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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 SPA transitions the Indiana's Medicaid nursing facility Medicaid reimbursement system from the RUG III model to the RUG-IV, model for which the MDS 3.0 was designed.
Summary: Makes conforming changes to the state plan to establish rates for services on or after July 1, 2016, at the same rates that were in effect for SFY 2016.
Summary: Continues concurrent cost-sharing policies for the applicable state plan populations and documents the state's mechanism for tracking Healthy Indiana Plan 2.0 member cost sharing, which shall not exceed 5% of family income as calculated on a quarterly basis.
Summary: Proposes for the aged, blind, and disabled medically needy group to disregard the amount by which an individual's Meedicare part B premium is reduced through enrollment in a Medicare Advantage Program.
Summary: This SPA specifies the dental benefits provided by Puerto Pico Medicaid Program to children under 21 years and beneficiaries over 21 years old.
Summary: Modifies the Medicaid reimbursement methodology for physician services by revising the payment rate so that the aggregate Medicaid reimbursement to physicians is at least 75 percent of the Medicare reimbursement for the same service, in accordance with the Healthy Indiana Plan.
