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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 was submitted in response to Companion letter MS 11-008 which was filed to allow the Mississippi Division of Medicaid to revise the reimbursement methodology for Ambulatory Surgical Centers payments. MS SPA 12-005 will specify coverage and separate reimbursement for Freestanding Birthing Center Facility Services and Professional Services in order to comply with Section 2301 of the Affordable Care Act.
Summary: This amendment was submitted to comply with The Patient Protection and Affordable Care Act of 2010 (Affordable Care Act, Public Law 111-148) enacted March 23, 2010 and further addresses the payment for other provider preventable conditions, to include the three never events.
Summary: Prohibits Payments to States for any amounts expended for providing medical assistance for certain hospital outpatient and other PPC health care-acquired conditions for dates of service on or after July 1, 2011.
Summary: This SPA proposes to revise the payment methodology for inpatient hospital services. Specifically, the amendment proposes to deny payment for Provider Preventable conditions.
Summary: Eliminates references to the Average Wholesale Price and defines how the Estimated Acquisition Cost is determined based on the lesser of the Wholesale Average Cost plus zero percent and increases the pharmacy dispensing fee from $4.67 to $5.00.
Summary: The amendment was submitted to appropriately set the rates for Ambulatory Surgical Centers (ASC) at 80 percent of the current Medicare Ambulatory Surgical Center Payment System. This methodology further allows the Division of Medicaid to update the ASC codes and rates annually based on the Medicare annual updates.
Summary: This SPA proposes amendments to Hawaii's approved Title XIX State Plan to eliminate certain optional services for Hawaii's QUEST beneficiaries, as well as to impose an inpatient service limitation on this population.
Summary: Revises the payment methodology for services provided by Nursing Facilities, Intermediate Care Facility for the Medically retarded and Psychiatric Residential Treatment Facilities.
