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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the following parts of Section 7.4 of the existing state plan: 1) Election A.1 to furnish medical assistance to uninsured group under 1902(a)(10)(A)(ii)(XXIII) and 1902(ss) of the Act; and 2) Election of B.1. to allow hospitals to make presumptive eligibility determinations for uninsured individuals described at section 1902(a)(10)(A)(ii)(XXIII) of the Social Security Act.
Summary: Implements California Assembly Bill (AB) 1088 (Chapter 450, 2019) for a new income disregard that would allow an aged, blind, or disabled individual to remain eligible for the Aged, Blind, and Disabled Federal Poverty Level (ABD FPL) program once the state pays the individual’s Medicare Part B premiums. The income disregard would disregard from an individual’s income the amount of such individual’s incurred Medicare Part B premium. The purpose of the legislation is to avoid any adverse impacts on beneficiaries.
Summary: apply a census income disregard for Medicaid eligibility groups subject to non-MAGI income methodology, and to migrate eligibility requirements already approved for those non-MAGI eligibility groups into the state plan. Additionally, this state plan amendment revises the MAGI
Summary: Designates entities that furnish health care items and services covered under the state plan as qualified entities to make presumptive eligibility determinations for the family planning group
Summary: increases the maximum age to 21 for individuals who are involved in or at serious risk of involvement with the juvenile justice system; and align targeted case management services with current evidence-based practices
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 suspend copayments for all adult enrollees for all services, and make specific temporary changes to the home health benefit (supplies and equipment) and requirements for referrals from primary care.
