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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 SPA update Third Party Liability (TPL) requirements as authorized under the Bipartisan Budget Act (BBA) of 2018 (Pub. L. 115- 123) and the Medicaid Services Investment and Accountability Act (MSIAA) of 2019 (Pub. L. 116-16).
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 proposes temporarily income disregard to allow Puerto Rico Medicaid Program to temperately increase the effective monthly income standard for the Optional Categorically Needy ABD Group and all Medically Needy Groups.
Summary: To update policies regarding how Medicaid applications may be submitted, the frequency and methods used for renewal of eligibility, requirements when determining ineligible assistance with application and renewal notice requirements and the use of authorized representatives.
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 authorize pharmacies, pharmacists, pharmacy interns, and pharmacy techs to administer the COVID vaccination under the preventive services benefit. The SPA also updates the reimbursement methodology for vaccine administration.
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
