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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to increase the reimbursement rates for the COVID-19 Vaccine to 100 percent of the Medicare reimbursement rate ($40.00 per dose) beginning April 1, 2021 through the end of the Public Health Emergency.
Summary: This amendment proposes to update the following hospital inpatient services effective July 1, 2021: 1) Update APR-DRG parameters, 2) use cost-to-charge (CCRs) ratios in effect July 1, 2021 to calculate outlier payments for claims with last dates of service on or after July 1, 2021, and 3) remove language that intensive outpatient programs and partial hospitalization programs are not covered in the outpatient hospital setting.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is a payment rate increase for personal care assistance services.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to reimburse all Mississippi Medicaid pharmacies, physicians, and non-physician practitioners 100% of the Medicare rate for the administration of an FDA-approved COVID-19 vaccine. The Division of Medicaid will reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) outside of the PPS rate for administering the COVID-19 vaccine at 100% of the Medicare rate only if there is no corresponding encounter. If there is an encounter, administration of the COVID-19 vaccine is reimbursed as part of the encounter rate.
Summary: Updates the bundled composite rate for services provided in an outpatient maintenance dialysis clinic. The Dialysis Clinic reimbursement rate will be increased 1.83% per legislative appropriation.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is a rate increase for procedures performed by Ground Ambulance providers effective July 1, 2020 through September 30, 2020.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to implement a Specialized COVID - 19 Behavioral Health Long Term Care Bed Rate.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to suspend the collection of data for performance measures other than those identified for the Health and Welfare assurance for the Section 1915 program and notes that the data will be unavailable for this time frame in ensuing reports due to the circumstances of the pandemic.
Summary: Updates reimbursement rates for medical supplies and durable medical equipment as part of the 21st Century Cures Act. Additionally, it adds coverage of specialty modified low protein foods and their reimbursement methodology.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to provide a per diem increase to nursing facility and HIV nursing facility per diem reimbursement rates of ten dollars and eighteen cents ($10.18) effective for dates of service July 1, 2021 through June 30, 2022.
