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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 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: To remove information related to a "Reasonable Eligibility Period" eligibility pilot that the state implemented from July 1, 2018, through June 30, 2019. SPA 21-0022 will remove the pilot information from the Medicaid State Plan.
Summary: This SPA proposes to expand the full continuum of substance use disorder care by increasing access to certain services to beneficiaries diagnosed with a substance use disorder.
Summary: Effective August 1, 2021, this amendment corrects an error regarding the required frequency of contacts between targeted case managers and beneficiaries.
