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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: 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.
Summary: Revise language to reflect the February 2017 changes in the Fourth (4th) Addition of the Bright Futures/American Academy of Pediatrics (AAP) .
Summary: Allow the Mississippi Division of Medicaid to include Psychiatric Residential Treatment Facility (PRTF) services as covered and reimbursed by the coordinated Care organizations (CCOs).
Summary: This removes the five percent (5%) assessment of outpatient hospital services, clarify the Outpatient Prospective Payment System (OPPS) payment methodology, and add the reimbursement methodology for Long Acting Reversible Contraceptives (LARCs).
Summary: Updated the reimbursement methodology for transportation services and place information regarding coverage and payment of transportation services.
Summary: Long-Term Care (LTC) Updates #2 is being submitted to allow the Division of Medicaid to (1) revise the number of allowed therapeutic leave days for nursing facilities (NFs) and intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs), (2) remove stock transactions as a change in ownership assets, (3) clarify the provider appeals process to include reconsideration prior to an administrative appeals request, (4) remove MDS submissions as appealable,(5) restrict providers from entering or modifying hospital and therapeutic leave days via the web portal after the corresponding quarter close cutoff and (6) update the table of contents to reflect changes in MS SPA 15-004.
