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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: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to increase the administration fee of the COVID-19 vaccine up to the Medicare rate, without geographic adjustment, in effect at the time of service.
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 provide a 10% increase in payment rates for Adult Mental Health Residential, Substance Use Disorder Residential Programs, and Child and Adolescent Mental Health Residential providers.
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 allow the use of an alternate random moment time study (RMTS) for reimbursement of School Health and Related Services in the event of a state of emergency, such as the COVID-19 public health crisis, that causes any quarter in the RMTS to become statistically invalid.
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 increase payment rates for durable medical equipment, dental services, ambulance services, physical therapy, occupational therapy, speech therapy, intermediate care facilities, and personal care services. The payment increases are effective from July 1, 2020 through December 31, 2020.
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 add pharmacy interns and techs to the providers who can administer vaccines. It also notes that the State will follow current vaccine administration reimbursement methodology for interns and techs, paying $14.15 per vaccine administration.
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 add nurse practitioners, clinical nurse specialists, and physician assistants to order home health as per the CARES Act.
Summary: Effective 1/1/21 this SPA rescinds the temporary expansion of Prior Authorization (PA) for medications that allowed automatic renewal of PA without clinical review or time/quality extensions, which was approved in Disaster Relief SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Summary: Effective 1/1/21 this SPA rescinds the temporary increase in the maximum number of bed hold days available for Nursing Facility (NF) and Intermediate Care Facility (ICF) residents from 30 days per calendar year to 60 days per calendar year, which was approved in OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
Summary: Effective March 18, 2020, the agency rescinds the election at A.1. of section 7.4 (approved on May 8, 2020 in SPA Number MT-20-0024) of the state plan to furnish medical assistance to the optional eligibility group.
Summary: Effective 1/5/21 this State Plan Amendment rescinds the temporary suspension of beneficiary copayments that was approved in DR SPA OH-20-0012 in response to the COVID-19 Public Health Emergency (PHE).
