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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 2016 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology fee schedule to remain compliant with the Health Insurance Portability and Accountability Act (HIPAA).
Summary: This SPA amends Attachment 4.19-B to incorporate various 2016 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the physician fee schedule.
Summary: This SPA amends Attachment 4.19-B of the Medicaid State Plan to implement: (1) a Medicaid rate increase to the ambulatory payment classification (APC) conversion factor for acute care general hospitals and (2) Medicaid supplemental payments for outpatient hospital services to specified acute care hospitals.
Summary: Plan to continue supplemental payments to the state government owned and operated hospital. The supplemental payments were initially implemented effective July 1, 2016, as part of the change to a reimbursement methodology using an ambulatory payment classification (APC) system based on Medicare's system but modified for Connecticut's Medicaid program.
Summary: Implements inpatient supplemental payments for inpatient hospital services to small independent hospitals in the amount of $12.85M for FY 2018 and FY 2019 separately.
Summary: Implements inpatient supplemental payments for inpatient hospital services to specified acute care hospitals in the amount of $435.2M for state fiscal yr 2018 and $353.5M for FY 2019.
Summary: This amends the State plan to make various changes to the reimbursement of chemical maintenance clincis including:pro-rating the weekly rate to account for weeks in which services are provided on fewer than seven days in the week, specifying in detail the services that are included in the rate, and providing for specific types of documentation regarding the services that are provided.
Summary: This amendment revises reimbursement for inpatient hospital services to implement a pay for- performance (P4P) program for children age seventeen and under at any private psychiatric hospital in Connecticut, which is c currently only Natchaug Hospital.