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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: Proposes to align the District’s Alternative Benefit Plan (ABP) with the District’s State Plan for Medical Assistance as required under Section 1937 of the Social Security Act.
Summary: Proposes to align Ohio’s Alternative Benefit Plan (ABP) with the Medicaid state plan by adding the single pharmacy benefit manager pre-paid ambulatory health plan to the ABP.
Summary: This amendment is to add coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials to Nevada’s Alternative Benefits Plan (ABP) pages.
Summary: Proposes to update Ohio's Alternative Benefit Plan to implement a Prepaid Inpatient Health Plan as part of the state's OhioRISE initiative for individuals eligible under Section 1902(a)(10)(A)(VIII) of the Social Security Act.
Summary: To align Ohio's Alternative Benefit Plan with the Medicaid State Plan provisions for coverage and payment for evaluation and management services provided by chiropractors.
Summary: Continues use of the budget adjustment factor (BAF) for nonpublic nursing facility payment rates for the 2022-2023 through 2025-2026 rate years.
Summary: Updates the supplemental payment pool amounts for the Rural Family Medicine Residency Development Payment, Family Medicine Residency Program Payment, State University Teaching Hospital Payment, Pediatric Major Teaching Payment and the Urban Safety Net Provider Payment.
