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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 implements coverage of the new mandatory benefits of COVID 19 Vaccines and Administration of the Vaccines, Diagnostic and Screening Tests, and Treatment, Specialized Equipment and Therapies, and Preventive Therapies in accordance with the requirements of Section 9811 of the American Rescue Plan (ARP) Act.
Summary: Indiana adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials and extends the prescription drug supply limit from thirty (30) days to ninety (90) days for the Health Indiana Plan (HIP) Basic group.
Summary: This amendment updates the alternative benefit plan to include coverage requirements for routine patient costs associated with participation in clinical trials for the Healthy Indiana Plan (HIP) Plus group.
Summary: This amendment attests to the state’s coverage of COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment, as required by sections 1905(a)(4)(E) and 1905(a)(4)(F) of the Social Security Act (Act).
Summary: This plan amendment updates the reimbursement methodology for Medicaid reimbursement for Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) to reimburse COVID-19 vaccine administration.
Summary: This State Plan Amendment proposes to increase the underlying per diem expenses for the Medicaid cost reports utilized in the calculation of the median beginning October 1, 2022.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse federally qualified health centers (FQHCs) and rural health clinics (RHCs) for the administration of the COVID-19 vaccines. This reimbursement would include a separate reimbursement for the administration of the COVID-19 vaccine in addition to the prospective payment system (PPS) rate for qualifying FQHC/RHC encounters.
