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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to cover COVID-19 drug treatment provided through Emergency Use Authorization effective March 1, 2020, increase the rate for procedure code 36561 from Ambulatory Surgical Center (ASC) grouper3 to ASC grouper 10, effective August 26, 2021, and increase the reimbursement rate for administration of a COVID-19 vaccine effective September 1, 2021.
Summary: Amends the provisions governing inpatient hospital services and ambulatory surgical centers in order to provide for reimbursement of laboratory testing for Coronavirus Disease 2019 (COVID-19) separately from inpatient hospital per diem payments and ambulatory surgical center flat fee reimbursement amounts.
Summary: Updates the requirements for Independent Practice Dental Hygienists when they are submitting for reimbursement to MaineCare for temporary fillings, by removing two outdated consent and referral forms.
Summary: Allows individuals over the age of 21 to access Research-Based Intensive Behavioral Health Treatment (RBI-BHT) that prevent or minimize the disabilities and behavioral challenges associated with Autism Spectrum Disorder (ASD) and promote, to the extent practicable, the adaptive functioning of a beneficiary under the Preventative Services benefit.
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 implement, as authorized under section 9811 of the ARPA, P.L. 117-2, COVID-19 treatment services, without cost-sharing, for enrollees in the COVID-19 uninsured testing group and enrollees in the adult group who are covered by an alternative benefit plan (ABP).
Summary: state adopts the "Katie Beckett" eligibility group, which serves children who have disabilities and are under the age of 19 and who will receive services in the community instead of an institution.
