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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 SP A is to amend the provisions governing the federal medical assistance percentage (FMAP) to establish a proxy methodology to account for the proportion of medical assistance expenditures for beneficiaries receiving extended postpartum coverage.
Summary: This amendment proposes to change provider requirements for community mental health centers, adds coverage of prophylaxis under the state’s dental benefit, allows for 90-day coverage of maintenance medications, and adds weight loss drugs to the state’s prescription drug formulary.
Summary: This amendment proposes to implement temporary policies, which are different from those policies and procedures otherwise applied under your Medicaid state plan, during the period of the Presidential and Secretarial emergency declarations related to the COVID- 19 outbreak (or any renewals thereof).
Summary: This amendment updates the state plan to reflect that Brokered Non Emergency Medical Transpo1iation (NEMT) Services are now provided through two Regional Transit Authorities.
Summary: This amendment proposes changes to incorporate language based on provisions for Medicaid non-emergency medical transpo1iation (NEMT) services added to Section 1902(a)(87), Title XIX of the Social Security Act, as part of the Consolidated Appropriations Act, 2021.
Summary: This amendment proposes to add four types of clinicians to the providers qualified to provide core services in Federally Qualified Health Centers: licensed certified social workers, licensed professional counselors, licensed mental health counselors, and licensed marriage and family therapists.
Summary: This amendment proposes to update the third-party liability and the Health Insurance Premium Payment program (HIPP) sections of the state plan.
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.
