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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 makes changes to the State Plan as a result of changes made to Indiana State Law by House Enrolled Act (HEA) 1001 (2011), including the implementation of an assessment fee on most hospitals, the revision of the reimbursement methodology for inpatient hospitals. The fees imposed will be utilized to cover the non-federal share of DSH payments as well as to increase Medicaid payment rates to the aggregate level of reimbursement that would be paid under Medicare payment principles.
Summary: This transmittal is being submitted to for technical corrections made when SPA approved prior to 11-14. This incorporates the language with appropriate dates.
Summary: This amendment eliminates a 5% rate reduction; implements a hospital adjustment factor; and provides for disproportionate share hospital (DSH) payment redistribution methodology.
Summary: This amendment implements concurrent care for children on hospice in compliance with Section 2302 of the Affordable Care Act. In addition, this amendment provides comprehensive coverage language on hospice services within the State plan in accordance with 1905(o) of the Social Security Act.
Summary: This SPA makes conforming changes to the State Plan to Implement a system to screen all participating providers according to their categorical risk level , upon initial enrollment and upon re-enrollment or revalidation of enrollment.
Summary: Develop and provide an Asset Verification System, that ,meets the requirements of Section 1940(a) of the Social Security Act, to determine or redetermine Medicaid eligibility for aged, blind and disabled Medicaid applicants and recipients.
Summary: This transmittal is being submitted to reflect a new methodology to calculate the DSH payments to DSH hospitals and to describe the Upper Payment limit calculation.
Summary: This amendment imposes a 5% rate reduction on all medical supplies provided from July 1, 2011 to June 30, 2013. This SPA also seeks to change the methodology of Medical Supply reimbursement to utilize Medicare rates as the reimbursed amount when available, or the acquisition cost when Medicare rates are not available.
