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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: Updates the inpatient hospital reimbursement methodology for Indirect Graduate Medical Education (IME) payments to specify calculation of annual IME payments based on the most recently filed and available cost reports. The amendment also adds inpatient state directed payment arrangements allowed under 42 CFR 438.6(c) approved pre-prints and made through managed care plans (“Inpatient DRG Enhanced Rate”) to the calculation of annual IME payments.
Summary: To temporarily extend Medicaid coverage of services to pregnant women for 12 months postpartum in accordance with section 9812 of the American Rescue Plan.
Summary: Approves revisions to the Ohio Department of Medicaid Supplemental Rebate Agreement, including adding the definition of Managed Care Entities.
Summary: WA-22-0019 is submitted to comply with the American Rescue Plan (ARP) requirements for states to ensure access and coverage to COVID-19 Vaccine, Treatment, and, Testing.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the election to add nursing facility health care isolation centers (HCICs) and the accompanying payment provisions that were temporarily implemented in response to the COVID-19 PHE.
Summary: Updates the statutory reference authorizing a hospital opting out of the inpatient “Full Cost” Payment Program if the hospital meets the criteria for the inpatient rate enhancement.
Summary: updates the fee schedule effective dates for several Medicaid programs and se1vices. This is a regular, budget neutral update to keep rates and billing codes in alignment with the coding and coverage changes from the Centers for Medicare and Medicaid Se1vices (CMS), the state, and other sources. These changes are routine and do not reflect significant changes to policy or payment.