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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 aligns the populations authorized through the State Plan versus 1115 waiver to include pregnant women eligible under 42 CFR 436.116, children eligible under 42 CFR 425.117 and 42 CFR 435.118, and presumptively eligible pregnant women.
Summary: This SPA makes changes to the State Plan to document the State's Collection of Federal Medical Assistance Percentages (FMAP) funds available for expenditures for medical assistance furnished to individuals enrolled in the new adult group created by the Affordable Care Act.
Summary: Extends the nursing facility quality assessment fee enhanced reimbursement provisions through June 30, 2017, makes changes to direct care services and supplies, and makes changes to requirements for reporting when there is a nursing facility change in ownership.
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.
Summary: This SPA incorporates MAGI-Based Eligibility Groups and AFDC Income Standards into Puerto Rico's state plan in accordance with the Affordable Care Act.
