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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.
Attachment 4.19-D of Mississippi’s Title XIX State Plan. Specifically, the amendment proposes to freeze all long-term care facility rates in effect July 1, 2021
Summary: proposes to add coverage language and requirements to targeted case management for the chronically mental ill to comply with 42 CFR §§ 440.169 and 441.18
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse all Mississippi Medicaid pharmacies, physicians, and non-physician practitioners 100% of the Medicare rate for the administration of an FDA-approved COVID-19 vaccine. The Division of Medicaid will reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) outside of the PPS rate for administering the COVID-19 vaccine at 100% of the Medicare rate only if there is no corresponding encounter. If there is an encounter, administration of the COVID-19 vaccine is reimbursed as part of the encounter rate.
Summary: This State Plan Amendment (SPA) 21-0039 is being submitted to allow the Division of Medicaid (DOM) to cover and reimburse for wraparound services under the targeted case management benefit, effective July 1, 2021. Under the targeted case management rules, services must be billed separately from case management services. The Division of Medicaid is submitting this SPA to cover wraparound services as a targeted case management benefit that will be reimbursed a monthly rate separate from direct care services included in the beneficiary’s plan of care.
Summary: Allows the Division of Medicaid (DOM) to set the fees for DPSDT extended services to the same as those in effect on July 1, 2020, to remove the five percent (5%) reimbursement reduction effective July 1, 2021, and add coverage and reimbursement of Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services effective July 1, 2021.
Summary: This amendment proposes to allow the Mississippi Division of Medicaid to make the following modifications to the Mississippi State Plan: (1) update coverage reimbursement of targeted case management (TCM) in order to align with the regulations at 42 CFR §§ 440.169 and 441.18; (2) update the fees for TCM for high-risk pregnant women to align with the fees in effect on July 1, 2021; and (3) remove the five percent reimbursement reduction effective July 1, 2021.
Summary: This amendment updates coverage and reimbursement of targeted case management (TCM) for infants under the age of one to comply with federal regulations 42 C.F.R. §§ 440. 169 and 441.18.
Summary: set the fees for transportation services the same as those in effect on July1, 2020, and removes the five percent (5%) reimbursement reduction effective July 1, 2021. This SPA also revises the coverage page to include attestation to meeting the federal transportation minimum requirements.
Summary: allow the Division of Medicaid to 1) set the fees for vaccines and vaccine administration the same as those effective for State Fiscal Year 2021, 2) to include language regarding the reimbursement for administration of Vaccine For Children (VFC) vaccines, and 3) remove the five percent reimbursement reduction
