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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: 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 implement a disregard of income that would have otherwise been part of an individual’s liability for institutional or home and community-based waiver services based on application of the post-eligibility treatment-of income (PETI) rules, but which became countable resources on or after March 18, 2020.
Summary: This SPA modifies the per member per month rate for medical home payments, specifically for primary care providers with assigned Tailored Care Management eligible beneficiaries.
Summary: Effective October 1, 2022, this amendment revises the quarterly nursing home supplemental payment, also known as MQIP, for dates of service in the quarter ending December 31, 2022.
Summary: This state plan home and community-based services (HCBS) benefit is Adding a moving expense allowance to Housing Stabilization - Transition Services.
Summary: This SPA adds conforming updates in state law, including commissioner authority to grant variance of behavioral health home service provider requirements; clarification of provider requirements and expectations; corrects the list of qualified positions for a Qualified Health Home Specialist, and adds requirement for Behavioral Health Home (BHH) providers to notify the contact designated by an enrollee’s managed care plan within 30 days of the start of BHH services.
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 extend the COVID-19 Emergency Sick Leave Benefits for In Home Supportive Services (IHSS) providers through December 31, 2022.
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 resume prior authorization of private duty nursing (PDN) services and home health (HH) services that were approved in Ohio DR SPA 20-0012 on 5/22/20 in response to the COVID-19 PHE and resumes review of the normal limits on PDN & HH services with a process to exceed based on medical necessity.