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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.


MS SPA 19-0018 Treatment of Resources
State Plan Amendment (SPA) 19-0018 Treatment of Resources is being submitted with a proposed effective date of July 1, 2019. SPA 19-0018 will allow qualified Medicaid eligibles who are receiving Social Security Income (SSI) benefits, and are under the age of nineteen (19), to continue to exclude two (2) automobiles. Those qualified beneficiaries that are over the age of nineteen (19) will only exclude one (1) automobile.

MS SPA 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement
State Plan Amendment (SPA) 19-0020 All Patient Refined-Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to make the following changes, effective July 1, 2019: 1) The following APR-DRG parameters will be updated for discharges on and after July 1, 2019: The base price will change from $6,585 in State Fiscal Year (SFY) 2019 to $6,574 in SFY 2020, which represents a 2.5% increase over the SFY 2018 base price, and the DRG cost outlier threshold will change from $45,000 to $47,000. 2) Clarify language regarding the issuance of public notices, and 3) Update transplant case rates and post the transplant case rates on the Division of Medicaid’s Fee Schedule webpage.