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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 permanently elect the option to extend the Reasonable Opportunity Period for non-citizens who are making a good faith eff ort to resolve any inconsistencies or obtain any necessary documentation, or the agency needs more time to complete the verifi cation process. In response to the COVID-19 Public Health Emergency that started March 13, 2020, Ohio elected to allow an extension to the ROP for noncitizens through an approved Disaster Relief SPA (SPA 20-012) due to the Public Health Emergency. With the approval of this state plan amendment, Ohio is electing to permanently allow extensions to the ROP for noncitizens.
Summary: Updates post-eligibility treatment of income exclusions in accordance with the Stephen Beck Jr. Achieving a Better Life Experience (ABLE) Act and recently passed State legislation.
Summary: This SPA is to amend the provisions governing adult dentures services in order to link reimbursement rates to the Louisiana Medicaid fee schedule.
Summary: The State adopts the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This SPA is to amend the provisions governing the Home Health Program in order to increase the number of medical professionals that can order home health services.
Summary: To adopt the changes to the eligibility rules for the Former Foster care Children eligibility group. as enacted by the substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act Pub. L. No. 115-217. section 1002.
Summary: This State Plan Amendment increases the inpatient hospital per-diem rate of reimbursement for extended observation bed (EOB) services in hospital-based comprehensive psychiatric emergency programs (CPEP), subsequent to a CPEP full or triage and referral visit and where the beneficiary remains in the CPEP for longer than 24 hours.
Summary: This State Plan change will allow Medicaid to reimburse for Opioid Treatment Program (OTP) services provided to individuals with an Opioid Use Disorder. OTP services are being revised to allow for a bundled payment consistent with Medicare rates that utilizes an integrated service model that includes medication, medication administration, counseling, laboratory tests and case management services.
Summary: This State Plan Amendment updates Nursing Home reimbursement rates to the 2020 nursing home cost reports. The SPA also updates calculation of the Property and Related Net Per Diem established under the FRV System by increasing the rate for construction cost for nursing facilities from $187.12 to 198.86, as derived from the 2020 RSMeans Building Construction cost data for Nursing Homes.