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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: Eliminates changes made by PR SPA 20-0011 and documents that the Puerto Rico Local Poverty Level will return to the levels in effect prior to SPA 20-0011
Summary: Establishes an alternative payment methodology for Rural Health Clinics based on 100% of the average of the reasonable cost of providing MaineCare-covered services during calendar years 2016 and 2017
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 coverage of Remdesivir and Convalescent Plasma therapy treatment for hospitalized patients with confirmed or suspected COVID-19.
Summary: Increase reimbursement rates for certain psychiatric medication management services and home and community-based behavioral therapy service rates
Summary: Updates the reimbursement methodologies for Multisystemic Therapy (MST), Multisystemic Therapy for Problem Sexualized Behaviors (MST-PSB), and
Functional Family Therapy (FFT) in order to reflect requirements for the evidence-based models, and to change the unit of service from a quarter-hour to a week.
