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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: Updates the Stateโs Asset Verification System (AVS) reflecting the Stateโs decision to go from using a contractor to build the system to joining a consortium to develop an Asset Verification System
Summary: Allows the state to comply with the Medicaid Drug Utilization Review (DUR) provisions
included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and
Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).
Summary: revise the Behavioral Health rehabilitation and include a level of care for Intensive In-Home Behavioral Health Services as a part of Oregonโs services for childrenโs behavioral health.
Summary: Proposes to update the payment rates for nursing facility residents to provide for reimbursement when a resident of a Disaster Struck Nursing Facility must be temporarily evacuated to another facility due to a disaster for a period of up to thirty (30) days.
Summary: This SPA amends the current Targeted Case Management State Plan Amendment for Public Health Nurse Home Visiting to include 3 additional counties.
Summary: Updates the physician office and outpatient fee schedule to increase the rates for select Long-Acting Reversible Contraceptive (LARCs) Devices and updates the pricing methodology for specified codes on the physician-surgery fee schedule for manually priced to a fixed fee at 57.5% of Medicare
Summary: Updates the physician office and outpatient fee schedule by restructuring the payment methodology for pediatric medical providers who apply fluoride varnish to the teeth of Medicaid members and expands the age range of individuals who can receive an oral assessment and/or application of fluoride varnish by a pediatric medical provider.