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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: Through this SPA, the state modifies its income levels in both its separate CHIP and title XXI funded Medicaid expansion program for children from ages 0 to 1.
Summary: This amendment is to conduct Medicaid presumptive eligibility (PE) determinations. PE groups: children under age 19, parents and other caretaker relatives, pregnant women, adults, and former foster care children, the effective date is May 12, 2023. PE for individuals needing treatment for breast or cervical cancer, the effective date is January 1, 2023.
Summary: This SPA will permanently remove beneficiary cost sharing requirements for non-emergency services provided in a hospital emergency departments and beneficiary pharmacy cost sharing requirements for claims with a date of service (DOS) from July 1, 2024 forward.
Summary: This amendment provides 12 months of continuous eligibility (CE) for children under 19 to comply with Section 5112 of the Consolidated Appropriations Act, 2023.
Summary: This amendment is to adopt the optional eligibility group described in section 1902(a)(10)(A)(ii)(XIII) of the Social Security Act, which serves working individuals who have disabilities and incomes below 250 percent of the federal poverty level.
Summary: This Amendment disregards state tax refunds, rebates, and credits, and certain teacher stipends, in determining eligibility for certain non-MAGI eligibility groups.
Summary: This amendment temporarily suspends beneficiary cost sharing for pharmacy claims with dates of service from February 22, 2024 to June 30, 2024. The terms of this State Plan Amendment sunset at midnight on June 30, 2024.
Summary: This amendment proposed to memorialize its new income standards for its optional state supplement program, the beneficiaries of which are eligible for Medicaid under Maine's State Plan.
Summary: To apply disregards, under the authority of section 1902(r)(2) of the Social Security Act, in determining eligibility for certain non-MAGI groups for settlement payments related to the February 3, 2023, train derailment in East Palestine, Ohio.
