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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 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 disregards state tax refunds, rebates, and credits, and certain teacher stipends, in determining eligibility for certain non-MAGI eligibility groups.
Summary: This amendment is to assure HHSC compliance with the mandatory reporting of the CMS Child Core Set and the behavioral health measures of the Adult Core Set as per Sections 1139A(a)(4)(B) and 1139B(b)(3)(B) of the Social Security Act respectively, beginning in 2024, and annually reporting in subsequent years, on all measures on the Child Core Set and the behavioral health measures in the Adult Core Set.
Summary: This SPA specifically, the Medicare economic index will be used as an annual adjustment to payment rates. Additionally, the state is replacing the “Partner Portal”, with a population health management tool, approved by the Minnesota Department of Human Services, to identify past and current treatment or services and identify potential gaps in care.
Summary: This plan in which the state disregards, under the authority of section 1902(r)(2) of the Social Security Act, all countable resources in determining eligibility for the Work Incentives eligibility group.
Summary: This Amendment which amended titles XIX and XXI of the Social Security Act (the Act) to require that states provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid effective January 1, 2024.
Summary: This amendment is to provide children under age 19 with 12 months of continuous eligibility in Medicaid, in accordance with Section 1902(e)(12) of the Social Security Act, as amended by Section 5112 of the Consolidated Appropriations Act, 2023. Children under age 19 will remain continuously eligible for the full 12-month certification period, regardless of changes in circumstances with certain exceptions.
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.
