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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: Clarifies language for existing benefits, specifically as they relate to those under the age of 21. The amendment will align the Alternative Benefits Plan (ABP) with the changes to traditional Medicaid.
Summary: This amendment updates the recipient and provider qualifications for Target Case Management (TCM) for individuals with a behavioral health condition.
Summary: This Medicaid State Plan is updated to attest that Montana complies with all requirements for reporting on the Child and Adult Core Sets and will report annually on the measures in the Child Core Set and the behavioral health measures in the Adult Core Set.
Summary: Assure compliance with annual mandatory Health Home core set reporting for the State of New York. This reporting includes all quality measure data for measures on the Health Home Core Set.
Summary: Technical change to align with New York statute, which allows residents of Adult Care Facilities to receive both Hospice and Assisted Living Program services without having to disenroll from either, was originally approved on February 26, 2025.
