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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 amendment revises methods and standards for establishing payment rates for nursing facility services. Specifically, this amendment proposes a change in determining the nursing component of the nursing facility rate with implementation of a minimum data set (MDS) based reimbursement methodology.
Summary: This amendment decreases payment rates to all hospitals by one percent, reduces a base year adjustment, eliminates payment for increased costs associated with a list of hospital acquired conditions, limits payments for certain child deliveries and adjust payment rates for an increase in costs for hearing tests.
Summary: This request increases the amount of funding in the Iowa state-owned teaching hospital disproportionate share fund. This also changes the GMS/DSH fund apportionnent claim sent.
Summary: This amendment revises payment rates to intermediate care facilities for the mentally retarded (ICF/MR), not paid on a cost basis. Specifically, this amendment reduces ICF/MR payment rates by 2.58%, eliminates the occupancy rate adjustment and freezes the variable rate adjustment.
Summary: This amendment allows the State to decrease the reimbursement paid for physician services under the Medicaid fee schedule to 60 percent of the 2006 Medicare fee schedule.
Summary: This SPA makes technical corrections to identify how incontinence supplies are reimbursed which reflects current practice and aligns with the current Medicare Advantage contracts.
