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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: Specifically, the SPA continues supplemental payments to private hospitals where a Type One teaching hospital maintains a minority interest by adding two additional private facilities.
Summary: This SPA proposes programmatic changes in the provision of Community Mental Health Rehabilitative Services in order to ensure appropriate utilization, provider qualifications, and cost efficiency appropriate to render these Medicaid covered services.
Summary: This SPA is being submitted to revise medical payment recovery thresholds from a fixed amount of $0 to the use of cost effectiveness to pursue based upon the claim amount.
Summary: Updates the ABP coverage limits for physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
Summary: This SPA proposes that in addition to payments for physician services specified elsewhere in the State Plan, the Department of Medical Assistance Services will make supplemental payments for physicians employed at a freestanding children's hospital serving children in Planning District 8 with more than 50 percent Medicaid inpatient utilization in fiscal year 2014.
Summary: This SPA updates physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
Summary: Reduces the inflation factor for inpatient hospital services from 2% to 1% for FY 2017 and makes specialized nursing care reimbursement fully prospective.
Summary: To include activities, interventions, and goal directed trainings that are designed to restore functioning and that are defined in an individual service plan.
Summary: This SPA proposes to cover low dose computed tomography lung cancer screening annually for members between the ages 55-80 years, who are current smokers, have quit smoking within thelast 15 years, or have a history of at least one pack of cigarettes per day for 30 or more years.
Summary: This SPA disregards unearned shelter-in-kind as income when determining financial eligibility for Medicaid programs administered by the Oregon Department of Human Services, Division of Aging and People with Disabilities.
