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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 define the Alternative Benefit Plan (ABP) that will be used to implement certain requirements for the new North Carolina Medicaid Expansion eligibility group as required by SL 2023-7. The Act allows for the inclusion of Medicaid eligibility to individuals aged 19‐64 with incomes at or below 133 percent of the federal poverty level who are not enrolled in or eligible for Medicare, consistent with the new adult group eligibility criteria as defined by the Affordable Care Act.
Summary: This amendment updates the State's Alternative Benefit Plan (ABP) to add managed care organizations (MCO) and prepaid ambulatory health plans (P AHP) for expansion adults.
Summary: This amendment aligns the Alternative Benefit Plan (ABP) with the Medicaid state plan by adding Diabetes Prevention Program (DPP) services for adults ages 18 years and older who meet certain federal Centers for Disease Control and Prevention (CDC) Diabetes Prevention Recognition Program (DPRP) eligibility criteria.
Summary: Makes administrative corrections to Ohio's Alternative Benefit Plan (ABP), specifically ABP 5, to better align it with the Medicaid State Plan.
Summary: This amendment is to update the Alternative Benefit Plan (ABP) to expand coverage for naturopath services and behavioral health clinician services.
