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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: Provide a twelve (12) month continuous eligibility period to children under age nineteen, who no longer meet eligibility requirements. This SPA will align the District's eligibility and operational practices with new federal requirements set forth under the Consolidated Appropriations Act of 2023.
Summary: This amendment allows the District to update the state’s excluded drug listing; to provide coverage for select agents for the treatment of infertility; to enter in Outcome-based arrangements with manufacturers; and to increase flexibility to improve access to prescription and over-the-counter drugs.
Summary: This State Plan Amendment (SPA) proposes to revise Medicaid reimbursement rates for medical supplies and medical equipment that are not subject to the requirements of the 21st Century Cures Act of 2016 as codified at Section 1903 (i)(27) of the Social Security Act.
Summary: This State Plan Amendment (SPA) proposes to makes changes to the Medicaid State Plan to establish Medicaid reimbursement rates for applied behavior analysis (ABA) therapy services.
Summary: 1) to supply assurances that it is complying with new third party liability requirements authorized under the Consolidated Appropriations Act, 2022 and 2) to provide clarity on the state’s option to adopt a new flexibility on creating liens for injury settlement proceeds attributable to future medical expenses.
Summary: This State Plan Amendment (SPA) proposes to make changes to the Medicaid State Plan to revise Medicaid reimbursement rates for physician and other practitioner services, including reimbursement rates for physician, anesthesiology, and dental services.
Summary: This amendment aligns Indiana Medicaid with the 21st Century Cures Act by including Electronic Visit Verification (EVV) assurance for home health services.
Summary: This State Plan Amendment (SPA) proposes revise the Medicaid reimbursement methodology for nonemergency medical transportation services and add clarifying language relating to emergency transportation. Emergency and non-emergency medical transportation services will be reimbursed at the Medicare urban ambulance rates for Indiana, if available, that take effect January 1 of the calendar year preceding the Medicaid rate effective date.
