Medicaid and CHIP State Plans

What Are 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 the Centers for Medicare & Medicaid Services (CMS) approves the original Plan, they must also approve all future changes to the Plan before any changes become effective. 

The CMS website provides more information about 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.

Proposed State Plan Amendments

When a state wants to change any of the Medicaid/CHIP benefits it offers or how 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 respond. CMS can:

• Approve or deny the SPA, or 
• Send a formal Request for Additional Information letter. Sending this letter stops the 90-day clock. The clock will not start again until CMS receives the state's written response to the letter. CMS then has another 90 days to approve, deny or request information. This cycle continues until CMS approves or denies the SPA. Throughout this process, CMS may also ask informal questions via email or phone. These procedures can make the SPA approval process quite lengthy.

Once CMS approves a SPA, the changes can take effect the first day of the quarter that OHA first submitted the SPA. For example, a SPA submitted in March 2023 could be effective Jan. 1, 2023, even if CMS did not approve the SPA until 2025.

The following SPAs are currently at CMS review.

Approved State Plan Amendments

Withdrawn State Plan Amendments

Contact Information