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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 amendment includes Long-Term Care Facility Reimbursement for services outlined within the State Plan. The amendment updates provisions as authorized in the State's General Appropriation Act for Fiscal Year 2021-22 and makes technical and editorial changes.
Summary: Establishes a new level of reimbursement for Medicaid-eligible individuals who have severe behavioral needs residing in or seeking admission to Intermediate Care Facilities for Individuals with Developmental Disabilities (ICFs/IID), updates buy-back provisions for ICFs as authorized in the State’s Fiscal Year 2021-22 General Appropriations Act, and makes technical / editorial changes.
Summary: This amendment proposes changes to Maine’s Accountable Community Program, including updates to performance years, lead entity requirements, TCOC (Total Cost of Care) core service inclusions as well as member assignments clarifications.
Summary: This amendment proposes to increase payment rates for home health and private duty nursing services; allow nurse practitioners, clinical nurse specialists, and physician assistants to order home health services and complete required face-to-face visits; and allow required face-to-face visits to occur through telehealth when clinically appropriate.
Summary: This amendment proposes to (1) clarify the different types of encounters when reimbursement is made for more than one encounter performed on the same days; (2) adds requirements for Federally Qualified Health Centers (FQHC) mobile units; and (3) adds language to refer to Attachment 3.1-A Introductory Pages for coverage of telehealth services to be in compliance with the Mississippi Code Annotated as amended by Senate Bill 2799, effective July 1, 2021.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to add an Intensive Outpatient rehabilitation benefit for youth with serious emotional disturbance (SED).
Summary: This plan amendment was submitted to allow the Division of Medicaid (DOM) to 1) set the fees for medication assisted treatment services the same as those in effect April 1, 2021, and 2) remove the five percent (5%) reimbursement reduction effective July 1, 2021.
