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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 increases the percentage of Medicaid enrollees, adds additional categories of eligibility, and requires mandatory participation in Mississippi Coordinated Access Network (MSCAN) for certain Medicaid beneficiaries.
Summary: This SPA incorporates the MAGI-based eligibility process requirements, including the single streamlined application, into Hawaii's approved Medicaid State Plan in accordance with the Affordable Care Act.
Summary: Removes barbiturates, benzodiazepines, and agents used to promote smoking cessation from the list of drugs the state Medicaid program may exclude from coverage or otherwise restrict in order to comply with the requirements of Section 2502(a) of the Affordable Care Act.
Summary: To continue the suspension of the annual inflation factor to inpatient hospital and nursing facility rates for the 4th quarter of FFY 2013, FFS 2014 and the 1st, 2nd and 3rd quarters of FFY 2015.
Summary: Updates language specifying Mississippi State Department of Health services as Clinic Services, removes "Other" from Clinic Services, removes "horne visits" from Clinic Services, removes Rural Health Center (RHC) and Ambulatory Surgical Center (ASC) services from the Clinic Services reimbursement page and requires providers to use a CMS-approved cost report. Additionally, this SPA places ASC services on a new benefits page and re-pages ASC reimbursement to coincide with the ASC services page.
Summary: To include the Centers for Medicare & Medicaid Services (CMS) required Attachment 4.32-A, Income and Eligibility Verification System Procedures and to update the corresponding State Plan page.
Summary: To define coverage and the reimbursement methodology for physician administered drugs, implantable drug system devices, diagnostic or therapeutic radiopharmaceuticals and contrast imaging agents in the office setting, effective.
Summary: This amendment transitions from a manual method of identifying and adjusting claims subject to inpatient hospital Health Care Acquired Conditions to the implementation of the 3M All Patient Refined Grouper (APR-DRG) HCAC utility.
Summary: Revises the reimbursement methodology for durable medical equipment (DME) and medical supplies when the Medicare rate is not sufficient to provide access to care for the Mississippi beneficiaries.
