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Medicaid and CHIP State Plans

Oregon's State Plans

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

  
CHIP State Plan
Oregon Medicaid State Plan

Proposed State Plan Amendments

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

  
19-0004 Updated Application Forms
19-0011 School-Based Health Services - Technical Revisions
20-0012 Nursing Home Visiting expansion - Submitted 6-17-2020
20-0016 Bariatric Rate for Nursing Facilities - Submitted 8-31-2020

Approved State Plan Amendments

  
20-0003 TCM Babies First! Rate - Approved 08-21-2020
20-0005 Lactation consultants - Approved 4-30-2020
20-0006 Telehealth - Approved 4-10-2020
20-0007 Nursing Facility Ventilator Assistance Program Rate - Approved 4-10-2020
20-0008 Temporary Changes to 1915(k) Community First Choice Program - Approved 6-03-2020
20-0009 Temporary Changes to 1915(j) Independent Choices Program - Approved 6-3-2020
20-0010 Temporary Changes to Eligibility, HPE, Payment Requirements - Approved 6-18-2020
20-0011 Temporary Changes to 1915(i) Home and Community-Based Services Program - Approved 6-17-2020
20-0013 New 1915(i) Provider Types During COVID-19 Emergency - Approved 7-16-2020
20-0014 Ambulance rate during COVID-19 public health emergency - Approved 07-30-2020
20-0015 1915(k) retainer payments during COVID-19 public health emergency - Approved 08-04-02020

Frequently Asked Questions about State Plans

Under Section 1902 of the Social Security Act, all states must comply with some basic requirements. For example, 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 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. The CMS website provides more information about Medicaid and CHIP State Plans and Medicaid demonstration waivers.​


​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).​

​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 email or phone.

​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.​

Contact Information

Jesse Anderson, State Plan Manager

Email: jesse.anderson@dhsoha.state.or.us
Phone: 503-945-6958

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