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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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Showing 111 to 120 of 570 results
Transmittal Number: ME-22-0044
State: Maine
Summary: This amendment proposes to comply with Electronic Visit Verification System (EVV) requirements by January 1, 2023, in accordance with Section 12006 of the 21st Century CURES Act.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: MD-22-0025
State: Maryland
Summary: This amendment rebases the rate for Residential Treatment Centers to $850 per day, updated annually based on CMS published market basket increase percentage relating to hospitals.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0034
State: Maine
Summary: This plan amendment authorizes a 4.9% rate increase for Family Planning and Supplies

services that do not have a Medicare rate.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0029
State: Maine
Summary: This plan amendment updates the reimbursement methodology for physician services,

family planning and supplies, nurse-midwife services, and nurse practitioner services to the lower

of provider charges or 72.4% of the current corresponding Medicare rate, updates the fee schedule

for those services not covered by Medicare, and removes outdated provisions related to the

Primary Care Case Management (PCCM) program.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0031
State: Maine
Summary: This plan amendment authorizes a 4.9% rate increase for Home Health Care services and Medical Social services.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0036
State: Maine
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 provide add-on payments for services rendered by family planning agency providers.
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Reimbursement
Links:
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Transmittal Number: ME-22-0039
State: Maine
Summary: Effective July 1, 2022, this amendment implements an add-on component to enable nursing facilities to cover labor costs for essential support workers to equal at least 125% of the state minimum wage, plus related taxes and benefits. The amendment also eliminates the requirement for base-year direct and routine aggregate costs per day to be less than the median aggregate direct and routine allowable costs for a facility’s peer group, so that all facilities with MaineCare days constituting more than 80% of total days across all payers will receive a High MaineCare Utilization Payment of $0.60 per diem for each one percentage (1%) of MaineCare days above 80%.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: MD-22-0023
State: Maryland
Summary: For dates of service beginning August 1, 2022, the Department is establishing reimbursement methods for vaccine administration for federally purchased vaccines to adults (e.g. COVID-19). MDH is providing payment for administration of monkeypox and/or smallpox vaccinations at a rate of $23.28 per dose.
Approval Date:
Effective Date:
Topics:
  • Reimbursement
Links:
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Transmittal Number: ME-22-0023
State: Maine
Summary: This SPA updates Maine’s Medicaid application on paper and online.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
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Transmittal Number: ME-22-0042
State: Maine
Summary: This amendment proposes to adjust the Accountable Communities (AC) total cost of care (TCOC) reconciliation for year seven (PY7), which covers August 2020 through July 2021.
Approval Date:
Effective Date:
Topics:
  • Coverage
  • Reimbursement
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT