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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 allows MO HealthNet to consider participants eligible for, but not enrolled in, a managed care plan for
the Health Insurance Premium Payment (HIPP) program, and determine whether enrolling such participants in HIPP would be cost effective.
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.
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 approval of DR SPA 21-0016 effective 1/1/23.
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 waive signature requirement for pharmacy counseling and to increase reimbursement rates for private duty nursing services.
Summary: This State Plan Amendment supersedes TN: 13-005 and increases the rate of reimbursement for Monkeypox Vaccine Administration to $15. This rate will expire with the conclusion of the Monkeypox public health emergency.
Summary: This SPA establishes ongoing authority for the reimbursement methodology for Durable Medical Equipment (DME) considered to be oxygen and respiratory equipment.