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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 provides for trend factors, revises the utilization adjustment for all hospitals except for safety net hospitals and children's hospitals, clarifies disproportionate share hospital (DSH) calculation to allow for payment up to 100% of DSH allotment, and defines the DSH cap.
Summary: The SSDC Iowa Medicaid Supplemental Drug Rebate Agreement utilized by the State to enter into a rebate agreement with a drug manufacturer has been revised to correct a formatting error on page 14 and must be authorized by CMS.
Summary: Adds a supplement to the State plan to definie the requirements of the Asset Verfication System as required under Sectio 1940 of the Social Security Act.
Summary: This SPA matches resource limits for individuals eligible for the full Low-Income Subsidy program benefits under Medicare Part D with those allowed for individuals who are also eligible for Medical Assistance under the Qualified Medicare Beneficiaries/Specified Low-Income Medicare Beneficiaries (QMB/SLMB) programs, as required by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
Summary: Provides full Medicaid coverage qualified alien children and pregnant women who are are fully residing in the U S but have either not met the 5 year waiting period or 5 year bar under Section 403 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 or are nonqualified aliens lawfully residing in the U S who are other otherwise eligible for such assistance.
