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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 SPA proposes changes to the District's disproportionate share hospital payment program. Specifically, this plan continues the previously approved recovery and redistribution methodology for DSH payments in excess of hospital-specific-limits. Additionally, this SPA eliminates one of two reductions to DC's annual DSH allotment that allowed DC to expand coverage under approved Medicaid Waivers and eliminates language that made an additional $12.5 million payment to a specific qualified DSH facility. The $12.5 million becomes part of the distribution pool for all DSH hospitals.
Summary: Adds outpatient mental health services mammography, and pelvic exams, and to make a technical correction adjust the EPSDT age limit to 21 years.
Summary: Change in the State Plan to reflect provisions of Amended Substitute House Bill l (128th Ohio General Assembly) requiring nursing facilities (NFs) to arrange for therapy services for their residents in return for an additional per diem amount.
Summary: increased federal financial participation (FFP) for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for
the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act;
