Medicaid & CHIP PDF Repository

Medicaid/CHIP State Plan Amendments for 2014

In preparation for implementation of the Medicaid and CHIP changes related to the Affordable Care Act, states will be submitting a number of State Plan Amendments (SPAs). In particular, SPAs are needed to implement the MAGI-based eligibility levels and income counting methodologies for Medicaid and CHIP, to elect a state’s single streamlined application format, and to indicate the design of their Medicaid alternative benefit plans (ABPs) for the new adult group in 2014. The vehicle for submitting these 2014-related SPAs will be a set of “fillable” PDF documents that will be submitted through the web-based repository known as the Medicaid Model Data Lab (MMDL). States will need to access and submit these PDFs through the MMDL system, but the list of SPA pages is available in the table below.

Instructions are available for accessing the Medicaid Model Data Lab (MMDL) and Waiver Management System (WMS) user ID:

Medicaid MAGI Eligibility & Benefits State Plan Amendments

See the 2014 Medicaid MAGI Eligibility & Benefits State Plan Amendments document for descriptions.

SPA Action 1

SPA Group: MAGI-Based Eligibility Groups

Mandatory PDF Number and Description

  • S25 parents and other caretakers
  • S28 pregnant women*
  • S30 infants and children under age 19*
  • S32 individuals below 133% of the FPL
  • S33 former foster care children up to age 26

Optional PDF Number and Description

  • S50 individuals above 133% of the FPL
  • S51 optional parents and caretakers
  • S52 reasonable classifications of individuals
  • S53 non IV-E adoption assistance
  • S54 optional targeted low income children
  • S55 tuberculosis
  • S57 foster care adolescents - Chafee
  • S59 family planning
  • S14 AFDC income standard

SPA Action 2

SPA Group: Eligibility Process

PDF Number and Description

  • S94 single streamlined application or alternative, renewals, coordination for enrollment and eligibility (agreements with exchanges)

SPA Action 3

SPA Group: MAGI Income Methodology

PDF Number and Description

  • S10 designates the income options the state is electing in 2014 (e.g. how pregnant women are counted, reasonably predictable changes in income, cash support, how full-time students are counted)

SPA Action 4

SPA Group: Single State Agency

PDF Number and Description

  • A1, A2, A3 addresses single state agencies delegation of appeals and determinations

SPA Action 5

SPA Group: Residency

PDF Number and Description

  • S88 state affirms residency regulations, addresses interstate agreements and temporary absence 

SPA Action 6

SPA Group: Citzenship & Immigration Status

PDF Number and Description

  • S89 state affirms citizenship regulations, specifies reasonable opportunity options, and specifies policy options related to immigrant eligibility

SPA Action 7

SPA Group: Hospital Presumptive Eligibility

PDF Number and Description

  • S21 state specifies options for presumptive eligibility conducted by hospitals