This amendment proposes to update the coverage description and prior authorization policies for transplantation services.

This amendment proposes to extend Maine’s previously granted Recovery Audit Contractor (RAC) program exception from June 1, 2023, to June1, 2025

The state submitted this SPA to align its ABP with previously approved SPAs 23-0017, 23-0023, and 23-0027 regarding dental therapists, podiatry services and prior authorization policies for prosthetic devices.

This amendment proposes to allow the Division of Medicaid (DOM) to revise the education and experience requirements for Early Intervention case managers, effective April 1, 2023.

To elect the option to provide 12 months of continuous eligibility for children under age 19

This BHH SPA amendment updates the reimbursement plan pages to identify two distinct PMPM rates: an adult PMPM rate and a child PMPM rate. This was due to in part a recently completed rate study performed by a contracted vendor for MaineCare Rate System Reform codification.

The state proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.

This SPA proposed to transition children enrolled in its separate Children's Health Insurance Program to its Medicaid program, and to adopt a new Medicaid eligibility group for certain insured children under age 19 with income up to 208% of the federal poverty level.

This SPA is to implement Community Care Teams (CCTs) to deliver health home services designed to address the whole-person needs to include assessment of the level of care coordination needs based on risk factors of adults and children with chronic conditions and polypharmacy and high emergency department utilization.

The state proposed to adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.