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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 adopt the optional Work Incentives eligibility group and incorporate additional disregards in the determinations of financial eligibility for the Ticket to Work-Basic eligibility group.
Summary: This amendment is to update the requirements for Third Party Liability – Payment of Claims for Third Party Liability- Identifying Liable Resources.
This SPA proposes to change the state’s multi-state Supplemental Rebate Agreement arrangement from being with National Medicaid Pooling Initiative (NMPI) to joining the Sovereign States Drug Consortium (SSDC). The SPA also proposes to allow the state to enter into individual Supplemental Rebate Agreements directly with manufacturers.
Summary: This amendment will add language back to the Medicaid State Plan to clarify the state covers and reimburses all United States Preventive Services Task Force (USPSTF) grade A and B preventive services and approved vaccines recommended by the Advisory Committee on Immunization Practices (ACIP).
Summary: This Supplemental Teaching Physician (STP) Payment Program state plan amendment updates the base year used to determine payments under the Average Commercial Rate (ACR) method.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to temporarily extend the suspension of premiums for the Medicaid Buy-In for Workers with Disabilities (MBIWD) effective 5/12/23 through 7/31/23. This provision was approved in disaster relief SPA OH-22-0013 effective 7/1/21.