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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: Under this SPA, the State proposes to change the maximum prescription refills for a non-controlled drug from five refills with a six month expiration period to eleven refills with a one year expiration period. In addition, the State further defines the expiration date for valid prescriptions.
Summary: This amendment inserts language into the State plan concerning a nursing ho,e patient paid amount deduction for non-covered, necessary remedial care expenses in the three months prior to eligibility.
Summary: This SPA transmitted a proposed amendment to Maine's approved Title XIX State plan to amend its State Plan so that the State can be in compliance with the mandatory provision in Section 2302 of the Patient Protection and Affordable Care Act (PPACA), entitled Hospice Care for Children. Section 2302 requires that children are able to receive hospice and curative care concurrently.
Summary: Decreases the estimated acquisition cost from average wholesale price minus 10.25 percent to AWP minus 13.1 percent for dates of service beginning on July 1, 2011.
