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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 proposes to revise the Oklahoma State plan to incorporate language that authorizes the state to negotiate supplemental rebate agreements for pharmaceuticals involving value-based purchasing arrangements with drug manufacturers.
Summary: This amendment was submitted to clarify the definition of school-based services, add language that outlines the notification requirements to schools regarding parental and legal guardian consent, and remove specific references which are no longer applicable.
Summary: This SPA makes a technical change to remove the comprehensive diagnostic evaluation (CDE) requirement for children diagnosed with autism spectrum disorder (ASD) to receive Behavioral Health Treatment (BHT) services under the preventive services benefit of the Medicaid state plan.
Summary: Change the Programs of All-Inclusive Care for the Elderly (PACE) rate development methodology from a percent of fee-for-service (FFS) costs to an experience-based rate methodology that uses PACE organization cost experience, encounter data and other data to set rates.
