Implements the required change to increase the maximum FPL limit or Medicaid for children age 6 18 from 100% FPL to 133% FPL.

MAGI.

This SPA updates its premium cost sharing amounts to be consistent with the state's approved Modified Adjusted Gross Income conversion plan, and makes technical updates to its CHIP State Plan.

This SPA clarifies the state's policy on household composition under 42 CFR 457.315. Married couples who are living separately will be treated as individual households, even when filing a joint tax return.

This SPA will allow Oregon to expand direct coverage to children currently enrolled in the Healthy Kids Connect Program and expand the Oregon Health Plan (OHP) to children with family incomes at or below 300 percent of the Federal Poverty Level (FPL).

In addition to proposing to come into compliance with CHIPRA's dental requirements, this SPA also clarifies language with regard to the transfer of the separate the Children's Health Insurance Program (CHIP) from the Health Insurance Management Board to the Division of Medicaid (DOM). This SPA also updates the language regarding emergency services clarifying emergent and non-emergent care as well as how the state provides access to covered services.

Updates the federal poverty levels (FPLs) of the eligibility levels and premium bands to be consistent with Modified Adjusted Gross Income (MAGI).

Changes the type of coverage that it is offering to targeted low-income children from the benchmark benefit package to Secretary-approved coverage, which is the same benefit package as Medicaid, including the provision of EPSDT.

This amendment allows Idaho to implement a health home model for case management services, a behavioral health managed care system and a developmentally disabled children's benefit. In addition, the SPA will implement a redesign of the children's benefit plan and eliminates prior uthorization requirements for therapy services.

This SPA modifies the state's delivery system by creating a new tier-based primary care case management fee structure for providers based on the complexity of the patient's health care needs and capabilities of the provider's ability to meet those needs.