Medicaid Policy Updates

Periodically Mississippi Division of Medicaid submits to CMS State Plan Amendments (SPA) and updates. You will find updates and plan amendments below. You can also find a complete list of SPAs at the State Plan Amendment page

The Division of Medicaid has submitted to the Centers for Medicare and Medicaid Services (CMS) the Access Monitoring Review Plan (AMRP) as of October 1,  2016 which can be accessed at this link: Access Monitoring Review Plan.

SPA 16-0010 All Patient Refined Diagnosis Related Groups (APR-DRG)
Mississippi State Plan Amendment (SPA) 16-0010 All Patient Refined Diagnosis Related Groups (APR-DRG) Reimbursement is being submitted to update the hospital inpatient payment methodology with an effective date of July 1, 2016.  This proposed SPA is to comply with approved SPA 2012-008.

SPA 16-0019 Hospital Reimbursement of Long-Acting Reversible Contraceptives (LARCs)
Mississippi State Plan Amendment (SPA) 16-0019 Hospital Reimbursement of Long-Acting Reversible Contraceptives (LARCs) is being submitted to allow the Division of Medicaid to reimburse for LARCs and their insertion at the time of delivery, outside of, and in addition to, the Diagnosis Related Group (DRG) base payment effective August 6, 2016.

SPA 16-0008 Primary Care Physician (PCP) Payment for Obstetricians and Gynecologists (OB/GYNs)
Mississippi State Plan Amendment (SPA) 16-0008 Primary Care Physician (PCP) Payment for Obstetricians and Gynecologists (OB/GYNs) proposes to reimburse certain eligible obstetricians and gynecologists for the provision of certain primary care services at one hundred percent (100%) of the Medicare Physician fee schedule or at the Mississippi regional maximum vaccine administration fee set by the Vaccines for Children program effective July 1, 2016. 

SPA 16-0017 Outpatient Prospective Payment System (OPPS)
Mississippi State Plan Amendment (SPA) 16-0017 Outpatient Prospective Payment System (OPPS) Update is being submitted to clarify the Medicare Ambulatory Payment Classification (APC) used to compute the observation code G0378 fee and the Medicare Average Sales Price (ASP) drug pricing file used to compute chemotherapy drug code fees effective July 1, 2016.

For more information contact:
Office of Policy
Office of the Governor, Division of Medicaid
550 High Street, Suite 1000
Jackson, MS 39201 Phone (601) 359-2081

Email: DOMPolicy@medicaid.ms.gov
Website http://www.medicaid.ms.gov