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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: 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.
Summary: This SPA allows the Division of Medicaid to revise the payment computation of the Mississippi Medicaid calculated fee for the observation code G0378 using the Ambulatory Payment Classification (APC) 8009 instead of the average of APC 8002 and APD 8003 effective July 1, 2014.
Summary: This amendment proposes to revise the Sovereign States Drug Consortium (SSDC) Supplemental Rebate Agreement (SRA) previously submitted to CMS on September 12, 2012, to allow supplemental rebates to be collected on coordinated care claims. This amendment also implements a uniform Preferred Drug List (PDL) for fee-for-service and coordinated care pharmacy claims.
