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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: Effective October 1, 2018, this amendment adds coverage of long term residential substance use disorder services, which would allow an individual to initiate and receive services to treat substance use disorders in a less intense care setting, to the state's alternative benefit plan (ABP).
Summary: This SPA adopts the option to provide Medicaid eligibility without a 5-year waiting period to otherwise eligible individuals who lawfully reside in Guam in accordance with the Compacts of Free Association (COFA) between the Government of the United States and the Governments of the Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau
Summary: Effective January 1, 2021, this amendment increases the local poverty level (LPL) such that the MAGI income standards of 138% of the LPL is equivalent to 150 percent of the federal poverty level (FPL).
Summary: Effective October 1, 2020 through June 30, 2021, this amendment authorizes a ten percent increasing adjustment to reimbursement rates for Class I, Class II, and Class III nursing facilities.