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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: The purpose of this SPA is to cover two optional eligibility groups under managed care: children under age 19 with income between 196% and 318% who have third-party liability and the work incentive group, pursuant to section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, which is limited to individuals aged 65 years and older.
Summary: Revises the current inpatient hospital 30-day re-admission policy to exclude re-admissions that are planned for repetitive or staged treatments.
Summary: This SPA was submitted on May 24, 2016 to remove Attachment 3.1-F from the Iowa State Plan. This attachment had previously provided federal authority for the state to operate their MediPass and managed care programs through the Medicaid state plan.
Summary: This SPA was submitted on March 30, 2016 to revise the delivery system through which the Iowa Wellness Plan, Alternative Benefit Plan (ABP), is delivered to reflect the move to Statewide managed care.
Summary: This change will bring the state plan into conformity with the State's approved 1915(b) waiver, which outlines disenrollment rights. Enrollees can disenroll within the first 90 days of enrollment with an MCO, after the first 90 days.