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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: Updates the supplemental payment pool amounts for the Rural Family Medicine Residency Development Payment, Family Medicine Residency Program Payment, State University Teaching Hospital Payment, Pediatric Major Teaching Payment and the Urban Safety Net Provider Payment.
Summary: Adds prospective payments and gainsharing to the physician services Alternative Payment Model (APM) for non-Federally Qualified Health Center primary care medical providers.
Summary: Updates the language for Rural Health Center's Alternative Payment Methodology rate setting process, adds a scope of service rate adjustment process, adds a process to ensure Rural Health Centers are paid at least their per visit Prospective Payment System rate by Managed Care Entities, and adds language for setting rates for new Rural Health Centers.
Summary: implements a 2.0% across-the-board rate increase for included services within SPA CO-22-0018 and targeted rate increases and rate decreases, per state statute
Summary: makes changes to the South Carolina Disproportionate Share Hospital (DSH) payment program, Medicaid Inpatient and Outpatient Hospital payment programs, and the Psychiatric Residential Treatment Facility (PRTF) payment program.
Summary: Adds clarifying language specific to Disproportionate Share Hospital (DSH) payments as well as updates the hospital quality incentive payments available for qualifying providers.
