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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: Removes references to the MediPass and Health Maintenance Organization (HMO) programs as these programs become obsolete by the approval of 1915(b) waiver #R08, Iowa High Quality Healthcare Initiative. In addition, the SPA updated the description of the qualifications of a Managed Care Organization (MCO) must meet to contract with the state.
Summary: Revises the delivery system and payment methodology for serious and persistent mental illness health home services to reflect the move to statewide managed care.
Summary: Reflects language to further define the reimbursement methodology for evaluation and management services provided by attending physicians in the emergency department of a hospital.
Summary: This SPA was submitted on April 19, 2016 seeking an exception to the Medicaid Recovery Audit Contractor (RAC) Program in accordance with 42 §CFR 455.516.
Summary: This SPA was submitted on May 24, 2016 to remove Attachment 3.1-F from the Iowa State Plan. This attachment had previously provided federal authority for the state to operate their MediPass and managed care programs through the Medicaid state plan.
Summary: The purpose of the SPA is to include individuals in the Marketplace Choice, Alternative Benefit Plan with income 101-133% of the federal poverty level (FPL) in the Iowa Wellness Plan, for alignment with the state's 1115 demonstration.
Summary: This SPA was submitted on March 30, 2016 to revise the delivery system through which the Iowa Wellness Plan, Alternative Benefit Plan (ABP), is delivered to reflect the move to Statewide managed care.
