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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 is to remove the designations for Prepaid Inpatient Health Plan (PIHP) and Prepaid Ambulatory Health Plan (PAHP) from the State Plan.
Summary: This amendment is to add coverage of routine patient costs for items and services furnished in connection with participation in qualifying clinical trials to Nevada’s Alternative Benefits Plan (ABP) pages.
Summary: With this amendment, the state is updating the SDPC pages of the State Plan to reflect the current practice of the department,
including language and role updates. There are no substantive changes to the program’s operations.
Summary: This amendment proposes to confirm the methodology used to determine eligibility for the Special Assistance in-Home optional state supplement program, the beneficiaries of which are eligible for Medicaid.
Summary: This amendment proposes to increase the number of days of therapeutic leave for Medicaid-eligible beneficiaries occupying beds in Nursing Facilities or Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF-IID) from 60 to 90 in any calendar year.
Summary: Proposes to update Ohio's Alternative Benefit Plan to implement a Prepaid Inpatient Health Plan as part of the state's OhioRISE initiative for individuals eligible under Section 1902(a)(10)(A)(VIII) of the Social Security Act.
Summary: This SPA updates the definition and criteria for Nominal Charge Providers and updates MO Health Net fee schedules for outpatient reimbursement when a Medicare rate is not available.
Summary: This plan amendment was submitted to allow the Division of Medicaid (DOM) to update rates for preventative services according to the appropriate payment methodology for the service.