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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 remove Long Acting Reversible Contraceptives (LARC) from the Federally Qualified Health Centers (FQHC) PPSrate and reimburse the LARC under FFS.
Summary: This SPA is to remove Long Acting Reversible Contraceptives (LARC) from the Rural Health Centers (RHC) PPS rate and reimburse the LARC under FFS.
Summary: This Amendment corrects the State plan regarding the state's payment of Medicare Part A and B deductibles and cost-sharing on Medicare crossover claims.
Summary: This SPA amends Attachment 4.19-B of the State Plan to reimburse at 95% of the calculated 2014 Medicare physician's fee schedule facility and non-facility rates for specified primary care services and vaccine administration provided under the Vaccines for Children program. This SPA is an increase from the previous level, which reimbursement at 90% of the calculated 2014 Medicare physician fee schedule for facility and non-facility rates.
Summary: Adds the following procedure code to the home health fee schedule: GO 162 - Skilled services by a registered nurse for management and evaluation of the plan of care; each 15 minutes.
Summary: Makes supplemental payments to the University of Connecticut (UConn) Health Center's physician group (which is the state-owned physician group that is affiliated with an academic medical center) for physicians' services provided to Medicaid members.
Summary: This amendment re bases Nursing Facility and Nursing Facility for Mental Health payment rates for State fiscal year 2018. Payment rates will increase on average by 4. 76 percent. This SPA also updates charts and exhibits within the State plan that demonstrate the revised factors and limits applicable to the rate period beginning with SFY 2018.
Summary: This amendment updates the plan to reflect the State's current policy of allowing inpatient hospital interim bills for inpatient hospital stays that exceed 30 days.
Summary: This amendment reverses the 4.00% rate decrease that was applied to fee-for-service inpatient hospital payment rates other than Diagnosis Related Group (DRG) outlier payment rates on July 1, 2016 for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.
