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Oregon's Medicaid State Plan

Learn how Oregon administers its Medicaid program and requests changes from the Centers of Medicare and Medicaid Services (CMS).


View Oregon's State Plan

Oregon posts its plan on this website for informational purposes only; it is not legally binding, will not contain any pending State Plan Amendment (SPA) information and is only current relative to the date on the title page. The CMS Region 10 office in Seattle, Washington, maintains our official plan.


State Plan

  
Medicaid State Plan (183 pages)

State Plan Attachment​

  
Medicaid State Plan Attachment 1.1A through 1.2D
Medicaid State Plan Attachment 2.2A through 2.7A (168 pages)
Medicaid State Plan Attachment 3.1A through 3.2A (199 pages)
Medicaid State Plan Attachment 4.10A through 4.42A (248 pages)
Medicaid State Plan Attachment 5.1A
Medicaid State Plan Attachment 7.2A through 7.3A

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Proposed State Plan Amendments

When a state wants to change any of the Medicaid benefits it offers, or change the way in which services are offered, it must submit a State Plan Amendment (SPA). The following SPAs are currently at CMS review.

  
State Plan Amendment 11-17
State Plan Amendment 12-06
State Plan Amendment 12-14
State Plan Amendment 13-02
State Plan Amendment 13-05
State Plan Amendment 13-06
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Questions and answers about State Medicaid Plans

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Answer
When do State Plan Amendments become effective?

Once CMS approves a SPA, the changes can take effect retroactive to the first day of the quarter of the federal fiscal year in which the SPA was submitted. These procedures can make the SPA approval process quite lengthy.

What is a State Plan Amendment?

When a state wants to change any of the Medicaid  benefits it offers, or change the way in which services are offered, it must  submit a State Plan Amendment (SPA).​

What is a Medicaid State Plan?
Under Section 1902 of the Social Security Act, all states must comply with some basic requirements. Each state must:
  • Serve certain mandatory populations, such as poverty-level children and low-income pregnant women.
  • Provide certain mandatory services, such as hospital care and physician services.
  • Provide services that are "sufficient in amount, duration, and scope to reasonably achieve (their) purpose."
  • Provide services throughout the state.
A State Medicaid Plan outlines how each state will meet these requirements. Once CMS approves the original Plan, they must also approve all future changes to the Plan before any changes become effective.

A state can also request CMS to waive certain federal requirements to allow greater flexibility or expand the Medicaid populations it serves.

 

For more information about Medicaid State Plans or Waivers in general, go to the CMS website.

What happens when a state submits a State Plan Amendment to CMS?
Once the CMS Regional Office receives a SPA, it has 90 calendar days to approve or deny the SPA, or send a formal Request for Additional Information (RAI) letter.
 
Once the CMS Regional Office receives a SPA, it has 90 calendar days to approve or deny the SPA, or send a formal Request for Additional Information (RAI) letter.
Sending an RAI stops the 90-day clock. The clock will not start again until CMS receives the state's written response to the RAI. Another 90-day clock starts at this point.
 

Throughout this process, CMS has the option of asking informal questions via e-mail or phone.

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