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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 the eligibility section in the state plan to remove the requirement for 40 qualifying quarters of employment for lawful permanent residents.
Summary: Effective January 01, 2021, this amendment adds substance use disorder (SUD) as an additional eligibility criterion for Health Home Services. For payments made to Health Homes providers for Health Homes participants who newly qualify based on the Health Homes program’s additional condition coverage under this amendment, a medical assistance percentage (FMAP) rate of 90% applies to such payments for 8 quarters from the effective date of this SPA. The FMAP rate for payments made to health homes providers will return to the state's published FMAP rate at the end of the enhanced match period.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to eliminate co-pays for a number of eligibility populations as well as a number of services.
Summary: Effective March 18, 2020, the agency rescinds the election at A.1. of section 7.4 (approved on May 8, 2020 in SPA Number MT-20-0024) of the state plan to furnish medical assistance to the optional eligibility group.
Summary: Effective 1/5/21 this State Plan Amendment rescinds the temporary suspension of beneficiary copayments that was approved in DR SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Summary: This SPA rescinds the temporary Presumptive Eligibility (PE) flexibilities, approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE), which expanded the populations for which PE determinations could be made.
Summary: This amendment modifies the state’s paper and online applications to integrate eligibility for the state’s 1115 family planning demonstration waiver into the state’s Medicaid eligibility application and eligibility determination system. The changes are limited to inclusion of two additional questions to ensure an applicant can apply and be determined eligible for family planning coverage, as provided under Montana’s section 1115 family planning demonstration.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to disregard any excess resources for LTC members as of the month the PHE ends.
Summary: Effective 11/01/2019 this amendment clarifies that substance use disorder (SUD) early intervention services provided by a SUD agency are covered and SUD treatment services may be provided in an institution for mental disease (IMD).
