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Medicaid State Plan Amendments

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.

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Showing 1 to 10 of 34 results
Transmittal Number: SD-25-0002
State: South Dakota
Summary: This amendment proposed a two-year extension of the exception from establishing a Medicaid Recovery Audit Contractor (RAC) program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SC-24-0028
State: South Dakota
Summary: This amendment updates the name of the designee to review State Plan Amendments for South Carolina.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-24-0013
State: South Dakota
Summary: SPA implements an inflationary increase to the Health Home Per Member Per Month and Clinical Outcome Measure payment rates as appropriated by the state legislature during the 2024 legislative session effective July 1, 2024 and assures that the requirements for general and annual reporting of child and adult core sets are met.
Approval Date:
Effective Date:
Topics:
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-23-0021
State: South Dakota
Summary: With this SPA the state expands eligibility to individuals under age 21 who are under a state-only funded adoption assistance agreement, and to confirm the scope of coverage under the state plan for certain reasonable classifications of children.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-23-0023
State: South Dakota
Summary: This SPA provides twelve months of continuous eligibility for children.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-23-0018
State: South Dakota
Summary: This Amendment expands Hospital Presumptive Eligibility (HPE) to include the Adult Medicaid Expansion group.
Approval Date:
Effective Date:
Topics:
  • Medicaid and CHIP Program (MACPro)
  • Eligibility
Links:
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Transmittal Number: SD-23-0003
State: South Dakota
Summary: The state adopts the the eligibility group serving individuals under age 65 with incomes at or below 133% of the federal poverty level (FPL), as described in section 1902(a)(10)(A)(VIII) of the Social Security Act.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-23-0007
State: South Dakota
Summary: The state adopt the changes to the eligibility rules for the Former Foster Care Children eligibility group, as enacted by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act, Pub. L. No. 115-217, section 1002.
Approval Date:
Effective Date:
Topics:
  • Eligibility
  • Medicaid and CHIP Program (MACPro)
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-22-0015
State: South Dakota
Summary: This SPA seeks an exception to the Medicaid Recovery Audit Contractor (RAC) program.
Approval Date:
Effective Date:
Topics:
  • Program Administration
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT
Transmittal Number: SD-20-0010
State: South Dakota
Summary: Effective March 1, 2020, this amendment establishes coverage of COVID-19 vaccine administration and a reimbursement rate for COVID-19 vaccine administration for providers reimbursed on a fee-for-service basis. 
Approval Date:
Effective Date:
Topics:
  • Disaster Relief
  • Program Administration
  • Tribal Issues
Links:
SHARE THIS MEDICAID STATE PLAN AMENDMENT