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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 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: Provides supplemental payments to St. John’s Riverside hospital and St. Joseph’s Medical Center under the state’s Vital Access Provider (VAP) program.
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 revise the provisions governing Medicaid Administrative Claiming for Early and Periodic Screening, Diagnostic and Treatment services provided by local education agencies, by waiving the second and third quarter 2020 time studies and using the four most recent time study results to calculate the time study percentage used in the 2020 and 2021 cost reports.
Summary: This amendment proposes to allow the Mississippi Division of Medicaid to make the following modifications to the Mississippi State Plan: (1) update coverage reimbursement of targeted case management (TCM) in order to align with the regulations at 42 CFR §§ 440.169 and 441.18; (2) update the fees for TCM for high-risk pregnant women to align with the fees in effect on July 1, 2021; and (3) remove the five percent reimbursement reduction effective July 1, 2021.
Summary: This plan amendment provides an update the methods and standards used by Massachusetts to determine rates of payment for renal dialysis clinic services. The proposed amendment adds a cost adjustment factor (CAF) of 5% to the portion of the bundled rate for dialysis procedures only, resulting in the proposed bundled rate of $185.18
Summary: This plan amendment provides updates to the rate of payment for hearing services. This SPA is making changes to (1) increase rates for certain hearing services covered by an adjustment of 9.66%; (2) incorporate certain cochlear implant device related services and increase these rates by an adjustment of 9.66%; and (3) establish service-specific codes and rates for bone-anchored hearing aid (BAHA) services.
Summary: Allows the Division of Medicaid (DOM) to set the fees for DPSDT extended services to the same as those in effect on July 1, 2020, to remove the five percent (5%) reimbursement reduction effective July 1, 2021, and add coverage and reimbursement of Mississippi Youth Programs Around the Clock (MYPAC) Therapeutic Services effective July 1, 2021.
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 1) Add emergency medical technicians (EMTs) to administer COVID-19 vaccinations, 2) Revise reimbursement to 100% of the Medicare rate for vaccine administration and 70% of the Medicare rate for testing services and telehealth, 3) Provide a one-time supplemental payment of $14,607,582.00 to behavioral health services providers, and 4) Add Code G2025 for RHC/FQHC telehealth services