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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 is to update the Alternative Benefit Plan to implement coverage for substance use disorder services under the rehabilitative services benefit category for services provided in outpatient and residential settings, as required by sections 1905(a)(13)(c) of the Social Security Act.
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 waive state rule beneficiary signature requirements for outpatient Rx drug pickup/delivery from 4/4/20-5/20/21. Add a $500 add-on per ventilation bed day to chronic disease hospital per diem rate from 10/1/21-6/30/2022 and add COVID vaccination administration reimbursement for dentists 12/11/20 through the end of the PHE and for hygienists from 12/11/20-4/14/22.
Summary: Effective January 1, 2022, SPA CT-22-0011 amends the Alternative Benefit Plan to implement mandatory coverage of routine patient costs furnished in qualifying clinical trials, as required by sections 1905(a)(30) and 1905(gg) of the Social Security Act.
Summary: This amendment to the Medicaid State Plan updates the Alternative Benefit Plan (ABP) State Plan to reflect the restoration of coverage for chiropractic services and addition of coverage for acupuncture services.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to rescind the flexibilities in which the state authorized a 90-day supply of medication other than controlled substance medications and allowed prescription refills when 80% or more of the prescription was used.
Summary: This amendment updates CT Alternative Benefit Plan (ABP) to reflect several updates to behavioral health services, including removing the requirements for registration for all routine outpatient behavioral health. This SP A also updates the ABP to reflect the resumption of authorization for intensive outpatient
services and removal of authorization for electroconvulsive therapy.
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 cover the new optional group for COVID testing, expand coverage to certain 1915, 1915(k), home health, laboratory and telehealth services, adjust prior authorizations for medications, and increase certain payment rates.
Summary: Incorporates various 2020 Healthcare Common Procedure Coding System (HCPCS) updates (additions, deletions and description changes) to the Physician Office & Outpatient, Physician-Radiology, Physician-Surgery, and Psychology fee schedules. In addition, there are updates to the reimbursement methodology for specified drugs in order to comply with the approved Medicaid State Plan methodology for physician-administered drugs
Summary: Changes the requirement for prescription refills to provide that a refill is allowed without prior authorization when the patient has consumed at least 93 percent of the original or latest refill prescription.
