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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: The State is attesting compliance with Section 1902(a) (80) of the Social Security Act, P.L. 111-148 (Section 6505). This amendment prohibits payments for items or services provided under the State plan or State waiver to any financial institution or entity located outside of the United States.
Summary: This State Plan Amendment addresses the list of incurred expenses that may be deducted for institutionalized persons as part of the post-eligibility treatment of income.
Summary: To adjust the method used for determining the cost-effectiveness of health insurance plans when determining if the State will pay premiums for private insurance under the Health Insurance Premium Payment (HIPP) under Section 1906 of the Act. Previously Iowa had allowed deemed cost effectiveness under certain criteria. This SPA eliminates the deemed cost effectiveness criteria so that the cost effectiveness of each plan must be considered individually against the cost effectiveness formula. This criterion had originally been added to the State Plan with TN #96-07.
Summary: This amendment confirms that Tennessee intends on contracting with Recovery Audit Contractor(s) (RAC)s to audit Medicaid providers and review Medicaid claims submitted by provider of services.
Summary: Remove IACare expansion language and establish disproportionate share hospital (DSH) payments. The non-federal share of the $7,500,000 increase in DSH payment to the UI is provided by the UI through an IGT, therefore we have shown $0 as the state dollar impact. DSH to Broadlawns has been moved from an IACare expenditure to a regular Medicaid expenditure freeing up budget neutrality space for IowaCare.
Summary: Removes the annual limit on the number of persons served and removing all references to payment slots and waiting lists for the 1915(i) State Plan HCBS program, on or after October 1, 2010 as required by the Affordable Care Act.
Summary: Iowa is implementing presumptive eligibility for children. The initial estimate assumes 1,176 children will become eligible because of presumptive eligibility by the end of FFY 2010, and 2,446 children will become eligible by the end of FFY 2011.
