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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: Updates the description of Iowa's Medical Managed Health Care program to reflect the participation of a managed care organization in the program.
Summary: Proposes to transition remedial services to managed care (MC) and reimburse non-MC providers on a fee schedule. The program name is also changing to Behavioral Health Intervention Services.
Summary: This SPA proposes amendments to Hawaii's approved Title XIX State Plan to eliminate certain optional services for Hawaii's QUEST beneficiaries, as well as to impose an inpatient service limitation on this population.
Summary: House File 649, as authorized by the IA General Assembly, modified the maximum amount of disproportionate share hospital payments that could be paid to Broadlawns Medical Center.
Summary: Results in all smoking cessation products (legend and nonprescription) being covered by IA Medicaid for all members. Sections in PPACA require coverage for pregnant women by 10/1/10 & for all members by 1/1/14. IA will cover all members beginning 11/1/11.
Summary: This change per the request of CMS in the letter dated November 21, 2011, to Jennifer Vermeer as attached) removes from coverage in the Non-prescription Drugs portion of the Pharmacy Program area, four categories of products that do not meet the definition of a covered outpatient drug as defined by section 1927 (k) (2) of the Social Security Act (SSA). These products will be covered under medical supplies.
Summary: Change inpatient hospital reimbursement methodology for Native American members to the inpatient hospital per diem (excludes physician/practitioner services). Inpatient for all other members will continue to be paid on the DRG methodology.
