Medicaid State Plan Amendments

This amendment proposes to extend Maine’s Recovery Audit Contractor (RAC) program exception from June 1, 2025, through May 31, 2027.

This plan amendment is amending its State Plan to implement a quality program funded by the provider assessment and clarifying how payment for ancillary services is part of the per diem rate.

This plan amendment updates the total inpatient pool amounts for the Total Critical Access Hospital (CAH) Supplemental Pool and the Total Acute Care Hospital (ACH) Supplemental Pool.

The purpose of this plan amendment is to add a Prospective Payment System (PPS) and an Alternative Payment Method for Provider Based Rural Health Clinics (PBRHCs).

This amendment was submitted to update section 7.2 Nondiscrimination and 7.4 State Governor’s review pages.

The purpose of this State Plan Amendment (SPA) is to enhance the Nursing Facility Services sections for both the Nursing Facility and IMD over 65 benefits by adding clarifying language to the authorization process. The SPA also removes obsolete language and adds language for both the Nursing Facility and IMD over 65 benefits (including IMD over 65 inpatient hospital services) to update terminology and demonstrate adherence to federal and state requirements.

This plan amendment updates base per diem rates, makes provisions for new and existing supplemental payments. It also makes technical edits to existing supplemental payments.

This plan amendment makes changes to reimbursement for nursing facility services. Changes include updates to specified cost adjustment factors and establishment of new add-on and supplemental payments.

The purpose of this SPA was to update the effective date of the fee schedules for several Medicaid services.

This plan amendment updates the payment rate and rate methodology for the Pediatric Care Facility Special Reimbursement Class of Nursing Facilities.