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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: Updates the TCM DD State Plan language; no longer request the MT Resource Allocation Tool to be updated every 3 years, but only when there are significant changes in needed services, and replaces the Cost Recovery Data Sheets with the electronic state-approved data system to record and calculate the units of services delivered for reimbursement.
Summary: Describes methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the Affordable Care Act applicable for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Summary: Implements Montana Health and Economic Livelihood Partnership Plan and provides ABP Essential Health Benefits, arranged by a Third Party Administrator to individuals in the new adult group with income between 51% -138% of the Federal Poverty Level.
Summary: Implements Medicaid expansion and an alternative benefit plan for individuals in the new adult group with income under 50% of Federal Poverty Level, individuals who are medically frail, and individuals who live in a region, including and Indian reservation.
