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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: This amendment allows Alternative Benefit Plan (ABP) coverage of a primary care case management program (PCCM) for pregnant individuals and of adult vaccinations and their administration without cost sharing in order to align with the South Dakota State Plan.
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 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 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.
