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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 251 to 260 of 350 results
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
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
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
Links:
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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: TN-13-003
State: Tennessee
Summary: Limitation on Amount Duration and Scope of Medical Care and Services Provided - Prescribed Drugs, Barbiturates and Benzodiazepines No Longer Excluded.
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
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
Links:
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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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Transmittal Number: OR-13-05
State: Oregon
Summary: This amendment changes the state plan Personal Care Coverage to a limit of 20 hours unless the assessed need is higher and prior authorization is obtained.
Approval Date:
Effective Date:
Topics:
  • Benefits
  • Program Administration
Links:
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Transmittal Number: OR-13-09
State: Oregon
Summary: This transmittal is being submitted to amend 1915(j) eligibility criteria.
Approval Date:
Effective Date:
Topics:
  • Eligibility
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT