Medicaid State Plan Amendments

This plan amendment updates the rate setting methodology for freestanding pediatric subacute (FS/PSA) facilities effective July 1, 2023, and changes the FS/PSA rate year to a calendar year rate year effective January 1, 2024.

This plan amendment updates the provisions governing leave of absence days for intermediate care facilities for individuals with intellectual disabilities (ICF/IID) in order to increase the total leave days for ICF/IID residents from 45 to 60 and from 30 consecutive days in any single occurrence to 45 consecutive days.

This plan amendment adds opioid antagonist as an inpatient hospital service that may be billed separately.

This plan amendment authorizes the Department to make an additional supplemental payment to certain nonpublic nursing facilities in a county of the eighth class.

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 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.