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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 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: Implements an electronic Asset Verification System (AVS) that will verify the assets of blind, aged, or disabled applicants and recipients of Medicaid as required by Section 1940 of the Social Security Act.
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: Replaces discontinued dental codes with new dental codes in the Medicaid State Plan and remove references to the temporary pilot program for Independent Practice Dental Hygienists (IPDHs) because the pilot had ended. There was no change in service as a result of the program ending. This SPA is estimated to have a Federal budget impact of $299,939 in 2016 and $410,830 in 2017.
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 updates physical therapy, occupational therapy, and speech benefits to separate coverage limits for rehabilitative and habilitative services.
