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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 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: 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: 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.
