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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: Increases the resource limits for QMB, SLMB and QI. Adds Qualified Individuals (QIs) to Attachment 26-A. Uses current language for specified Low Income Medicare Beneficiaries (SLMB) in Attachment 2.2-A, and Re-numbers 28 to 29 and 29 to 30 in Attachment 2.2-A.
Summary: CHIPPRA 2009 gave states the option to use express lane procedures for determining Medicaid eligibility for children. SF 389 requires IA DHS to implement this option. DHS has chosen to rely on information from the IA Supplemental Nutrition Food Assistance Program eligibility to determine Medicaid eligibility for children under 19 who are not current Medicaid members.
Summary: Increase PMIC maximum rate to 1034 of the statewide weighted average for SFY 2010. Transition out-of-state placements to in-state and allow for Third Party Liability payments from other insurers for SFY 2011. Implement 100% cost reimbursement with cost settlement for state-owned PNIC.
Summary: This request modifies the nursing facility rate setting for implementation of a nursing facility provider tax (quality assurance assessment fee).
Summary: This amendment revises methods and standards for establishing payment rates for nursing facility services. Specifically, this amendment proposes a change in determining the nursing component of the nursing facility rate with implementation of a minimum data set (MDS) based reimbursement methodology.
Summary: This request increases the amount of funding in the Iowa state-owned teaching hospital disproportionate share fund. This also changes the GMS/DSH fund apportionnent claim sent.
