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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 is to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that
Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Summary: To include coverage and reimbursement for gambling treatment provided to individuals receiving services from the Office of Addiction Services and Supports (OASAS) certified services, pursuant to 14 NYCRR Part 818 Chemical Dependence Inpatient Services, 14 NYCRR Part 820 Residential Addiction Rehabilitation Services, 14 NYCRR Part 822 Outpatient Addiction Rehabilitation Services, 14 NYCRR Part 825 Integrated Outpatient Addiction Rehabilitation Services and 14 NYCRR Part 857, with the OASAS gambling designation, when services are for gambling disorder/problem gambling only.
Summary: This plan updates the reimbursement methodology for clinic services and provides a rate increase for Children’s Behavioral Health Home-Based Rehabilitation Services.
Summary: This plan updates the reimbursement methodology for Physician Services, Laboratory Services, Medical Equipment, Devices and Supplies (MEDS), Dental, and Independent Radiology Services.
Summary: Effective July 1, 2022, this amendment proposes rate increases for privately owned and operated intermediate care facility for individuals with intellectual disabled (ICF/IID) services. Specifically, it provides for applicable fair rent increases, and a rate increase of 4.5% to support wage and benefit enhancements. The amendment also establishes a $501.00 per day minimum rate for eligible providers.
Summary: This amendment proposed to memorialize the new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Connecticut's State Plan.
Summary: State is implementing provisions approved in the 9817 ARPA Spending Plan, including reimbursement increases (rate increases, performance based supplemental payments, infrastructure payments); as well as expanding coverage provisions to continue services previously approved under disaster relief SPAs.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to 1. 3/1/20-12/31/22 removes annual cap on PCMH+ FQHC PMPM payments. 2. PCMH+ CY 2021 measurement year, removes specified challenge pool rule. 3. 7/1/22-9/30/22 increases specified 1915(i) CHCPE rates 5.2%. 4. ARPA sec. 9817 HCBS coverage expansions and rate increases for home health, 1915(i) CHCPE & CHESS, 1915(k) CFC.
Summary: This amendment proposes to allow the remote delivery of Crisis Services for Individuals with Intellectual and/or Developmental Disabilities (CSIDD) through telephonic or other technology in accordance with State, Federal, and Health Insurance Portability and Accountability Act (HIPAA) requirements. Other technology means any two way, real-time communication technology that meets HIPAA requirements.
Summary: This amendment proposes to expand Medicaid Harm Reduction Services for people who actively use drugs, provided at New York State Commissioner of Health waivered comprehensive harm reduction programs.
