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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: Specifically, this SPA updates the income standard to 75% of the Federal Poverty Level (FPL) used in eligibility determinations for low income families with children under Section 1931 of the Social Security Act, and for children under age 21 under 42 CFR §435.222 for whom public agencies are assuming full or partial financial responsibility (e.g. foster children).
Summary: Which assure compliance with and implementation of Section 6401 of the Affordable Care Act regarding Medicaid Provider Screening and Enrollment.
Summary: This SPA makes conforming changes to the State Plan to implement changes made to the Indiana Code at IC 12-15-13-4 by HEA 1001 (2011) that directs OMPP to issue a final recalculated Medicaid rate due to an audit after the reconsideration period rather than waiting until all the appeal rights under 405 IAC 1-1.5-2 have been exhausted, increases Medicaid reimbursement to nursing facilities fur initiatives that promote and enhance improvements in quality of care to nursing facility residents, extends the effective dates of various rate parameters and limitations, increases administrative reimbursement, and clarifies provider cost classification and reporting issues.
Summary: This SPA makes changes to the State Plan as a result of changes made to Indiana State Law by House Enrolled Act (HEA) 1001 (2011), including the implementation of an assessment fee on most hospitals, the revision of the reimbursement methodology for inpatient hospitals. The fees imposed will be utilized to cover the non-federal share of DSH payments as well as to increase Medicaid payment rates to the aggregate level of reimbursement that would be paid under Medicare payment principles.
