CHIP State Plan Amendments
As part of a strategy to increase transparency, enhance efficiency, and reduce burden for states in the review and approval process of state plan amendments (SPA), CMS committed to providing a tool kit to assist states in the development of complete submissions, and facilitate quicker adjudication of SPA submissions. This page provides a collection of existing CHIP SPA templates for completing the templates that will be enhanced as more tools are developed.
States apply for changes to their CHIP state plan using the CHIP State Plan Template (DOCX, 206.04 KB). Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
CHIP State Program Information
In order to be eligible for payment under this statute, each State must submit a Title XXI plan for approval by the Secretary that details how the State intends to use the funds and fulfill other requirements under the law and regulations at 42 CFR Part 457.
States can design their CHIP program in one of three ways:
1. Separate CHIP: a program under which a state receives federal funding to provide child health assistance to uninsured, low-income children that meets the requirements of section 2103 of the Social Security Act.
2. Medicaid expansion CHIP: a program under which a state receives federal funding to expand Medicaid eligibility to optional targeted low-income children that meets the requirements of section 2103 of the Social Security Act.
3. Both Separate CHIP and Medicaid expansion: a program under which a state receives federal funding to implement both a Medicaid expansion and a separate CHIP.
CHIP Program by State (PDF, 350.84 KB) has more information about how each state has implemented its program.
To see CHIP information by state, select a state on the map to find details about enrollment and dental providers. Click here for the CHIP Annual Reports.
CHIPRA creates a broad quality mandate for children's health care and authorizes health care quality initiatives for both the Children's Health Insurance Program (CHIP) and Medicaid programs. Persons with disabilities having problems accessing the PDF files may call 410-786-0429 for assistance.
Results
Transmittal Number: CA-24-0046
Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023). In California, this provision applies to the targeted low-income children and from-conception-to-end-of-pregnancy (FCEP) populations.
- Eligibility
Transmittal Number: TN-24-0023
Through this SPA, the state provides 12 months of continuous eligibility (CE) coverage to individuals enrolled in its separate CHIP, pursuant to section 5112 of the Consolidated Appropriations Act, 2023 (CAA, 2023). In Tennessee, this provision applies to the targeted low-income children and the from-conception-to-end-of-pregnancy (FCEP) populations.
- Eligibility
Transmittal Number: MD-24-0001-CHIP
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing.
- Vorteile
Transmittal Number: IN-24-0003
Through this SPA, the state documents the state's compliance with the longstanding requirement to cover children's vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Vorteile
Transmittal Number: WA-24-1000
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Vorteile
Transmittal Number: NJ-24-0034
Through this SPA, the state has demonstrated compliance with the Inflation Reduction Act (IRA) section 11405(b)(1) to cover adult vaccines, without cost sharing. Additionally, this SPA documents the state’s compliance with the longstanding requirement to cover children’s vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing.
- Vorteile
Transmittal Number: AR-24-0007
This SPA updates the cost sharing and reimbursement for continuous glucose monitors (CGMs) and diabetic supplies and removes annual dollar limits for these services. Additionally, the SPA aligns cost sharing for CGMs and diabetic supplies provided by pharmacies and DME providers to be the same $5 copay, regardless of the provider type furnishing the services.
- Vorteile
Transmittal Number: KS-24-0004
Through this SPA, the state documents the state's compliance with the longstanding requirement to cover children's vaccines under current regulations at 42 CFR §§ 457.410(b)(2) and 457.520(b)(4), which requires states to cover age-appropriate vaccines in accordance with the recommendations of the ACIP without cost sharing. Additionally, the state makes technical updates to the CHIP state plan.
- Vorteile
Transmittal Number: UT-23-0029
Through this SPA, the state updates the CHIP dental benchmark plan and benefits.
- Vorteile
Transmittal Number: NY-24-0037-CHIP
Through this SPA, the state adds residential treatment services to the state’s behavioral health benefits.
- Vorteile