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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 amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.
Summary: This SPA proposes to revise the payment methodology for Nursing Facility services. Specifically, this amendment proposes to replace the intensive Technical Services reimbursement program with the Complex care reimbursement program and update the payment rate for this program.
Summary: This amendment seeks to revise the reimbursement methodology of DM Medical Equipment and Hearing Aids as well as reduce the rates by 5% for services rendered between July 1, 2011 and June 30, 2011.
Summary: This SPA proposes to change the Medicaid reimbursement for covered outpatient prescriptions to average wholesale price (AWP) minus 16 percent and the dispensing fee to $3.00 in the Prescribed Drug section of the State plan to be consistent with the same reimbursement methodology and dispensing fee recently approved under South Carolina Frontis SPA 11-011.
Summary: This amendment seeks to revise the state plan to add freestanding birthing renters and provide Medicaid coverage and reimbursement for services provided in those centers.
Summary: This amendment seeks to eliminate Targeted Case Management services for Individuals with HIV, Pregnant Woman, Persons Identified as Seriously Mentally Ill or Seriously Emotionally Disturbed, Low Functioning Severely and Persistently Mentally Ill Adults Needing Assertive Community Treatment (ACT), Individuals with Developmental Disabilities, and Case Management for. Elderly or Disabled Individuals Diverted/Deinstitutionalized from Nursing Facilities from the State Plan.
