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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 141 to 150 of 269 results
Transmittal Number: OR-18-0005
State: Oregon
Summary: This SPA sunsets the nursing facility bed reduction process as of June 30,2018, and sets the nursing facility reimbursement at the 62"d percentile of allowable costs for the period July l, 2018 to June 30, 2026.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OR-18-0004
State: Oregon
Summary: This SPA seeks to make changes to the 1915(k) Community First Choice state plan option.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OR-18-0003
State: Oregon
Summary: This SPA updates the Hospital Presumptive Eligibility (HPE) application to align with the state's new eligibility system.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Program Administration
Links:
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Transmittal Number: OR-17-0010
State: Oregon
Summary: This SPA creates the Ground Emergency Medical Transportation (GEMT) program.
Approval Date:
Effective Date:
Topics:
  • Benefits
Links:
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Transmittal Number: OR-18-0002
State: Oregon
Summary: This SPA affirms Oregon's status as a SSI criteria state for evaluating non-MAGI eligibility under the Medicaid state plan.
Approval Date:
Effective Date:
Topics:
  • Program Administration
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Transmittal Number: OR-17-0012
State: Oregon
Summary: Increases the professional dispensing fees and revise reimbursement for Physician\uDBC0\uDC03Administered Drugs when no published Medicare rate exits.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OR-18-0001
State: Oregon
Summary: Increases Fee-For-Service Dental Rates for selected services.
Approval Date:
Effective Date:
Topics:
  • Financing & Reimbursement
Links:
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Transmittal Number: OR-17-0011
State: Oregon
Summary: This SPA removes the Express Lane Eligibility (ELE) option for children under age 19 under the Medicaid state plan.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OR-17-0008
State: Oregon
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.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
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Transmittal Number: OR-17-0007
State: Oregon
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).
Approval Date:
Effective Date:
Topics:
  • Prescription Drugs
Links:
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