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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 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: Extends the Quality and Efficiency Incentive Program to June 30, 2016, and reduces the Medicaid nursing facility rate from the 63rd percentile to the 55th percentile.
Summary: This SPA increases the personal needs allowance for the aged, blind and disabled population from $30 to $60 for individuals and from $60 to $120 for couples as authorized by the state legislature.
Summary: Modifies the rate methodology for the Programs for the All-Inclusive Care of the Elderly (PACE) aligning payment with the Oregon Health Authority's (OHA) performance-based reimbursements.
Summary: This SPA describes the methodology used by the state for determining the appropriate FMAP rates, including the increased FMAP rates, available under the provisions of the ACT for the medical assistance expenditures under the Medicaid program associated with enrollees in the new adult group adopted by the state.
Summary: Amends the primary care reimbursement method outlined in section 1202 of the Affordable Care Act in order to utilize the site of service adjustment.
