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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: Updates G2c and G3 templates to eliminate the Healthy Michigan Plan copay tier and modify the cost sharing limitation language to remove the references to the Healthy Michigan Plan.
Summary: This amendment is to increase the total compensated amount on all claim types to $250.00 in accordance with Title 42, Chapter IV, Subchapter C, Part 433 of the Code of Federal Regulations.
Summary: This amendment proposes to implement premiums for working adults who have disabilities as authorized by the Ticket to Work and Work Incentives Improvement Act.
Summary: This amendment provides assurances in Attachment 4.22-B related to third party liability, under the Consolidated Appropriations Act of 2022. In addition, the state is restoring a statement related to long term care insurance, originally approved under SPA 09-001, but was missing from the submission of page 3 under previously-approved SPA 22-0015.
Summary: This amendment complies with the federal requirement that the state implement a tracking system that ensures that cost sharing and premiums of a Medicaid beneficiary will not exceed five percent of the family income.
Summary: This amendment will allow Medicaid to exempt anti-retroviral medications used to treat HIV for the purpose of reducing viral load from Medicaid co-payments. These medications currently require a co-payment of $4 per prescription.
Summary: 1) to supply assurances that it is complying with new third party liability requirements authorized under the Consolidated Appropriations Act, 2022 and 2) to provide clarity on the state’s option to adopt a new flexibility on creating liens for injury settlement proceeds attributable to future medical expenses.
Summary: The purpose of this amendment is to assure that the State is in compliance with Section 202 of the Consolidated Appropriations Act 2022, as requested by the Centers for Medicare & Medicaid Services.
