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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 amendment is submitted as part of the agency rate standardization project. The Oregon Health Authority will set the rate methodology for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) and Home Enteral/Parenteral Nutrition and IV Services under the Home Health state plan benefit at 80% of 2024 Medicare rate.
Summary: This amendment is to add Certified Indian Health Service Community Health Aide Program providers into the other licensed providers section of the state plan.
Summary: This amendment expands school-based health services (SBHS) under the Rehab benefit by 1) adding specialized transportation to school-based rehabilitative services and 2) increases reimbursement for students covered under the Individuals withDisabilities Education Act (IDEA). The SPA also introduces a new reimbursement methodology for SBHS.
Summary: This amendment is to add coverage and reimbursement of community violence prevention services performed by certified violence prevention professionals as a new benefit within the preventive services benefit category.
Summary: This amendment is to allow for home-based Behavior Rehabilitation Services to be paid based on a state-wide fee schedule per service; update minimum requirement for staff to address staffing shortages; and update terminology to avoid confusion between mental health and substance use disorder rehabilitation services.
Summary: This amendment proposes to update the coverage criteria for home health services as well as medical social services and to increase the reimbursement rates for those services.
