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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 update Ohio’s Alternative Benefit Plan by revising the language regarding the interplay between the fee-for-service and managed care delivery systems for the adult expansion group to more accurately reflect current policy.
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: increases the percentage used to calculate rates for Certified Registered Nurse Anesthetists (CRNA) Services to 100% of North Carolinas’ Medicaid Physician Fee Schedule.
Summary: allows increase Medicaid Direct rates from the pre-COVID rate level for Private Duty Nursing service providers, enrolled in the Medicaid or NC Health Choice program. The new rate will be $11.25 per 15-minute unit.
