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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 contracting with a Recovery Audit Contractor to identify underpayments and overpayments of Medicaid claims under the State Plan and any waiver of the State Plan.
Summary: The purpose of this SPA is to provide governing long-term personal care services (LT-PCS) in order to update and remove obsolete terminology and to ensure that consistent language is used.
Summary: Proposes to increase the maximum monthly court-ordered guardian fee deduction for the purposes of determining a long-term care recipient’s monthly cost of care.
Summary: amend the provisions governing the long-term personal care services to reflect current practices in order
to: (1) clarify that instrumental activity of daily living can be provided outside of the participant's home if approved; (2) remove language in regards to what relatives can be the direct service workers (DSWs); (3) remove the language that service logs must document place of service; (4) clarify the statement regarding DSWs being paid at least the current federal or state minimum hourly rate.
Summary: Effective January 1, 2021, this amendment updates the DSH program as well as inpatient hospital payments. Specifically, this (1) Updates the base year used to calculate the interim DSH payments and update the inflation rate used to trend the DSH base year cost; (2) expend 100% of its FFY 2021 allotment; (3) discontinue the normalization adjustment to the hospital specific DSH limits; (4) update the inflation rate used to trend the DSH base year cost to the end of the 2019 calendar year; (5) create separate DSH pools from the existing 2021 DSH allotment to be spread among rural hospitals. Additionally, South Carolina will (1) update the swing bed and administrative day rates based on the October 1, 2020 Nursing Facility Payment rate update; (2) update the long term per diem psychiatric hospital rates based on the FY2019 cost reporting period trended forward to the payment period; (3) provide for 100% retrospective cost settlement for all IP and OP services in rural hospitals.
