Medicaid State Plan Amendments

This plan amendment authorizes the Department to make an additional payment to nonpublic and county nursing facilities that qualified for supplemental ventilator care and tracheostomy care payments.

This amendment will allow South Carolina to enter Value Based Agreements and Direct Manufacturer Supplemental Rebates.

This amendment makes several changes related to the coverage of substance use disorder (SUD) treatment services.

This amendment is to comply with the requirements of section 5112 of the Consolidated Appropriations Act of 2023. The territory seeks CMS approval (1) to provide continuous eligibility for hospitalized children until the end of a child's inpatient stage if the child would have remained eligible but for having turned 19; and (2) to provide continuous eligibility for children for 12 months or until the child turns 19.

This amendment makes modifications to targeted case management provider qualifications.

This SPA increases the Prospective Payment System rates for Federally Qualified Health Centers (FQHCs) and updates the definition of behavioral health encounters.

This amendment removes the requirement to obtain employer sponsored insurance as a condition of Medicaid eligibility.

This plan amendment updates the Crisis Services.

This plan amendment updates the Durable Medical Equipment (DME) and Physician administered fluoride varnish.

This plan amendment provides Physician Supplemental UPL Payments to Westchester, Erie, and Nassau Medical Centers.