Medicaid State Plan Amendments

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.

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.

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. 

Adds Medication Assisted Treatment (MAT) as a mandatory benefit.

Authorizes fee-for-service rate increase in the aggregate amount of $4,071,430 for Class I, Class II and Class III nursing facilities.

updates the durable medical equipment, prosthetics, orthodontics, supplies (DMEPOS) fee schedule.

1) Clarify the different types of encounters and when more than one encounter is performed on the same day, 2) Add the requirements for RHC mobile units, and 3) add language to refer to Attachment 3.1-A Introductory Pages for coverage of telehealth services to be incompliance with Miss. Code Ann. as amended by Senate Bill 2799, effective July 1, 2021.

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.

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).

Updates the Alternative Benefit Plan (ABP) State Plan to include the CHESS program approved in SPA 21-0001 which improve housing stability and health outcomes for a targeted set of Medicaid members who meet specified needs-based criteria, including individuals who have complex health conditions, have experienced homelessness, and have been determined to be likely to benefit from targeted tenancy sustaining services based on risk factors.