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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: The SPA uses American Rescue Plan Act (ARPA) reinvestment funds to establish peer recovery support services in SUD setting in alignment with behavioral health priorities and stakeholder response. This SPA also removed the waiver requirement for prescribing buprenorphine for opioid use disorder based on the federal Drug Enforcement Agency (DEA) Announcement.
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.
Summary: This amendment rebases the rate for Residential Treatment Centers to $850 per day, updated annually based on CMS published market basket increase percentage relating to hospitals.
Summary: For dates of service beginning August 1, 2022, the Department is establishing reimbursement methods for vaccine administration for federally purchased vaccines to adults (e.g. COVID-19). MDH is providing payment for administration of monkeypox and/or smallpox vaccinations at a rate of $23.28 per dose.
