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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: Request implements a GEMT supplemental payment program for services provided by public and publicly contracted Emergency Medical Services (EMS)
Summary: Amending the Medicaid State Plan to reflect Iowa's current payment methodology showing when multiple therapy services are received on the same day.
Summary: Recognizes the removal from the State's nursing facility provider tax of the state-imposed limitation on the percentage used for calculating the amount of non-Medicare revenue to determine the amount of assessment fees.
Summary: SPA Implements the CAP for dental services received in a clinical setting. Diagnostic, preventive, emergent, anesthesia in conjunction with allowable oral surgery procedures and fabrication of denture services are excluded procedures.
Summary: Revises the current inpatient hospital 30-day re-admission policy to exclude re-admissions that are planned for repetitive or staged treatments.
Summary: The purpose of the SPA is to implement a statewide fee schedule reimbursement for case management services in accordance with 2018 Iowa Acts, Senate File 2418, Section 132.
