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Proposed State Plan Amendments

Proposed State Plan Amendments

The State Plan Amendments below have been submitted to Centers for Medicare and Medicaid Services (CMS) for approval.

2019

MS SPA 19-0004 Prescription Drug Limit Increase
State Plan Amendment (SPA) 19-0004 Prescription Drug Limit Increase is being submitted to allow the Division of Medicaid to increase the prescription drug limit from five (5) to six (6) per month, effective July 1, 2019.

MS SPA 19-0014 Utilization Review (UR) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs)
State Plan Amendment (SPA) 19-0014 Utilization Review (UR) in Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs) is being submitted to allow the Division of Medicaid to change control of the utilization of ICF/IIDs from the Mississippi State Department of Health (MSDH) to the contracted Utilization Management/Quality Improvement Organization (UM/QIO), effective September 1, 2019.

2018

SPA 18-0015 Disproportionate Share Hospital (DSH) Payments 
State Plan Amendment (SPA) 18-0015 Disproportionate Share Hospital (DSH) Payments has been submitted to update the hospital DSH program effective October 1, 2018:
1. To clarify: a) The treatment of hospital assessments on hospital cost reports according to the entire Section 2122 of the Medicare Provider Reimbursement Manual 15-1,
b) Medicaid costs include Graduate Medical Education (GME) approved program costs in DSH calculations, c) Medicaid costs do not include costs associated with services covered by another third-party payer, including Medicare. When Medicaid eligible patients have access to coverage from another party, payments may be used as a proxy for cost offsets when calculating the Medicaid payment shortage or overage, d) The DSH payment period is from October 1 through September 30. The determination of a hospital DSH status is made annually for hospitals that meet the DSH requirements as of October 1, and 2. Add Section 5-6, Revised Allotments, which describes the treatment of revised DSH allotments.

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