State Plan Flexibilities

Medicaid State Plan: Presumptive Eligibility

States can elect to use Presumptive Eligibility in the Medicaid state plan for expedient enrollment of individuals in coverage.  During an emergency or disaster, the Medicaid agency can act as the qualified entity conducting presumptive eligibility determinations.

CHIP Disaster Relief SPAs

States can submit CHIP State Plan Amendments (SPAs) that allow for temporary adjustments to enrollment and redetermination policies during disaster events. The purpose is to implement provisions for temporary adjustments to enrollment and redetermination policies and cost sharing requirements for children in families living and/or working in Governor or FEMA declared disaster areas. In the event of a natural disaster, the State will notify CMS that it intends to provide temporary adjustments to its enrollment and/or redetermination policies and cost sharing requirements, the effective and duration date of such adjustments, and the applicable Governor or FEMA declared disaster areas.