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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to allow for a one time supplemental payment of $500 to currently employed home care staff and another $500 retention bonus for remaining as a Medicaid home care worker for an identified six month period.
Summary: state adopts the "Katie Beckett" eligibility group, which serves children who have disabilities and are under the age of 19 and who will receive services in the community instead of an institution.
Summary: This amendment proposes changes to Maine’s Accountable Community Program, including updates to performance years, lead entity requirements, TCOC (Total Cost of Care) core service inclusions as well as member assignments clarifications.
Summary: This amendment proposes to increase payment rates for home health and private duty nursing services; allow nurse practitioners, clinical nurse specialists, and physician assistants to order home health services and complete required face-to-face visits; and allow required face-to-face visits to occur through telehealth when clinically appropriate.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to temporarily increase payment rates for state plan home and community-based services through quarterly supplemental payments based upon a percentage of Medicaid allowable paid claims in order to maintain a stable workforce and preserve services during the declared public health emergency.
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 expand telehealth, allow 90-day refills and expand prior authorization for medications, nursing home rate increase, reimbursements to certain providers for COVID-19 related expenses; increase therapeutic leave for individuals with IID/IDD living in ICFs, and waive automatic discharge from ICF after 30 hospital stay days.
Summary: The purpose of this SPA is to increase the reimbursement rates for Individual Providers, Agency Providers, and Adult Family Homes, and raise the Nursing Facility budget dial and swing bed rates.