Medicaid State Plan Amendments

This amendment proposes to memorialize the new income standards for its optional state supplement program and increase its medically needy income level.

The proposed amendment updates the physicians’ and other practitioners’ program fee schedule.

This SPA is making a technical correction to remove "Intensive In-Home Service" from the services list since this is not a service within this approved 1915 benefit.

This amendment adds enhanced mobile crisis services to the Medicaid state plan.

This Amendment align with Section 5112 of the Consolidated Appropriations Act (CAA, 2023), which requires that state provide 12 months of continuous eligibility (CE) for children under the age of 19 in Medicaid and the Children's Health Insurance Program (CHIP).

This amendment allows Alternative Benefit Plan (ABP) coverage of a primary care case management program (PCCM) for pregnant individuals and of adult vaccinations and their administration without cost sharing in order to align with the South Dakota State Plan.

This amendment abolishes copayments for Medicaid fee-for-service beneficiaries within the state.

This SPA is to amend 1915(k) Community First Choice (CFC) benefit.

To increase the income standard for its Ticket to Work Basic eligibility group and disregard “Work Incentive Accounts” in determining resource eligibility for certain non-MAGI eligibility groups.
 

This amendment proposes to update the state plan to reflect the Third-Party Liability-Related provisions that bar responsible third-party payers from refusing payment for an item or service solely on the basis that such item or service did not receive prior authorization under the third-party payer rules.