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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: This SPA will update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019.
Summary: This amendment is to increase an income disregard for an optional eligibility group serving individuals who are 65 years old or older or who have blindness or a disability.
Summary: This amendment assures the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add nursing rate for Personal Care Attendant Services and a flat nursing rate for the initial assessment to the U.S Virgin Islands Medicaid State Plan for both the categorically needy and the medically needy populations.
Summary: This SPA adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in Guam 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
Summary: Effective January 1, 2021, this amendment increases the local poverty level (LPL) such that the MAGI income standards of 138% of the LPL is equivalent to 150 percent of the federal poverty level (FPL).
Summary: This amendment proposes adding coverage and payment methodology of Personal Care Attendant Services (PCAP) in the U.S. Virgin Islands Medicaid program, approved initially on March 25, 2021. At the time of approval, the end of the PHE was not known. Now that the date is known, this SPA has been updated to reflect an effective of May 12, 2023.
