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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 updates the State Plan section on third party liability to reflect recent internal changes to third party liability claims processing, including diagnosis & trauma code edits, availability of other insurance coverage, determination of correct billing and other related changes.
Summary: Conforming the existing Virginia Medicaid Works ABP to the requirements of the Affordable Care Act by adding to the package Essential Health Benefits that were not previously provided.
Summary: This SPA proposes to disregard all resources for individuals otherwise eligible under section § 1902( a)( 1 O)(A)(ii)(V) who meet the definition of the group described under the reasonable classification of the following individuals: Individuals under the age of 18, or 19 if the individual is anticipated to graduate from high school by his or her 19th birthday.
Summary: This SPA proposes to amend Eligibility Groups - Mandatory Coverage Former Foster Care Children S33 to cover children who were in foster care and on Medicaid in any State at the time they turned 18, or aged out of the foster care system.
Summary: This SPA increases the maximum allowable gross annual earnings to $75,000 for participants in the Medicaid Buy-in-(MBI) program, Medicaid Works.
