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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: Effective April 1, 2020, this amendment provides an annual update to the State's supplemental teaching physician payment program using the Average Commercial Rate.
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 provide a 10% increase in payment rates for Adult Mental Health Residential, Substance Use Disorder Residential Programs, and Child and Adolescent Mental Health Residential providers.
Summary: Effective January 7, 2021, this amendment increases the daily encounter limit from one encounter per day to five encounters per day. This change applies to Indian Health Service and Tribal 638 clinics.
Summary: Effective February 1, 2021, this amends the current targeted case management state plan amendment for public health nurse home visiting to include three additional counties (Baker, Clatsop and Marion).
Summary: This amendment provides an increase to rates for Medicaid nursing facility providers relating to COVID-19 occupancy issues, COVID-19 employee test costs, and updated base year cost reports.
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 increase certain payment rates and to allow additional providers the ability to order Home Health services including Durable Medical Equipment.
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 continue the same stability payment rate method for Tribal 638 and Urban Indian Health programs into 2021 using the 2019, month actuals for 2020 and 202l until the PHE ends.
Summary: updates the base year used to determine payments under the Average Commercial Rate (ACR) method for the Supplemental Teaching Payment (STP) Program. It is also noted that this plan amendment excludes Greenville Hospital System (GHS), Palmetto Health Richland Hospital, and University of South Carolina College of Medicine d/b/a Prisma Health as eligible participants in the STP program.
Summary: Provides an increase to the current home based private duty nursing services rates, vision services rates, and anesthesia services codes for services provided
