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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 plan amendment proposes to allow the state to individually negotiate reimbursement rates for EPSDT providers when it is demonstrated that the in-state payment methodology insufficiently accounts for the level of acuity, effective July 1, 2024.
Summary: This SPA authorizes an Alternative Payment Methodology (APM) for the insertion and removal of Long-Acting Reversible Contraction (LARC) Services and for LARC devices when provided at Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs).
Summary: This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities in a township of the first class in a county of the second class A.
Summary: This plan amendment extends enhanced payments to private Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID), in order to allow more time to address the needs of private ICF/IID that still rely on this variance while continuing to provide services to the residents of these facilities.
Summary: This plan amendment authorizes the Department to make supplement payments to certain nonprofit nursing facilities in a city of the second class A in a county of the third class.
Summary: This plan amendment authorizes the Department to make supplement payments to certain nonpublic nursing facilities in a home rule county of the second class.
Summary: This plan amendment increases per diem payment for services provided to ventilator-dependent Medicaid beneficiaries residing in a ventilator-dependent wing of a contracting South Carolina Medicaid nursing facility to a total per diem rate of $708 per member, per day.
