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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: This amendment proposed to memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Connecticut's State Plan.
Summary: This amendment looks to implement updates to physician, medical clinic, DME/MEDS fee schedules, increase rates for Etonogestrel implant system LARC devices, add a code for monkeypox testing to select fee schedules, and update DME/MEDS fee schedule. This SPA also removes age limits for naturopath coverage and expands coverage for behavioral health clinicians to include associate practitioners.
Summary: 1)Incorporates federal HCPCS updates to Medical Clinic and Ambulatory Surgical Center fee schedules to remain compliant with
HIPAA; 2. Adds payment for specified drugs on Family Planning Clinic fee schedule; 3. As federally required by approved state
plan, updates physician-administered drug rates on Dialysis Clinic, Behavioral Health Clinic, and Medical Clinic fee schedules.
Summary: proposes updates to Attachments 3.1-A and 3.1-B of the Medicaid State Plan to update the Person-Centered Medical
Home Plus (PCMH+) program’s quality measures, which are used as part of the calculation methodology for the individual pool and challenge pool shared savings payments. These updates are necessary to reflect various changes to the measures by the applicable measure stewards. These changes include removing quality measures that have been retired, incorporating changes to the measures that have been made by the measure stewards, and updating measures to new stewards as appropriate.
Summary: Effective January 1, 2021, this plan amendment revises the Medical Clinic, Family Planning Clinic, Behavioral Health Clinic, Rehabilitation Clinic, and Ambulatory Surgical Center fee schedules.
Summary: Implements various program changes in Wave 3 of the PCMH+ program. This SPA also sets forth the total amount available for care coordination add-on payments to Federally Qualified Health Centers (FQHCs) participants for 2020 and 2021.