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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: Establishes a new level of reimbursement for Medicaid-eligible individuals who have severe behavioral needs residing in or seeking admission to Intermediate Care Facilities for Individuals with Developmental Disabilities (ICFs/IID), updates buy-back provisions for ICFs as authorized in the State’s Fiscal Year 2021-22 General Appropriations Act, and makes technical / editorial changes.
Summary: provides for a per diem increase to nursing facility and HIV nursing facility per diem reimbursement rates of ten dollars and eighteen cents ($10.18) effective for dates of service July 1, 2021 through June 30, 2022. This per diem increase provides an adjustment to nursing facility per diem rates for increases in costs associated with staffing, supplies, social distancing standards, and other factors due to the COVID-19 national emergency.
Summary: add-on payments to Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) providers for state required minimum wage increase. This amendment also makes provisions for ICF/IID ownership and control payments for specified circumstances.
Summary: Increases rates for skilled and private duty nursing, and allows for overtime and sick leave for providers of consumer-directed care under certain circumstances.
Summary: Grants the Ohio Department of Medicaid (ODM) an exception to establishing a Recovery Audit Contractor (RAC) program for the two-year period beginning on January 1, 2022 through December 31, 2023.