Final Public Notice for Supplemental Teaching Payments

The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following action regarding its methods and standards for setting payments for the Supplemental Teaching Physician Payment Program under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after April 1, 2016, SCDHHS will amend the South Carolina Title XIX Supplemental Teaching Physician reimbursement methodology to become compliant with the Centers for Medicare and Medicaid Services (CMS) guidance. The SCDHHS will make the following changes:

• Remove the cap on the number of teaching physicians that can be used to establish the supplemental teaching physician payment.
• Revise the supplemental teaching physician payment calculation methodology from 35% of billed charges to payment up to the average commercial rate on an individual provider specific basis.
• Apply a trend factor to the computed ACR payments to take into account the difference in the base year period and the payment period.

SCDHHS is making the above changes in order to become compliant with CMS guidance relating to the calculation of the supplemental teaching physician payments.

SCDHHS projects that based upon the above actions, annual aggregate Medicaid fee for service expenditures will result in payment reductions of approximately $4.0 million total dollars, or a 9.82% decrease.

Copies of this notice are available at each County Department of Health and Human Services Office and at www.scdhhs.gov for public review. Additional information concerning the above action is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Acute Care Reimbursements, Room 1209, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.