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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 SPA proposes to expand the full continuum of substance use disorder care by increasing access to certain services to beneficiaries diagnosed with a substance use disorder.
Summary: Effective July 1, 2021, this amendment allows for 12-month contraception dispensing and participation in the National Medicaid Pooling Initiative (NMPI).
Summary: Enables the state to change from using a prior Authorization method to using a Pre-Payment Review process for the Physical Therapy, Occupational Therapy and Speech Therapy programs.
Summary: Effective July 1, 2021, this amendment implements an Indian Managed Care Entity that will provide case management services on behalf of American Indian and Alaska Native (AI/AN) Oregon Health Plan members.
Summary: Effective March 31, 2021, this amendment removes a limit for psychiatric hospitalization that prevented more than 21 days in a hospital in a 60-day period for the same or similar diagnosis or treatment plan and updates practitioner terminology as it relates to working titles.
Summary: Effective February 24, 2021, this amendment adds payment for tribal health clinics including an alternate payment method for tribal Federally Qualified Health Center (FQHCs) equal to OMB all-inclusive rate.
