Medicaid State Plan Amendments

This amendment proposes to include coverage of FDA-approved over-the-counter COVID-19 tests under the State Plan. The initial SPA submission has been revised to incorporate the required language in the Preventive Services benefit instead of the Pharmacy benefit.

This amendment makes changes to tribal consultation policies.

This amendment revises the COVID-19 Vaccine administration rates from 100% to 50% of current Medicare rates

The SPA makes provisions governing the Medicaid Purchase Plan to increase the income limit and countable resources and to adjust the premium structure accordingly.

This amendment proposes to amend the Title XIX State Plan in response to the Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System final rule issued by CMS on November 27, 2024.

This amendment added pre-natal plus program to Alternative Benefit Plan (ABP).

This amendment proposes to extend Maine’s Recovery Audit Contractor (RAC) program exception from June 1, 2025, through May 31, 2027.

This plan amendment is amending its State Plan to implement a quality program funded by the provider assessment and clarifying how payment for ancillary services is part of the per diem rate.

This plan amendment updates the total inpatient pool amounts for the Total Critical Access Hospital (CAH) Supplemental Pool and the Total Acute Care Hospital (ACH) Supplemental Pool.

The purpose of this plan amendment is to add a Prospective Payment System (PPS) and an Alternative Payment Method for Provider Based Rural Health Clinics (PBRHCs).