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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 adopt the optional eligibility group described in section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, which serves working individuals who have disabilities and incomes below 250 percent of the federal poverty level.
Summary: This amendment establishes coverage and payment provisions for preventive services provided by doulas and lactation consultants under the state plan.
Summary: Clarifies coverage of diabetes self-management training services as dieticians’ services and reflects a change in terminology from “lactation counseling services” to “lactation consultation services.”
Summary: This amendment is to amend its hospital presumptive eligibility SPA and presumptive eligibility program to include a performance standard for qualified entities or hospitals determining presumptive eligibility for pregnant women and/or children.
Summary: This amendment clarifies state plan language related to the coverage of ambulatory surgical center services. This SPA is for clarification purposes and does not propose any policy changes.
Summary: Clarifies state plan language related to the coverage of physician services and eyeglasses. This SPA is for clarification purposes and does not propose any policy changes.
Summary: To establish coverage and payment provisions for targeted case management for a new target group consisting of children and youth with complex behavioral needs as part of the OhioRISE
Summary: Proposes to remove telehealth references from the state plan since the coverage provisions and payment rates for services delivered via telehealth are the same as services delivered face-to-face.
