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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: changes to Hospital Presumptive Eligibility (HPE), modifications to Presumptive Eligibility (PE) for Pregnant Women, the Eligibility Process Reviewable Unit, and the state’s election to end the option to provide Presumptive Eligibility to children under age 1.
Summary: Updating the relationship with the federally facilitated marketplace to become an assessment state amending the delegation of certain functions to the FFM and the HHS appeals entity.
Summary: This SPA proposes to bring Tennessee into compliance with the pharmacy reimbursement requirements in the Covered Outpatient Drug final rule with comment period (COD final rule) (CMS-2345-FC) (81 FR 5170) published on February 1, 2016.
Summary: This State Plan Amendment (SPA) describes the single state agency and other entities responsible for administering or implementing the Medicaid state plan.
