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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: One time supplemental payment for private providers of Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) services.
Summary: The purpose of the amendment is to update the quality measures and associated weights for the health home quality incentive payment methodology. The updated methodology was reduced from ten weighted measures to seven. The total quality incentive payment pool for this disbursement remained the same
Summary: This SPA changed the telehealth rates used during the COVID-19 Public Health Emergency (PHE) to rates based on Relative Value Units (RVUs) multiplied by the Oregon conversion factor.
Summary: This amendment to adds coverage and reimbursement of eConsult telemedicine services for consultations between primary care providers and specialty providers.
Summary: This amendment implements a quality-of-care incentive payment program (QIPP) for participating non-state government owned or operated nursing facilities (NSGO).
Summary: This amendment would expand providers who are eligible to furnish case management services for two Target Case Management Groups (TCM). (Children at risk ages 0-5 and pregnant women), by revising the provider qualifications.
