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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 amendment provides for a 4.00% reduction in inpatient hospital payment rates other than Diagnosis Related Group (DRG) and DRG outlier payment rates for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.
Summary: This amendment provides for a 4.00Yo reduction in intermediate care facility for individuals with intellectual disabilities (lCF/IID) payment rates.
Summary: This amendment provides for a 4.00% reduction in inpatient hospital Diagnosis Related Group (DRG) outlier payment rates for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.
Summary: Under this SPA, outpatient hospital services are reimbursed using an ambulatory payment classification (APC) system based on Medicare's system but modified for Connecticut's Medicaid program.
Summary: Updates the reimbursement methodology for autism spectrum disorder (ASD) services, allowing for a wider range of medically necessary ASD services to be reimbursed.
Summary: Updates the Physician Radiology Fee Schedule by removing Current Procedural Terminology (CPT) codes: 77061 (Digital breast tomosynthesis; unilateral), 77062 (Digital breast tomosynthesis; bilateral) and 77063 (Screening digital breast tomosynthesis, bilateral).
Summary: Increases the fee for Healthcare Common Procedure Coding System HCPCS billinb code 17302 (Levonorgestrel-releasing intrauterine contractaceptive system.
