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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: Implements direct enrollment into managed care for all mandatory managed care eligible Medicaid recipients and establishes children under 19 in foster care or other in-home placement as a voluntary population in managed care versus an excluded population.
Summary: Amends the provisions governing Medicaid eligibility in order to return to a determination state and accept Medicaid eligibility determinations made by the Federally Facilitated Marketplace.
Summary: Individuals in the New Hampshire Health Protection Program Premium Assistance Program will get coverage from qualified health plans rather than from the ABP offered through Medicaid, except for medically frail and those in the Health Insurance Premium Program.
Summary: Establishes provisions to use the Supplemental Nutritional Assistance Program (SNAP) option for the streamlined enrollment of SNAP recipients who meet the eligibility requirements for the new adult group under Medicaid expansion as authorized under the provisions of the Affordable Care Act.
Summary: Children with SED will qualify for health home services whereas SED will be defined to include serious emotional disturbance, co-occurring developmental disability and mental illness, co-occurring mental health and substance abuse, or developmental Disability eligible (per NJ Statute 10:196) with symptomology of SED.
Summary: Non-Financial Eligibility-State Residency for Title IV-E Foster Care children. Lays out the residency authority for enrolling new and maintaining existing Title IV-E Foster Care children.