Medicaid State Plan Amendments

This plan amendment rescinds the alternative payment methodology (APM) for Federally Qualified Health Centers (FQHCs), Rural Health Centers (RHCs), and Tribal Health Programs (THPs) when COVID-19 vaccines are administered on their own and outside of a billable visit.

This SPA describes coverage and adds per diem reimbursement for private duty nursing care for Early and Periodic Screening, Diagnostic and Treatment (EPSDT) beneficiaries.

This plan amendment updates the methodology for pediatric nursing facility care pediatric facility care currently applies only for members up to age 21.

This plan amendment adds the reimbursement rate for Women, Infants and Children (WIC) supplement.

This plan amendment increases the funding for disproportionate share hospital (DSH) payments to qualifying acute care general hospitals that provide enhanced access to multiple types of medical care in economically distressed areas of the Commonwealth.

This amendment amends vision services providers eligible to order, prescribe, refer or render vision services to include those providing services within their scope of practice per State Law.

This amendment expands the nurse home visiting Targeted Case Management (TCM) services program to Coos County.

This amendment confirms that Oregon allows retroactive enrollment of eligible providers.

This Amendment updates the state plan assurances in accordance with federally mandated quality reporting requirements for the Child Core Set and the behavioral health quality measures on the Adult Core Set outlined in 42 CFR 431.16 and 437.10 through 437.15.

This amendment proposes an update to the Standards for Coverage of Organ Transplant Services to include small bowel transplant
as a covered service for adults aged 21 years and older.