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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: This amendment is submitted as part of the agency rate standardization project. The Oregon Health Authority will set the rate methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Home Enteral/Parenteral Nutrition and IV Services under the Home Health state plan benefit at 80% of 2024 Medicare rate.
Summary: This plan amendment changed the reimbursement methodology for publicly owned Ground Emergency Medical Transportation (GEMT) providers from a cost-based reimbursement methodology to a uniform add-on rate.
Summary: This plan amendment increased laboratory and radiology, podiatry, chiropractic, PT/OT and any other practitioner’s procedure codes under the CMS Resource Based Relative Value (RBRVS) to a minimum of 80% of current Medicare rate.
Summary: This plan amendment created an annual quality assurance fee on each emergency medical transport and established reimbursement to be paid to nonpublic emergency medical service providers.
Summary: This Amendment updates the state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.
Summary: Health Homes Payment Methodologies Under this SPA, for dates of service beginning July 1, 2024, the Maryland Medical Assistance Behavioral Health, Health Home program reimbursement rates will increase by 3%.
