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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: 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: 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.
Summary: Makes changes to the state plan to differentiate payments for routine home care based on length of stay and to implement a service intensity add-on payment.
Summary: Modifies Reimbursement Methodology for Inpatient Hospital Services by Adopting the All Patient Refined (APR) Diagnosis Related Group (DRG) Grouper, Version 30 & Implementing Updated Inpatient DRG Relative Weights & Payment Rates.
Summary: This State Plan amendment makes conforming changes to the SPA to extend the current three percent (3%) rate reduction for nursing facilities that is currently set to expire on June 30, 2015. This rate reduction will be extended for the period July 1, 2015 through June 30, 2017.
Summary: This State Plan Amendment makes conforming changes to the SPA to extend the current three percent (3%) rate reduction for inpatient hospital services that is currently set to expire on June 30, 2015. This rate reduction will be extended for the period July 1, 2015 through June 30, 2017.
Summary: Increases Medicaid Reimbursement to Intermediate Care Facilities for Individuals with Intellectual Disabilities and Community Residential Facilities for the Developmentally Disabled by 3% from the Methodology in Effect on December 31, 2013.
