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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 implement Community Care Teams (CCTs) to deliver health home services designed to address the whole-person needs to include assessment of the level of care coordination needs based on risk factors of adults and children with chronic conditions and polypharmacy and high emergency department utilization.
Summary: This amendment proposes to extend Maine’s previously granted Recovery Audit Contractor (RAC) program exception from June 1, 2023, to June1, 2025
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is, effective January 1, 2023, to rescind the temporary rate increases found in section E.2.b.i.I and the temporary rate increases and rate caps found in section E.2.b.i.J of Section 7.4 (approved on March 30, 2022, and effective January 1, 2022, in SPA number ME-22-0006) of the state plan.
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 SPA proposes reimbursement for providers of Personal Care Services (PCS) and Private Duty Nursing (PDN) services under the Early Periodic Diagnostic and Treatment (EPSDT) benefit will be set at the same rate as 1915(c) provider rates.
Summary: This SPA proposes a temporary rate increases for providers of personal care services (PCS) and private duty nursing (PDN) under the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
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.