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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 proposes to update the state plan by adding coverage and payment provisions for evaluation and management services provided by chiropractors, as permitted under state law.
Summary: This amendment proposes to establish coverage and payment for mobile response and stabilization services and updates the payment rates for child and adolescent needs and strengths as part of the OhioRISE program.
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.
Summary: Proposes to rescind the temporary third-party liability bypass for behavioral health providers who bill a third party but do not receive a response after 30 days.
Summary: Proposed the addition of a resource disregard under the authority of section 1902(r)(2) of the Social Security Act for all non-MAGI based groups covered under Ohio's state plan.
Summary: authorizes 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.
Summary: To update state plan language related to the coordination of benefits for hospital services and remove obsolete rules-based language that is no longer pertinent.
