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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: Continues to freeze rates for direct graduate medical education (DME), indirect graduate medical education (lME) and Catastrophic Aid payments for the state's next biennial budget (state fiscal years 2018 to 2019).
Summary: Updates the state's Resource Utilization Group (RUG) reimbursement system to version IV and Minimum Data Set (MDS) 3.0 to be consistent with Medicare. Additionally, the state made a technical correction to the state plan language to clarify that the state budget adjustment factor is30o/o, which was previously undefined as part of the methodology.
Summary: Requests an exemption pursuant to 42 CFR 455.508(f) to the regulation requiring the states Recovery Audit Contractors (RAC) not review claims older than 3 years, as well as correct theSection number.
Summary: This SPA proposes to bring Oregon into compliance with the reimbursement requirements in the Covered Outpatient Drug final rule with comment period (CMS-2345-FC).
Summary: This amendment revises the fiscal year 2017 pool amounts for Disproportionate share hospital (DSH) and supplemental access payments for uncompensated care costs.
Summary: This SPA is being submitted in order move Doula services from the other licensed provider section to the preventive services option and increasing the fee for those services.
Summary: This SPA moves the Modified Adjusted Gross Income (MAGI) eligibility determinations from the Oregon Health Authority to the Oregon Department of Human Services.
Summary: Transmitted addition of a laboratory outpatient services co-payment of $3.00 for NH Premium Assistance Program participants above 100% of the federal poverty level (FPL).
