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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 state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: This amendment proposes to add the requirement for Tier 2 and Tier 3 PCPlus practices to ensure the provision of community based Community Health Worker (CHW) services. It also includes minor methodological and operational updates.
Summary: This amendment proposes to extend Maine’s previously granted Recovery Audit Contractor (RAC) program exception from June 1, 2023, to June1, 2025
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.
Summary: Sets a new rate exception for Southern Maine Health Care, updates the supplemental payment pool for inpatient hospital services, and updates a supplemental payment pool for certain other hospital classes.
