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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: To adopt the optional Work Incentives eligibility group and incorporate additional disregards in the determinations of financial eligibility for the Ticket to Work-Basic eligibility group.
Summary: This SPA implements a health home for Medicaid beneficiaries with intellectual disabilities and a diagnosis of serious mental illness or autism.
Summary: 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.
Summary: This SPA proposes to amend the language provisions for coverage of selective non-legend outpatient drugs. This SPA also updates additional Pharmacy coverage items on the State Plan pages.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend for one year the telehealth flexibilities for Idaho's three Section 1915(i) programs that were originally approved in Disaster Relief SPAs ID-20-0014, ID-21-0008, and ID-23-0018.
Summary: This SPA proposes to amend the pharmacy page's provision to cover all prescriptions for FDA-approved oral contraceptives for up to a 12-month supply at one time.
