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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 plan continues the additional 25 percent rate enhancement initially authorized as a temporary increase under provisions of section 9817 of the American Rescue Act of 2021 (ARPA) for Children and Family Treatment and Support Services (CFTSS).
Summary: To add an assessment fee to the Health Home program to ensure that any child who may be eligible for Home and Community-Based Services (HCBS) under the Children's Waiver, demonstration or State Plan authority will be eligible to receive an HCBS assessment under the Health Home program.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to allow Tribal 638 Health Programs enrolled with the Oregon Health Plan (OHP) as an FQHC to use the Indian Health Service Memorandum of Understanding All-inclusive Rate (IHS MOU AIR Rate) for Medicaid reimbursement, rather than a clinic-specific Prospective Payment System (PPS) Rate as an Alternative Payment Methodology (APM).
Summary: This amendment proposes to provide a lump sum payment for eligible nursing facilities that are facing financial challenges and are participating in the health, retirement, and training benefit fund.
Summary: Proposes to allow Article 29-I Health Facilities to be reimbursed for care and services provided by exempt practitioners as defined under State law who were employed by an authorized setting as of June 24, 2022 and continue to work there or in another authorized setting, working under the supervision of a professional licensed pursuant to Article 153 (psychologists), 154 (social workers) or 163 (mental health practitioners) of the State Education law.
Summary: This amendment is to continue flexibilities granted in the Oregon 1915(j) Self-Directed Personal Assistance Services beyond the end of the COVID-19 Public Health Emergency (PHE).
Summary: This SPA has been submitted as related to the Inflation Reduction Act of 2022 temporary, 5-year increase for physician administered biosimilar drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to extend the 5% increase in payment rates for ODDS services and settings for the period 1/1/23 through 6/30/23 or until the end of the PHE which ever is first.
