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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: To memorialize the new income standards for its optional state supplement program, beneficiaries of which are eligible for Medicaid under the state's plan.
Summary: This amendment revises the Medicaid State Plan to ensure that laws are in effect barring third-party payers from refusing payment for an item or service solely because it did not receive prior authorization under the third-party payer's rules.
Summary: This plan proposes to establish an Alternative Payment Methodology (APM) for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Summary: Revises the Medicaid State Plan to comply with a CMS directive to remove non-emergency medical transportation services from the list of services covered under a Medicaid waiver.
Summary: To expand Applied Behavior Analysis services provided by New York State Licensed Behavior Analysts to all Medicaid eligible individuals, regardless of age, as the current State Plan limits Applied Behavior Analysis services to individuals under 21 years of age.
Summary: This SPA amends Attachment 3 .1-A to reflect updates to the "Ohio Department of Medicaid Supplemental Rebate Agreement" template. This agreement is between pharmaceutical manufacturers and the state, and governs supplemental rebates for medications dispensed to Medicaid recipients.
Summary: This amendment proposes to revise the State Plan to assist safety net hospitals by providing a temporary rate adjustment under the closure, merger, consolidation, acquisition, or restructuring of a health care provider.
