10/26/2026

The South Dakota Department of Social Services published notice in the October 26, 2026 South Dakota Register of its intent to submit a State Plan Amendment (SPA) to update the South Dakota Medicaid State Plan. The SPA removes a provisional sunset date that was attached to CMS approval of SPA SD-25-003, which authorized mandatory coverage of targeted case management (TCM) services for eligible juveniles who are inmates of public institutions under Section 5121 of the Consolidated Appropriations Act, 2023. CMS had conditioned removal of the sunset on the state completing stakeholder engagement, outreach, and recruitment of TCM providers pursuant to Section 1902(a)(84)(D) of the Social Security Act; the state represents those activities are now complete. The proposed SPA incorporates two additional modifications beyond sunset removal. First, it updates the TCM coverage period to ninety days post-release, reflecting stakeholder feedback that many adjudicated individuals are released to the community immediately upon adjudication without additional time served, making pre-release TCM delivery impractical. Second, the SPA incorporates coverage authority under Section 5122 of the Consolidated Appropriations Act, 2023, to provide Medicaid and CHIP services to eligible youth who are incarcerated pending disposition of charges, covering the pre-adjudication period. The SPA amends page 2 and adds page 3 to Attachment 3.1-M and page 1 of Supplement 1-A to Attachment 3.1-A of the Medicaid State Plan. It also amends pages 6, 7, and 9 and the CS31 Incarcerated CHIP Beneficiaries template pages of the CHIP State Plan. The department estimates no fiscal impact in Federal Fiscal Year 2027 or Federal Fiscal Year 2028. The intended effective date is December 1, 2026. The public comment period runs from October 26, 2026 through November 25, 2026. Comments may be submitted to MedicaidSPA@state.sd.us or mailed to the Division of Medical Services, Department of Social Services, 700 Governors Drive, Pierre, South Dakota 57501-2291.