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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 plan amendment allows Connecticut to increase emergency and non-emergency ambulance rates by 10% (excluding the mileage rate) and increase the ambulance mileage rates for all emergency and non-emergency transports by $3.00.
Summary: This plan amendment makes the following changes: increases the rate for pediatric complex care skilled nursing services provided by home health agencies by l. 7%, reduces the rates for diabetic test strips and lancets on the medical/surgical supplies fee schedule to l00% of the current Medicare rates, and reduces specified soft quantity limits for certain procedure codes within the medical/surgical supplies, durable medical equipment (DME), and prosthetic/orthotic fee schedules.
Summary: This plan amendment allows Connecticut to make the following changes: increase rates for nurse-midwife and podiatrist services to 100% of the applicable physician rates, add select vaccines to the physician office and outpatient and medical clinic fee schedules, incorporate quarterly Healthcare Common Procedure Coding System (HCPCS) updates to the physician office and outpatient and medical clinic fee schedules, and update specified performance measures for the supplemental reimbursement for obstetrical services.
Summary: This plan amendment makes the following changes: increases the rate for pediatric complex care skilled nursing services provided by home health agencies by 1.7%, reduces the rates for diabetic test strips and lancets on the medical/surgical supplies fee schedule to 100% of the current Medicare rates, and reduces specified soft quantity limits for certain procedure codes within the medical/surgical supplies, durable medical equipment (DME), and prosthetic/orthotic fee schedules.
Summary: permits IHS and Tribal facilities to claim Medicaid reimbursement under the FQHC services benefit, including the IHS All Inclusive Rate, provided outside the “four wall” of the facility.
Summary: Updates the Alternative Benefit Plan (ABP) State Plan to include the CHESS program approved in SPA 21-0001 which improve housing stability and health outcomes for a targeted set of Medicaid members who meet specified needs-based criteria, including individuals who have complex health conditions, have experienced homelessness, and have been determined to be likely to benefit from targeted tenancy sustaining services based on risk factors.
Summary: This SPA changes the total funding of the Iowa State-Owned Hospital payment to $0.00 resulting from the implementation of the managed care state-directed payment to the Iowa State-Owned Hospital.
