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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: The proposed amendment to Attachments 4.19-A and 4.19-B of your Medicaid State plan submitted under transmittal number 21-0032 titled "Value-Based Purchasing: Suspending Episode-Based Payments Program for Calendar Year 2022.
Summary: Clarifies that providers must wait 100 days after billing a non-responsive child enforcement-related third party in order to be eligible for Medicaid reimbursement.
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: Grants the Ohio Department of Medicaid (ODM) an exception to establishing a Recovery Audit Contractor (RAC) program for the two-year period beginning on January 1, 2022 through December 31, 2023.
Summary: This amendment proposes to increase payment rates for home health and private duty nursing services; allow nurse practitioners, clinical nurse specialists, and physician assistants to order home health services and complete required face-to-face visits; and allow required face-to-face visits to occur through telehealth when clinically appropriate.
