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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: Modifies Idaho's Healthy Connections Primary Care Case Management Program by creating a new tier-based case management fee structure with four distinct payment tiers that vary in amount and increase by tier based upon qualifying criteria.
Summary: Amends the Alternative Benefit Plan to specify that the Prenatal and Postnatal care benefits provided in these respective ABPs does not meet the requirements for Minimal Essential Coverage as designated by the Internal Revenue Services regulations.
Summary: This SPA amends the Medicare-Medicaid Coordinated Plan (MMCP) Alternative Benefit Package (ABP) to reflect the MMCP's expanded geographic availability to forty-two (42) of Idaho's forty-four (44) counties. The coverage exceptions are Lemhi and Franklin Counties.
Summary: This SPA permits states to require certain Medicaid Beneficiaries to share in the costs of providing medical assistance through premiums and cost sharing.
Summary: This SPA transitions the state from the Federally Facilitated Marketplace to a State-Based Marketplace. This SPA also updates the single state agency's delegation of appeals and determinations in accordance with the Affordable Care Act.
Summary: This transmittal describes the single state agency's delegation of appeals and determinations in accordance with the Affordable Care Act and updates the state's organizational structure.
