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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 expands the Targeted Case Management Family Connects® Nurse Home Visiting program into Douglas County and revise the provider qualifications for the program.
Summary: This SPA allows coverage of authorized drug imports when there is inadequate supply of the fully FDA-approved, non-imported drug product during a recognized critical drug shortage.
Summary: This amendment is to temporarily suspend otherwise covered benefits for the period January 1, 2024 through September 30, 2024 in response to the territory’s local funding shortfall.
Summary: This amendment authorizes additional provider types the Oregon state plan to include Licensed School Psychologist, Licensed School Social Worker and Licensed School Counselor as Medicaid allowable providers for services provided in the school setting.
Summary: This SPA amendment is submitted to align the state plan with current law and clinical practice related to transplants and to streamline, minimizing duplicative content.
Summary: This amendment preserves approved coverage of prescription drugs, dentures, and prosthetic devices while resolving a technical duplicate page number issue in Attachment 3.1A.
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 provide a temporary rate increase for nursing facilities, assisted living facilities, and residential care facilities.
Summary: This amendment adds optometry services to the state plan, revises coverage of eyeglasses/contact lens, and adds a fee-for-service payment methodology for these benefits.
