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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: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment to suspend the requirement for ambulance providers to transport beneficiaries to the nearest appropriate medical facility and to suspend the requirement for beneficiaries to be stretcher bound to use non-emergency ambulance services, to ensure that ambulance services and service destinations are not restricted during the public health emergency period.
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 include coverage and reimbursement for the administration of monoclonal antibody treatment or any drug treatment authorized under an FDA Emergency Use Authorization for COVID-19.
Summary: CMS is approving this time-limited state plan amendment (SPA) to respond to the COVID-19 national emergency. The purpose of this amendment is to designate Local Health Departments as qualified entities for purposes of making presumptive eligibility determinations during the COVID-19 national emergency.
Summary: This SPA proposes to expand the full continuum of substance use disorder care by increasing access to certain services to beneficiaries diagnosed with a substance use disorder.
Summary: Enables the state to change from using a prior Authorization method to using a Pre-Payment Review process for the Physical Therapy, Occupational Therapy and Speech Therapy programs.
Summary: Effective January 1, 2021, this amendment adds a $1,000 per calendar year dental benefit for adults receiving Medicaid benefits through an Alternative Benefit Plan.
Summary: Effective July 1, 2021, this amendment implements an Indian Managed Care Entity that will provide case management services on behalf of American Indian and Alaska Native (AI/AN) Oregon Health Plan members.
Summary: Moves Oregon’s current Medication Assisted Treatment (MAT) benefit from the optional benefit section in Oregon’s state plan to the required benefit section to comply with Section 1006(b) of the SUPPORT Act.
