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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: Incorporate the 2019 Healthcare Common HCPCS changes to the Independent Radiology and Independent Laboratory fee schedules to remain compliant with HIPPA as well as adding 49 new molecular pathology codes and 2 chemistry codes to the Independent Laboratory fee schedule.
Summary: Revises the fee scheudles for the Ambulatory Surgical Centers, Dialysis Clinics, Family Planning Clinics, Medical Clinics, Private Behavioral Health Clinic and Rehabilitation Clinics.
Summary: To remove the requirement for prior authorization for non-emergency ambulance transports within Connecticut.his includes border transportation providers who are routinely accessed and treated as the closest provider due to their proximity to Connecticut. All non-emergent ambulance transports to and from or within a state other than Connecticut must be authorized in advance.
Summary: Amends Attachment 4.19-B of the Medicaid State Plan to incorporate the 2019 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Medical Equipment, Devices and Supplies (MEDS) and Early Intervention Services (EIS) pursuant to Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services fee schedules.
