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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 ensure that the agency's cost-sharing authority reflects co-payments that are currently in practice. This request also seeks to remove cost sharing for vaccine administration per the Inflation Reduction Act provision prohibiting cost sharing for Advisory Committee on Immunization Practices (ACIP) recommended vaccines for adults.
Summary: This amendment clarifies state plan language related to the coverage of ambulatory surgical center services. This SPA is for clarification purposes and does not propose any policy changes.
Summary: This SPA provides Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: Proposes a resource disregard for individuals who received refunds of premiums paid while enrolled in Ohio's Ticket to Work Basic and Medically Improved eligibility groups.
Summary: This SPA expanded eligibility in the former foster care children (FFCC) eligibility group consistent with the changes mandated by Section 1002 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (Support) Act.
Summary: Clarifies state plan language related to the coverage of physician services and eyeglasses. This SPA is for clarification purposes and does not propose any policy changes.
Summary: This amendment modifies the eligibility criteria for Ohio’s Comprehensive Primary Care (CPC) program to prevent duplication of payments for CPC services and the new Comprehensive Maternal Care program services. This SPA also re-aligns quality metrics to reflect accurate industry terminology.