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Medicaid State Plan Amendments

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.

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Transmittal Number: CT-16-018
State: Connecticut
Summary: Authorizes supplemental payments to specified acute care hospitals in the amount of $105.7 million for state fiscal year 2017.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: CT-17-0001
State: Connecticut
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.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: CT-17-0002
State: Connecticut
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.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: KS-16-015
State: Kansas
Summary: This SPA added two new services under the Early and Periodic Screening Diagnosis and Treatment (EPSDT) section of the state plan.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
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Transmittal Number: CT-16-0034
State: Connecticut
Summary: Revises the durable medical equipment fee schedule concerning repairs and modifications of customized wheelchairs.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
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Transmittal Number: CT-12-011
State: Connecticut
Summary: To revise the reimbursement methodology for medical clinics, mental clinics and substance abuse.
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Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CT-16-0014
State: Connecticut
Summary: This SPA adds the following services: Behavioral Modification, Personal Care services, and SBCH services included in a Section 504 plan.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: CT-13-024
State: Connecticut
Summary: To amend the fee schedule for mental health and substance abuse clinics to reimburse those clinics for providing group counseling for tobacco cessation.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CT-16-0030
State: Connecticut
Summary: This amendment was submitted to reduce payment rates for children's dental services by two percent.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: CT-16-0028
State: Connecticut
Summary: This amendment was submitted to reduce payment rates for four procedure codes for dental crowns and for periodic orthodontic services for adults by one percent.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT