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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 SPA, in accordance with Section 115 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPP A), exempts from the Medicaid estate recovery process the Medicare cost sharing benefits paid by the Medicaid program under the Medicare Savings Program for categories of Medicare and Medicaid dual eligibles aged 55 and older, with dates of service on or after January 1, 2010.
Summary: This SPA ensures compliance with the Qualifying Individual Program Supplemental Funding Act of 2008, whereby the State has an eligibility determination system that provides for data matching with medical assistance programs operated by other States in order to prevent duplicate enrollments.
Summary: Modify the Medicaid School-based Child Health Services reimbursement from state aggregated cost-based rates for evaluation and monthly services to a local educational agency service-specific methodology.
Summary: This SPA transmitted a proposed amendment to Connecticut's approved Title XIX State Plan to change the payment methodology pertaining to physician's radiology by eliminating payment of the technical and professional components at 50% of the global component.
Summary: This SPA transmitted a proposed amendment to Connecticut's approved Title XIX State Plan to allow the State to negotiate supplemental rebates for covered outpatient drugs to Connecticut's Medicaid beneficiaries using The Optimal PDL $olution (TOP$) multi-State supplemental rebate agreement (SRA).
Summary: This amendment modifies the methods and standards for making Medical Assistance payments to nursing facilities (NFs). Specifically, this SPA increases NF reimbursements by reducing the net reduction factor applied to select cost centers used in developing rates and implements a supplemental payment using quality indicators to formulate the payments.
Summary: This SPA defines the States coinsurance payment for Part B claims for all dual Medicare and full Medicaid covered individuals and Qualified Medicare Beneficiary-only individuals.
Summary: This amendment adds a new provision for inpatient psychiatric services. Specifically, it establishes rates for acute psychiatric care in general hospital psychiatric units for individuals requiring extended care.
