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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: The purpose of this SPA to implement mandatory coverage and reimbursement of COVID-19 testing, vaccine and vaccine administration, and treatment in accordance with Section 9811 of the American Rescue Plan (ARP) Act.
Summary: This BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to adjust rates for Therapeutic Communities.
Summary: CMS is approving this time-limited state plan amendment to allow the state to implement temporary policies while returning to normal operations after the COVID-19 national emergency. The purpose of this amendment is to provide a lump sum payment to Home and Community Based Providers for services provided during the PHE and can be used for hiring, longevity, and complex care longevity bonuses.
Summary: To clarify plan language in connection with recent federal guidance. This SPA has been submitted as related to Inflation Reduction Act of 2022 temporary, 5-year increase for for physician administered biosimilars drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).
Summary: This plan amendment updates the reimbursement methodology for physician services to align payment for topical fluoride varnish with the applicable dental service reimbursement methodology.
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 rescind the increased reimbursement for gloves used in home services in AR-21-0002.