Individuals Age 19 through 64, with MAGI Based Household Income at or Below 133% of the Federal Poverty Level.
Summary: This SPA describes the methodology used by thr state for determining the appropriate FMAP rates, including the increased FMAP rates available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Summary: Aligns Coverage of preventive services under the Medicaid State Plan with preventive services in Hawaii's approved ABP and allows for coverage of these services without cost sharing.
