An official website of the United States government
Official websites use .gov
A .gov website belongs to an official government organization in the United States.
Secure .gov websites use HTTPS
A lock ( ) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.
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: The state raises the income eligibility standard for its Family Planning eligibility group from 133 percent of the federal poverty level (FPL) to 205 percent.
Summary: The SPA proposes to move South Dakota Medicaid from the Resource Utilization Group Ill (RUG Ill) reimbursement model to the Patient Driven Payment Model (PDPM) reimbursement model for Nursing Facility services.
Summary: Amendment to increase acute rates for freestanding psychiatric hospitals paid on a per diem and to restore the 15% rate reduction for Acute II facilities while also increasing the restored rate by 5%.
Summary: This SPA authorizes increased federal financial participation (FFP) for newly-eligible individuals receiving postpartum coverage and further includes the addition of Attachment D, which describes the special circumstances and other proxy adjustments that are applied to account for the proportion of individuals covered under the extended postpartum coverage option who would otherwise be eligible for coverage in the adult group and for the newly eligible FFP under section 1905(y) of the Social Security Act;
Summary: The purposed amendment will increase the base rate for standard nursing facilities, nursing facilities serving patients with Acquired Immune Deficiency Syndrome (AIDS), and standard private and specialized private intermediate care facilities for individuals with intellectual disabilities (ICF/IIDs).
Summary: Amendment to add provisions to comply with the requirements of 42 CFR Part 447, Subpart A, and sections 1902(a)(4),1902(a)(6), and 1903 with respect to non-payment for provider-preventable conditions.
Summary: This SPA implements the five-percent inflationary increase to the Health Home Per Member Per Month and Clinical outcome measure payment rates appropriated by its state legislature during the 2023 legislative session
