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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 reduces the inpatient hospital supplemental payment pool amount among privately owned Acute Care Non\u00ADCritical Access hospitals, hospitals reclassified to a wage area outside Maine by the Medicare Geographic Classification Review Board and Rehabilitation hospitals.
Summary: This revises reimbursement for inpatient hospital services. Specifically it: 1) adds reimbursement for Long Active Reversible Contraceptives (LARC) during postpartum inpatient hospital stay to provide adequate reimbursement to provider for the device; 2) changes data used to calculate Prospective Interim Payment (PIP) to provide more accuracy; and 3) further revises the state's fourteen day readmission protocol which was approved under TN 14-0003 and further amended under TN 15- 0010.
Summary: UPDATED 11/17/2020 - The approved page inadvertently contained a typographical error in describing Private Duty Nursing Level IV reimbursement at $11,570 per month—the correct reimbursement amount of $1,570 per month is included in the attached pages. The official approval date remains May 24, 2018.
