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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 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: Calculation of state supplemental pharmacy rebate amounts in accordance with the National Medical Pooling Initiative (NMPI). This change will allow Nevada to receive additional supplemental rebate amounts and generate savings for the state.
Summary: This amendment is comply with new mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials.
Summary: This amendment adds an assurance of coverage of routine patient services and costs associated with participation in qualifying clinical trials, as required by section 210 of the Consolidated Appropriations Act.
Summary: Renamed an existing EPSDT service to Comprehensive Behavioral Health Treatment, clarifies the amiability of comparable services to individuals not enrolled in public schools, and authorized an Intergovernmental Transfer (IGT) methodology for the state share of the service's reimbursement.
