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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 time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to add provider types and make payment rate changes for certain home and community based services.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to designate Contracted Community Partner organizations as qualified entities to make presumptive eligibility determinations; consider individuals evacuated from the state due to the emergency to continue to be residents; allow flexibility for mobile testing for COVID-19; and waive medication supply limits when appropriate to reduce exposure risk. In addition, this amendment will allow for changes in reimbursement policies and adjustment of payment rates for certain services and providers.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to allow hospital services provided by Commonwealth Healthcare Corporation (CHCC) using telehealth to be cost-reimbursed using the existing state plan cost protocol.
Summary: implement temporary changes to the Oregon 1915(k) Independent Choices Program related to Oregon’s response to the COVID 19 pandemic during the period of the Presidential and Secretarial emergency declarations (or any renewals thereof).
Summary: implement temporary changes to the Oregon 1915(j) Independent Choices Program related to Oregon’s response to the COVID 19 pandemic during the period of the Presidential and Secretarial emergency declarations (or any renewals thereof).
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to cover the new optional group for COVID testing, continue to consider residents who leave the Territory due to the disaster residents of the Territory, extend the reasonable opportunity period, allow 90-day supplies of drugs and early refills, extend all prior authorizations for medications without clinical review, or time/quantity extensions, allow exceptions to the Territory's preferred drug list in case of shortages, and allow use of telehealth methods in lieu of face-to-face reimbursed at 80% of the face-to-face rate.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to apply less strict income methods for determining eligibility, allow the SMA, hospital and public health centers to make presumptive eligibility (PE) decisions, and allow 12 months continuous eligibility for children under age 19.
Summary: This time-limited state plan amendment responds to the COVID-19 national emergency. The purpose of this amendment is to expand telehealth, allow e-signatures to person-centered service plans in place of in-person ink signatures to minimize in person contact and allow verbal consent as authorization for providers to deliver services while awaiting receipt of the signed person-centered service plan, and allow certain home and community based services to be provided to individuals in inpatient settings.
