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Medicaid State Plan Amendments

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.

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Showing 211 to 220 of 296 results
Transmittal Number: OR-13-0018-MM7
State: Oregon
Summary: Specifies Options for Presumptive Eligibility Conducted by Hospitals.
Approval Date:
Effective Date:
Topics:
  • Eligibility
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Transmittal Number: OR-13-23
State: Oregon
Summary: Removes the sunset date of September 30 2013 for Express Lane Eligibility option underMedicaid and to add language regarding eligibility determinations using Modified Adjusted Gross Income based methodology in accordance with the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: OR-13-11
State: Oregon
Summary: This amendment provides a payment incentive through the Quality and Efficiency Incentive Program to nursing facilities that voluntarily reduce bed capacity maintain compliance with all statewide nursing facilities licensing requirements and have no substantiated facility abuse within the preceding six month in order to increase quality efficiency and to improve statewide occupancy levels.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: OR-13-24 t
State: Oregon
Summary: To amend the current Durable Medical Equipment fee schedule from a percentage of 2010 to 2012 Medicare Fee Schedule.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: OR-13-0014-MM3
State: Oregon
Summary: Incorporates the Modified Adjusted Gross Income Based Methodologies into the Medicaid State Plan inaccordance with the Affordable Care Act.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Benefits
  • Program Administration
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Transmittal Number: OR-13-019
State: Oregon
Summary: Defines New Alternative Benefit Plan ABP for New Adult Expansion Group.
Approval Date:
Effective Date:
Topics:
  • Benefits
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Transmittal Number: OR-13-21
State: Oregon
Summary: This SPA adjusts the state estate recovery program to recover only on claims for all approved services of individuals age 55 and over who receive nursing facility services or home and community-based services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
  • Program Administration
Links:
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Transmittal Number: OR-13-20
State: Oregon
Summary: This SPA disregards all income for children with non IV-E adoption assistance and all reasonable classifications of children covered by the state.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
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Transmittal Number: MP-12-004B
State: Northern Mariana Islands
Summary: Adds Fee Schedule and Reimbursement Methodology for Non-Hospital Outpatient Providers and Services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
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Transmittal Number: OR-13-02
State: Oregon
Summary: Increases detoxification treatment locations, services, and benefits offered for Oregon Health Plan beneficiaries with a diagnosedsubstance abuse need.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Prescription Drugs
  • Program Administration
Links:
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