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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 specifies the dental benefits provided by Puerto Pico Medicaid Program to children under 21 years and beneficiaries over 21 years old.
Summary: This SPA permits states to require certain Medicaid Beneficiaries to share in the costs of providing medical assistance through premiums and cost sharing.
Summary: This SPA establishes the income standards for the specific MAGI eligibility groups and the mandatory MAGI eligibility groups for Parents and Other Caretakers, Pregnant Women, Infants and Children Under Age 19, and Former Foster Care Children up to Age 26.
Summary: Establishment of Puerto Rico poverty level (PRPL) for non-ABO (aged, blind, and disabled) coverage groups, expansion of income threshold to 133% of PRPL for R(2) groups.
