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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: Enclosed is Ohios state plan amendment TN08-006 that contains new outlier services language proposed for adoption under Attachment 3. I A of Ohios state plan. This amendment also requests removal of existing sections contained under Attachment 4. l 9D, and removal of obsolete sections 5101 :3-3-54.l and 5101 :3-3-54.5 from Attachment 3. lA.
Summary: This SPA modifies the methods and standards for making Medical Assistance payments to nursing facilities (NFs). Specifically, this SPA increases the net reduction factor in Maryland's rates for certain cost centers (Administrative/Routine, Other Patient Care, and Capital) from the current 4.816% to the proposed 8.681% effective August 1, 2009.
Summary: This amendment defines units of mental health rehabilitative services that Medicaid eligible children can receive. Establishes a fee schedule reimbursement methodology for each individual service.
Summary: Revises the Medicare Savings Program in response to the Medicare Improvements of Patients and Providers Act of 2008 in order to incorporate provisions regarding the submittal of low income subsidy data and to disregard certain assets in the eligibility determination process.
Summary: Updates the vision services section of the fee schedule for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies in the state plan.
Summary: This amendment elects the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 option in Section 214 to lift the five year bar ban on eligibility and provide full Medicaid coverage to all otherwise eligible alien children or pregnant women lawfully residing in the District of Columbia.
