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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: To implement discounts of claims with more than one significant procedure and compute a Mississippi Medicaid fee when a procedure's Ambulatory Payment Classification rate including all of its bundled services, is determined to be insufficient for the Mississippi Medicaid population effective June 1, 2015.
Summary: Proposes to add clarifying language regarding properly reimbursement calculations for the following facilities: Alzheimer's Unit, Nursing Facilities for the Severely Disabled, Intermediate Care Facilities for Individuals with intellectual Disabilities and Psychiatric Residential Treatment Facilities.
Summary: To modify the State's reimbursement methodology. Specifically, this amendment remove the UPL program and all related language in the state plan.
Summary: Implement changes to the current reimbursement methodology for nursing facilities, psychiatric residential treatment facilities and intermediate care facilities for individuals with intellectual disabilities.
Summary: Provides supplemental payment for physicians and other professional services practitioners who are employed by a qualifying hospital for services rendered to Medicaid recipients in compliance with the Social Security Act.
Summary: This SPA increases primary care provider payment for primary care services that was required by Section 1202 of the Affordable Care Act during 2013 and 2014.
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 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: 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.