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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: To clarify plan language in connection with recent federal guidance. This SPA has been submitted as related to Inflation Reduction Act of 2022 temporary, 5-year increase for for physician administered biosimilars drugs that will be paid Medicare's Average Sales Price (ASP) plus 8% (rather than plus 6%).
Summary: This plan amendment updates the reimbursement methodology for physician services to align payment for topical fluoride varnish with the applicable dental service reimbursement methodology.
Summary: This amendment updates methods and standards for establishing Medicaid Disproportionate Share Hospital (DSH)
payments to qualifying DSH hospitals using the FY ending 2021 base year cost reporting period to calculate interim DSH payments; updates the inflation rate used to trend the DSH base year cost to the end of the 2021 calendar year; updates swing bed and administrative day rates based upon the October 1, 2022, redetermination of nursing facility payment rates; and updates the statewide outpatient hospital fee schedule relating to Vagus Nerve Stimulation codes.
Summary: CMS is approving this time-limited state plan amendment to respond to the COVID-19 national emergency. The purpose of this amendment is to add supplemental payments to several providers.
Summary: This SPA terminates the Hemophilia program arrangement with the South Carolina Department of Health and Environment Control Agency, at their request.
