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Medicaid State Plan Amendments

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.

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Showing 1 to 10 of 102 results
Transmittal Number: OH-24-0004
State: Ohio
Summary: Revises the state plan to allow an incentive payment for coverage of private rooms in nursing facilities when specific facility criteria are met.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OH-24-0006
State: Ohio
Summary: Revises the state plan to update the interagency agreement summaries with the Ohio Department of Health and the Ohio Department of Aging.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OH-23-0024
State: Ohio
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.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OH-24-0005
State: Ohio
Summary: This amendment revises the state plan to reflect that Ohio imposes property liens on account of benefits incorrectly paid.
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • 21st Century Cures Act
  • Long-Term Services & Support
Links:
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Transmittal Number: OH-23-0001
State: Ohio
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.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OH-23-0045
State: Ohio
Summary: Proposes an exception to the Recovery Audit Contractor (RAC) program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OH-22-0010
State: Ohio
Summary: To update the description of the Ohio Department of Medicaid organization and the administration of the state’s Medicaid program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: OH-21-0036
State: Ohio
Summary: Assurance Requirements for and Medicaid Coverage of Non-Emergency Medically-related Transportation
Approval Date:
Effective Date:
Topics:
  • Program Administration
  • Coverage
Links:
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Transmittal Number: OH-21-0033
State: Ohio
Summary: Authorizes the state to enter in Value-Based Purchasing (VBP) rebate agreements with drug manufacturers for drugs provided under the Medicaid program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OH-21-0034
State: Ohio
Summary: Clarifies that providers must wait 100 days after billing a non-responsive child enforcement-related third party in order to be eligible for Medicaid reimbursement.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT