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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: The state proposed to: transition its separate NC Health Choice Children's Health Insurance Program to the NC Medicaid Program; adopt a new Medicaid eligibility group for certain children under age 19; and align the income standard for all children under age 19 at 211 percent of the federal poverty level.
Summary: This amendment changes to Hospital Presumptive Eligibility (HPE) to include the adult group in the eligibility groups for which hospitals may conduct HPE determinations.
Summary: This amendment expands PE to include the Parents and other Caretaker Relatives, Former Foster Care and Breast
and Cervical Cancer groups, in addition to Children and Pregnant Women, and to allow the state-designated Qualified Entities to complete PE determinations for all groups covered in PE.
Summary: To adopt the optional Work Incentives eligibility group and incorporate additional disregards in the determinations of financial eligibility for the Ticket to Work-Basic eligibility group.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of premiums for the Medicaid Buy-In for Workers with Disabilities (MBIWD) effective 5/12/23 through 7/31/23. This provision was approved in disaster relief SPA OH-22-0013 effective 7/1/21.
Summary: To provide authority for access to family planning for Michiganders who do not qualify under the income eligibility for Healthy Michigan or traditional Medicaid but have incomes below 200 percent of the federal poverty level (195 percent of the federal poverty level with a 5 percent income disregard).
Summary: This state plan amendment allows the state to disregard, under the authority of section 1902(r)(2) of the Social Security Act, all countable resources for all eligibility groups covered under the state plan to which a resource standard applies.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to extend Premiums and Cost-sharing provisions.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the increased eligibility income limit at 180% of the SSI Federal Benefit Rate.
