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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: To allow Mississippi Medicaid to change control of the utilization of Intermediate Care Facilities for Individuals with Intellectual Disabilities.
Summary: This allows the MS Division of Medicaid to include less restrictive language for reporting transitional medical assistance (TMA) under Section 1931 of the Social Security Act, allowing the DOM to continue Medicaid eligibility under TMA for an initial period of twelve (12) months.
Summary: To allow the Mississippi Division of Medicaid to include post eligibility treatment of income (PETI) deductions by institutionalized individuals for amounts of incurred expenses for medical or remedial care that are not subject to payment by the DOM or other third party insurance.
Summary: Allows the Mississippi Division of Medicaid to: a) add Autism Spectrum Disorder (ASD) as a covered diagnosis, b) remove the needs-based criteria, c) revise the qualifications and training requirements for Targeted Case Managers, and d) revise the reimbursement for TCM for beneficiaries with IDD in community-based settings from $14.88 per fifteen (15) minute unit to a rate of $151.01 per month.
Summary: Allows the Mississippi Division of Medicaid to increase the number of home health visits from twenty-five (25) to thirty-six (36) visits per state fiscal year and to clarify the provider appeals process to include reconsideration prior to an administrative hearing request.
Summary: This amendment reimburses certain physician administered drugs (PAD), referred to as Clinician Administered Drug and Implantable Drug System Devices (CADDs), using the state's existing lesser of methodology under the pharmacy reimbursement methodology.
Summary: Increases the physician office and outpatient hospital visit limit from twelve (12) to sixteen (16) per state fiscal year for both psychiatric and non-psychiatric services.
