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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 SPA amends Attachment 4.19-8 of the State Plan in order to increase fees for injectable codes (J codes and certain A, S and Q codes) to I 00% of the applicable April 2013 Medicare fee for physicians, mid-level practitioners (nurse practitioners, physician assistants, certified nurse-midwives, and pediatric and family nurse practitioners) and medical clinics.
Summary: Changes the requirement for prescription refills to provide that a refill is allowed without prior authorization when the patient has consumed at least 93 percent of the original or latest refill prescription.
Summary: Authorizes supplemental payments to qualified small independent acute care hospitals in the amount of $11.8 million for state fiscal year 2017.
Summary: This SPA is an amendment to Connecticut' s approved Title XIX Medicaid State plan to renew the home and community-based services benefit under Section 1915 (i ) of the Social Security Act for individuals 65 and older who meet the needs-based and financial eligibility criteria in the approved SPA.
Summary: This proposed SPA transmitted an amendment to the coverage and reimbursement sections of Connecticut' s approved Title XIX State plan to establish the PCMH + program. The PCMH+ program is being added as an Integrated Care Mode l within section I 905(a)(29) of the Social Security Act (Act). The PCM H+ program also involves shared savings payments and care coordination add-on payments for primary care case management services, as defined by section l 905(t) of the Act.
