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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: To align Ohio’s Alternative Benefit Plan with the Medicaid State Plan by adding language for coverage of inpatient hospital treatment of chemical dependency and intensive home-based treatment, which is a component of the OhioRISE program, under the early and periodic screening, diagnosis, and treatment benefit for individuals under age 21.
Summary: To align Ohio’s Alternative Benefit Plan with the Medicaid State Plan by adding language for the coverage of routine patient costs associated with qualifying clinical trials.
Summary: To provide authority to the state to cover and to reimburse for doula services for eligible Michigan Medicaid beneficiaries under the Alternative Benefit Plan.
Summary: This amendment establishes compliance with mandatory Medicaid coverage and reimbursement of routine patient costs furnished in connection with participation in qualifying clinical trials in the Alternative Benefit Plan.
Summary: This Alternative Benefit Plan amendment is to comply to the Consolidated Appropriations Act for 2021, which amended the Medicaid statute to add as a mandatory benefit, in both state plan and benchmark and benchmark equivalent coverage, for “routine patient costs for items and services furnished in connection with a qualifying clinical trial.”
Summary: This SPA amends the Alternative Benefit Plan (ABP) to restore comprehensive adult optional dental benefits, subject to medical necessity and utilization controls, for eligible adults. This SPA aligns the ABP with the restoration of adult optional dental benefits in the State Plan under the approval of SPA 17-0027.
