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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 amendment is to update State Plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment provides the required assurances regarding the reporting of mandatory Core Set measures by Health Home providers in accordance with 42 CFR §§ 437.10 and 437.15. This amendment also updates state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment provides the required assurances regarding the reporting of mandatory Core Set measures by Health Home providers. In accordance with 42 CFR §§ 437.10 and 437.15.
Summary: This amendment streamlines the process of integrating the state's compliance with continuous eligibility (CE) authority into the Medicaid and Chip Program (MACPro) Portal.
Summary: The purpose of this amendment is to comply with Section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023) amended Titles XIX to require that states provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid.
Summary: This amendment is to provide full coverage of Medicaid benefits for lawfully present non-citizen pregnant individuals and children under 19, effective January 1, 2024.
Summary: This amendment is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance-Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This amendment expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast
and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
