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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: This amendment reimburses certain physician administered drugs (PAD), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), using the state's existing lesser of methodology under the pharmacy reimbursement methodology.
Summary: Increases the physician office and outpatient hospital visit limit from twelve (12) to sixteen (16) per state fiscal year for both psychiatric and non-psychiatric services.
Summary: Add private practice settings to the fee for service (FFS) delivery system to ensure that individuals who had been receiving services in those settings under the Rhody Health Options (RHO) program.
Summary: Revise language to reflect the February 2017 changes in the Fourth (4th) Addition of the Bright Futures/American Academy of Pediatrics (AAP) .
Summary: Allow the Mississippi Division of Medicaid to include Psychiatric Residential Treatment Facility (PRTF) services as covered and reimbursed by the coordinated Care organizations (CCOs).
Summary: Increases flexibility by moving some requirements from the State Plan into the broker agreement and to expand the types of transportation providers, allow for mileage reimbursement and transportation to non-Medicaid providers.
