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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 SPA is to implement Community Care Teams (CCTs) to deliver health home services designed to address the whole-person needs to include assessment of the level of care coordination needs based on risk factors of adults and children with chronic conditions and polypharmacy and high emergency department utilization.
Summary: This SPA implements a health home for Medicaid beneficiaries with intellectual disabilities and a diagnosis of serious mental illness or autism.
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: Chronic Care Management for Individuals with Serious and Persistent Mental Health Conditions to expand the Behavioral Health Home to more geographic areas and update staffing requirements to allow flexibility for the required provider infrastructure.
Summary: To add an assessment fee to the Health Home program to ensure that any child who may be eligible for Home and Community-Based Services (HCBS) under the Children's Waiver, demonstration or State Plan authority will be eligible to receive an HCBS assessment under the Health Home program.
