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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 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: The purpose of this SPA is to adjust inpatient psychiatric fee-for-service per diem rates of reimbursement for distinct exempt units specializing in inpatient psychiatric services in Article 28 hospitals by increasing the case mix neutral psychiatric statewide per diem base price from $742.86 to $950.43.
Summary: This plan amendment provides a one time across the board funding increase of up to $19.5 million to Assisted Living Programs (ALPS), Adult Day Health Centers (ADHC) and Hospice providers.
Summary: This plan amendment adds an across-the-board adjustment of a 4.0% Cost of Living adjustment (COLA) to operating rates of payment, per the enacted 2024 Budget to the inpatient service Specialty Hospitals.
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 SPA amends the State Plan for coverage of drugs authorized for import by the Food and Drug Administration when medically necessary during drug shortages.
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.
