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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.
This Amendment align with Section 5112 of the Consolidated Appropriations Act (CAA, 2023), which requires that state provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid and the Children's Health Insurance Program (CHIP).
This amendment changes to Hospital Presumptive Eligibility (HPE) to include the adult group in the eligibility groups for which hospitals may conduct HPE determinations.
Summary: This amendment proposes to assure the American Rescue Plan Act’s (ARP) mandatory coverage of the COVID-19 vaccine, testing, and treatment without cost sharing.
Summary: This SPA provides Oklahoma with approval to provide 12 months of continuous postpartum coverage to individuals enrolled in its Medicaid program.
Summary: This SPA expanded eligibility in the former foster care children (FFCC) eligibility group consistent with the changes mandated by Section 1002 of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (Support) Act.
Summary: Provides assurances regarding the state's compliance with federal medical transportation requirements found under the Consolidated Appropriations Act, 2021.
Summary: Revises the language describing the methodology used to calculate the capitation rate payment for PACE organizations. The SPA will remove the Medicare Economic Index ( MEI) adjustment from the rate methodology, as the PACE capitation rate is based on the amount that would otherwise be paid (AWOP) which is reviewed annually and adjusted as needed, without regard to the MEI.
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 establish coverage and reimbursement for all FDA authorized self-collected COVID-19 tests inclusive of those requiring laboratory processing.
Summary: establishes the reimbursement rate for intensive residential substance use disorder (SUD) treatment for adolescents (clinically managed medium intensity residential services for adolescents, intensive).
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 allow SoonerCare adults expanded access to independently licensed psychologist services from only crisis services authorized in DR SPA OK-20-0032 to all services within licensed psychologist's scope of practice under state law from July 1, 2021 through the end of the public health emergency.