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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: This amendment clarifies the reimbursement methodology for Intermediate Care Facilities (ICFs) also applies to facilities with more than 16 beds, updates the annual reporting criteria, clarifies the frequency by which per diem rates are set and adds a provisional per diem reimbursement methodology for new facilities.
Summary: To update state plan language related to the coordination of benefits for hospital services and remove obsolete rules-based language that is no longer pertinent.
Summary: The SPA amends the preventative services benefit to allow dentists to also order community health worker services, clarifies what services are considered non-covered, and updates the community health worker ce1iification criteria.
Summary: To temporarily extend Medicaid coverage of services to pregnant women for 12 months postpartum in accordance with section 9812 of the American Rescue Plan.
Summary: Approves revisions to the Ohio Department of Medicaid Supplemental Rebate Agreement, including adding the definition of Managed Care Entities.
Summary: The SPA implements community mental health center (CMHC) and substance use disorder (SUD) agency rate increases appropriated by the state legislature during the 2022 legislative session.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the election to add nursing facility health care isolation centers (HCICs) and the accompanying payment provisions that were temporarily implemented in response to the COVID-19 PHE.
Summary: This amendment extends the supplemental payments for qualifying, private hospitals and nursing facilities for an additional state fiscal year.
