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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: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials and extends the prescription drug supply limit from thirty (30) days to ninety (90) days for the Health Indiana Plan (HIP) Basic group.
Summary: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials for the Healthy Indiana Plan (HIP) Plus group.
Summary: Aligns Michigan’s Alternative Benefit Plan with the changes to prior authorization requirements for non-routine therapy services provided to beneficiaries residing in nursing facilities approved in the traditional Medicaid State Plan under MI-22-0017.
Summary: This Alternative Benefit Plan (ABP) is to amend the State Plan to account for the change in managed care organization for Medicaid Expansion members between ages 21 - 64.
Summary: This amendment updates the Alternative Benefit Plan (ABP) pages to align with the addition of the mandatory benefit that covers routine patient costs associated with participation in qualifying clinical trials approved in SPA 22-0004.
Summary: This amendment updates Alaska’s Alternative Benefit Plan (ABP) to align with Alaska’s Medicaid State Plan with revisions to the preventive services, vision services, and therapy services which includes physical therapy, occupational therapy, and speech-language therapy in accordance with the ten essential health benefits requirements for ABPs.
Summary: This amendment removes the designations for Prepaid Inpatient Health Plan (PIHP) and Prepaid Ambulatory Health Plan (PAHP) from the state's Alternative Benefit Plan (ABP).
Summary: Proposes to align the District’s Alternative Benefit Plan (ABP) with the District’s State Plan for Medical Assistance as required under Section 1937 of the Social Security Act.
