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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 is to update the definition of a visit to include telehealth services in Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), and Tribal Health programs and adds associate marriage and family therapists (AMFTs) and associate clinical social workers (ACSWs) in FQHCs and RHCs.
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 waive signature requirement for pharmacy counseling and to increase reimbursement rates for private duty nursing services.
Summary: Implements the Comprehensive Maternal Care (CMC) program, which is a comprehensive care coordination and service model incorporating supportive care for expectant and postpartum individuals.
Summary: This amendment modifies the eligibility criteria for Ohio’s Comprehensive Primary Care (CPC) program to prevent duplication of payments for CPC services and the new Comprehensive Maternal Care program services. This SPA also re-aligns quality metrics to reflect accurate industry terminology.
Summary: This amendment makes permanent the addition of Intensive Outpatient Therapy, previously approved under disaster relief authority, remove a prior authorization requirement, and removes some face-to-face service delivery requirements.
Summary: This amendment establishes compliance with the mandatory coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials under Section 1905(gg) of the Social Security Act.
Summary: This amendment expands the coverage and payment for the use of Silver Diamine Fluoride (SDF) to all HUSKY Health (Medicaid) children and adults who receive dental services.
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 waive requirements for signatures for dispensing of drugs during PHE.
