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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: State is implementing provisions approved in the 9817 ARPA Spending Plan, including reimbursement increases (rate increases, performance based supplemental payments, infrastructure payments); as well as expanding coverage provisions to continue services previously approved under disaster relief SPAs.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to 1. 3/1/20-12/31/22 removes annual cap on PCMH+ FQHC PMPM payments. 2. PCMH+ CY 2021 measurement year, removes specified challenge pool rule. 3. 7/1/22-9/30/22 increases specified 1915(i) CHCPE rates 5.2%. 4. ARPA sec. 9817 HCBS coverage expansions and rate increases for home health, 1915(i) CHCPE & CHESS, 1915(k) CFC.
Summary: This SPA provides mandatory coverage for COVID-19 vaccines and vaccine administration, COVID-19 testing, and COVID-19 treatment including specialized equipment and therapies during the period through the last day of the first calendar quarter that begins one year after the last day of the public health emergency period.
Summary: Established coverage and reimbursement for a new Targeted Case Management (TCM) services for Integrated Care for Kids (InCK) in New Haven, CT. The target group is individuals under age 21 and those who are pregnant or up to twelve months postpartum residing in zip coded 0610 and 0611.
Summary: This amendment is to update the Alternative Benefit Plan (ABP) to expand coverage for naturopath services and behavioral health clinician services.
Summary: This amendment expands the coverage and payment for the use of Silver Diamine Fluoride (SDF) to all HUSKY Health (Medicaid) children and adults who receive dental services.
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.
