Proposed State Plan Amendments
The State Plan Amendments below have been submitted to Centers for Medicare and Medicaid Services (CMS) for approval.
2024
MS SPA 24-0011 Affiliation Disclosures submitted to CMS
State Plan Amendment (SPA) 24-0011 Affiliation Disclosures is being submitted to comply with 42 C.F.R. § 455.107 requiring newly enrolling and revalidating providers to disclose affiliation information, effective October 1, 2024.
MS SPA 24-0015 Prescription Drugs submitted to CMS
State Plan Amendment (SPA) 24-0015 is being submitted to allow adults to receive above the monthly prescription limit when prior authorized as medically necessary and to allow for coverage of prescription drugs that are not covered outpatient drugs when medically necessary during drug shortages identified by the Food and Drug Administration (FDA), effective October 1, 2024.
MS SPA 24-0014 Diabetic Supplies submitted to CMS
State Plan Amendment (SPA) 24-0014 is being submitted to allow the Division of Medicaid (DOM) to reimburse certain diabetic equipment and supplies according to the reimbursement methodology for drugs when provided through the pharmacy venue, effective July 1, 2024.
MS SPA 24-0012 Value-Based Drug Rebate submitted to CMS
State Plan Amendment (SPA) 24-0012 is being submitted to allow the Division of Medicaid (DOM) to enter into value-based contracts with manufacturers on a voluntary basis, effective July 1, 2024.
MS SPA 24-0010 Presumptive Eligibility for Pregnant Women submitted to CMS
State Plan Amendment (SPA) 24-0010 is being submitted to allow the Division of Medicaid (DOM) to provide coverage of ambulatory prenatal care to women deemed presumptively eligible by a qualified provider, effective July 1, 2024.
MS SPA 24-0003 Physician Upper Payment Limit (UPL) submitted to CMS
State Plan Amendment (SPA) 24-0003 Physician Upper Payment Limit (UPL) is being submitted to allow the Division of Medicaid (DOM) to update the Medicare Equivalent of the average commercial rate (ACR) ratio and remove other professional practitioners, effective April 1, 2024.
2023
MS SPA 23-0005 Former Foster Care Eligibility submitted to CMS
State Plan Amendment (SPA) 23-0005 is being submitted to add coverage for individuals that were enrolled in Medicaid as former foster care children in any state, as required by Section 1002(a) of the SUPPORT Act, effective January 1, 2023.
2022
MS SPA 22-0033 Nursing Facility Level of Care submitted to CMS
State Plan Amendment (SPA) 22-0033 is being submitted to reflect needed updates and changes to the tool used to determine nursing facility level of care for beneficiaries prior to receiving long-term care services, effective October 1, 2022. The process to determine nursing facility level of care along with level of care requirements remain unchanged.