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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a one-time supplemental payment to community mental health providers for mental health and SUD services; non-institutional DMEPOS providers; and home health agencies for COVID-19 relief.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement one-time supplemental payments to nursing facility (NF), intermediate care facility (ICF), and hospice Medicaid providers for COVID-19 relief.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the reimbursement rate for the administration of in-home COVID-19 vaccinations (HCPCS M0201) for homebound individuals from the Medicare geographically adjusted Ohio rate of $33.36 to $62.02 when billed with an SY modifier.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover prescribed drugs that are not covered outpatient drugs during critical drug shortages.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to temporarily suspend the 5% penalty imposed on nursing facilities (NF) for late, inaccurate, or insufficient resident assessment data used in calculating the case mix score.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to add coverage and payment provisions for the administration of COVID-19 vaccinations and establishes all pharmacy professionals (pharmacists, techs, and interns) as qualified providers of the vaccine.
Summary: This is a time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add the COVID-19 vaccine to the Medicaid State Plan.
Summary: Effective 1/5/21, this SPA rescinds the temporary implementation of the telehealth originating site fee and associated billing code that was approved in OH-20-0012 to help providers set up the necessary infrastructure to implement and expand telehealth services in response to the COVID-19 Public Health Emergency (PHE). The Ohio Department of Medicaid has determined that sufficient time has passed to allow providers to implement needed changes and reallocate funding in order to render additional telehealth services.