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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 update Ohio’s Alternative Benefit Plan by revising the language regarding the interplay between the fee-for-service and managed care delivery systems for the adult expansion group to more accurately reflect current policy.
Summary: To align Ohio’s Alternative Benefit Plan with the Medicaid State Plan by adding language for coverage of inpatient hospital treatment of chemical dependency and intensive home-based treatment, which is a component of the OhioRISE program, under the early and periodic screening, diagnosis, and treatment benefit for individuals under age 21.
Summary: To align Ohio’s Alternative Benefit Plan with the Medicaid State Plan by adding language for the coverage of routine patient costs associated with qualifying clinical trials.
Summary: Proposes to establish coverage and payment for intensive home-based treatment (IHBT), which is a component of the OhioRISE program, under the early and periodic screening, diagnosis, and treatment benefit for individuals under age 21.
Summary: To establish coverage and payment for lactation consulting services, nurse home visiting services, and revise payment rates for group prenatal education as part of Ohio’s Maternal and Infant Support Program.
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 implement one-time supplemental payments to hospitals for COVID-19 disaster relief.
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 disregard certain accumulated resources that are normally subject to the post-eligibility treatment of income (PETI) rules for long term care beneficiaries.
Summary: This amendment extends coverage for inpatient hospital services to include rehab services for chemical dependency to align with Ohio's current payment policy for SUD treatment facilities. In addition, this SPA proposes to delete 3 older sections from the state plan and incorporate the language from those sections into the amended Attachment 3.1-A and 4.19-A pages with no policy changes.
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
