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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 reduces the amount of medical and remedial expenses that may be deducted in the post-eligibility process to zero if they were incurred as the resuh of the imposition of a transfer of asset penalty period.
Summary: This amendment serves to implement Section 19002(a)(10)(A) of the Social Security Act (the Act), including continuous eligibility under Section 1902(e)(12) and presumptive eligibility for children under Section 1920A of the Act . Ohio is a Medicaid expansion state under Title XXI; this is a companion state plan submission to our Title XXI state plan amendment, SCHIP #5.
Summary: This amendment clarifies the reimbursement methodology for Federally Qualified Health Centers (FQHCs) in Attachment 4.19-B; delineates the providers covered under the FQHC benefit under Attachment 3.1-A and 3.1-B; and outlines the State's liability for cost-sharing for full-benefit dual eligibles and Qualified Medicare Beneficiary (QMB) Plus individuals who receive Medicaid-covered services outside the FQHC setting under Supplement 1 to Attachment 4.19-B.
Summary: This amendment revises supplemental payments to children's hospitals for inpatient outliers and supplemental inpatient hospital upper limit payments for children's hospitals.
Summary: The proposed amendment updates five State Plan Amendment pages to reflect the new resource limit for Medicare Savings Plans, as amended by MIPP A section 112. The proposed amendment addresses MIPPA section 115 by exempting Medicare cost sharing from Medicaid estate recovery for six categories of dual eligibles with dates of service on or after January 1, 2010.
Summary: This amedment changes the resource limit for Qualified Medicare Beneficiaries (QMB), Specified LowIncome Medicare Beneficiaries (SLMB) and Qualifying Individuals (QI) to conform to the resource limit for individuals who qualify for the full subsidy Medicare Part D LIS as required by section 112 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
Summary: Enclosed is Ohios state plan amendment TN08-006 that contains new outlier services language proposed for adoption under Attachment 3. I A of Ohios state plan. This amendment also requests removal of existing sections contained under Attachment 4. l 9D, and removal of obsolete sections 5101 :3-3-54.l and 5101 :3-3-54.5 from Attachment 3. lA.
