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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 BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.
Summary: This SPA is to amend the provisions governing the Home Health Program in order to increase the number of medical professionals that can order home health services.
Summary: This SPA makes changes to the definition of home with settings in which normal life activities take place to better align the language with CMS regulations from 2017, and was originally approved on December 1, 2021.
Summary: This amendment removes Prior Authorization Request requirements for Home Health Services. Additionally, the SPA allows practitioners to order and re-order that the patient is eligible for Medicaid Home Health Services.
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 update housing supportive services provider qualification criteria, provide reimbursement for retroactive provider rate changes, to increase the personal needs allowance, and to waiver pharmacy signature requirements.
Summary: This SPA proposes to amend the pharmacy page's provision to cover all prescriptions for FDA-approved oral contraceptives for up to a 12-month supply at one time.
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 waive any signature requirements for the dispensing of drugs effective 3/1/2020.
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 waive any signature requirements for the dispensing of prescription drugs for the duration of the COVID-19 Public Health Emergency.
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 waive the counseling signature requirements for the dispensing of drugs during the COVID-19 Public Health Emergency.
