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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 allows individuals, with income between 101-133% of FPL, who use to be mandated into the MarketPlace plan to elect enrolling in the Health and Wellness Plan.
Summary: This SPA discontinues disproportionate share hospital payments to out-of-state hospitals and modifies the qualification criteria for children's hospitals to receive DSH payments.
Summary: This SPA increases the monthly income standards for Domiciliary Care to reflect the 1.7% SSI Cost of Living Adjustment increase from the Social Security Administration.
Summary: This SPA incorporates the MAGI-based eligibility process requirements, including the single streamlined application, into Hawaii's approved Medicaid State Plan in accordance with the Affordable Care Act.
Summary: This SPA submission replaces MMDL pages replaces S25: Parents and Other Caretaker Relatives; S28: Pregnant Women; S30: Infants and Children under Age 19; and S33: Mandatory Coverage Former Foster Care children; replacing those sections as originally approved in SPA 13-0026-MM1. This SPA is to adding presumptive eligibility determinations for these eligibility groups.
Summary: Removes barbiturates, benzodiazepines, and agents used to promote smoking cessation from the list of drugs the state Medicaid program may exclude from coverage or otherwise restrict in order to comply with the requirements of Section 2502(a) of the Affordable Care Act.
Summary: To continue the suspension of the annual inflation factor to inpatient hospital and nursing facility rates for the 4th quarter of FFY 2013, FFS 2014 and the 1st, 2nd and 3rd quarters of FFY 2015.
