An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to (1) effective December 11, 2020, this SPA: (A) implements coverage of COVID-19 vaccine administration when provided by pharmacists, pharmacy interns, and pharmacy technicians, to the extent authorized pursuant to the PREP Act and (B) establishes reimbursement for COVID-19 vaccine administration at 100% of the Medicare rate for the pharmacy providers referenced above and on the applicable fee schedules (physician, home health agency, hospice, medical clinic, dialysis clinic, and family planning clinic); (2) effective from January 1, 2021 through February 28, 2021, implements a 2% rate increase for chronic disease hospitals; (3) effective from January 1, 2021 through February 28, 2021, implements a 5% rate increase for nursing homes and effective from March 1, 2021 through March 31, 2021, implements a 10% rate increase for nursing homes; and (4) clarifying language effective March 1, 2020 that (A) the coverage flexibility for laboratory services under 42 CFR 440.30(d) does not include self-collected COVID-19 tests for home use and (B) each laboratory testing code is priced at 100% of the applicable Medicare rate that is in effect on the date of service.
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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to remove the limit on the number of home and hospital bed leave days for which an ICF/IID can be paid in order to reserve the beds for when the individuals are able to return to the ICF/IID. This SPA also rescinds the flexibility approved in SPA CT-20-0015 that allowed PNMIs for adults to conduct only one random-moment time study (RMTS).
Summary: This SPA offers Medicaid eligibility pathway to certain individuals who meet the coverage requirements for the Connecticut Housing Engagement and Support Services (CHESS) Initiative State Plan Home and Community Based Services Benefit Pursuant to Section 1915(i) of the Social Security Act.
Summary: Effective August 6, 2021, this amendment adds the optional eligibility group of individuals who are eligible for state plan home and community-based services (HCBS) and meet the requirements for an approved section 1915(c) waiver. The amendment also offers a Medicaid eligibility pathway to certain individuals who meet the coverage requirements for the Connecticut Housing Engagement and Support Services (CHESS) Initiative State Plan Home and Community-Based Services Benefit Pursuant to Section 1915(i) of the Social Security Act.
Summary: Effective April 1, 2021, this amendment updates the physician office and outpatient fee schedule to incorporate various Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) from the most recent HCPCS quarterly update issued by CMS. Codes that are being added are being priced using a comparable methodology to other codes in the same or similar category.
Summary: Effective April 1, 2021, this amendment updates the DME fee schedule to incorporate the April 2021 Healthcare Common Procedure Coding System (HCPCS) changes to remain compliant with the Health Insurance Portability and Accountability Act (HIPPA). Newly added codes are priced using a comparable methodology to other codes in the same or similar category.
