PORTLAND, Ore. (AP) — Officials charged with implementing changes to the Oregon Health Plan are worried a new federal directive could undo the state's Medicaid reform.

The directive is outlined in a letter the Centers for Medicare and Medicaid Services sent to the state this month.

According to The Oregonian (http://bit.ly/1tpxNBN ), officials say the new rules could increase costs and force the state to return hundreds of millions of dollars received from the federal government.

Oregon's reforms were supposed to create the flexibility to invest in creative programs to improve health and reduce costs.

Rather than tracking individual procedures, the state gives regional coordinated care organizations a "global budget" of Medicaid funds.

But the federal government now says the state should go back to budgeting and tracking for each service provided by the CCOs.