Bulletins




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Bulletin: Prostate Cancer Screenings Added to Limited Benefit Program

Post Date: 07/08/2021 - 3:01pm

SCDHHS today announced it will add coverage of prostate cancer screenings for members of the Family Planning limited benefit program beginning Aug. 1, 2021.

Bulletin: Payment Error Rate Measurement (PERM) Program

Post Date: 06/14/2021 - 3:32pm

CMS has informed SCDHHS that the South Carolina Healthy Connections Medicaid program will participate in the Payment Error Rate Measurement (PERM) program for State Fiscal Year 2022.

Bulletin: SCDHHS Policy Updates for July 1, 2021

Post Date: 06/03/2021 - 1:46pm

The South Carolina Department of Health and Human Services (SCDHHS) is announcing updates to several policies. The updates are described below and are effective for dates of service beginning July 1, 2021.

Bulletin: South Carolina Recovery Audit Contractor

Post Date: 04/06/2021 - 2:41pm

SCDHHS has awarded a contract to Health Management Systems, Inc. (HMS) to act as the agency’s recovery audit contractor (RAC). Federal regulations (42 CFR 455.500 et. seq.) require states to establish a RAC program as a measure to promote the integrity of the Medicaid program. As a part of the RAC contract, HMS will also conduct Credit Balance audits according to 42 CFR § 455.506(a).

Bulletin: Updates to Behavioral Health Policies

Post Date: 03/01/2021 - 4:08pm

Beginning Sept. 1, 2021, SCDHHS will require that the MTCM assessment include printed name, title, date and signature of the person conducting the assessment to validate the need or lack of need for MTCM services.

Bulletin: Changes to Prior Authorization Review Process for Select Physician administered Drugs

Post Date: 01/20/2021 - 2:24pm

SCDHHS today announced the prior authorization review for several physician-administered drugs will transition from a review process administered by KEPRO to a review process administered by Magellan Specialty (formerly ICORE).

Provider Alert: 1099s for Calendar Year 2020

Post Date: 01/19/2021 - 12:52pm

Provider Alert: Centene/WellCare Acquisition

Post Date: 01/07/2021 - 10:44am

Bulletin: CNA Clinical Training Sites

Post Date: 12/31/2020 - 2:19pm

The South Carolina Department of Health and Human Services (SCDHHS) is updating agency policy to allow hospitals to serve as CNA clinical training sites. Effective Jan. 1, 2021, CNA candidates may receive the required 40 hours of clinical skills training in a hospital or approved nursing facility.

Bulletin: Coronavirus Disease 2019 (COVID-19) Vaccination Administration Coverage

Post Date: 12/22/2020 - 4:34pm

SCDHHS will reimburse for COVID-19 vaccine administration, without patient cost-sharing, when provided to Healthy Connections Medicaid members in a manner consistent with recommendations of the Advisory Committee on Immunization Practices (ACIP).

Bulletin: Vaccines for Children Policy and Coding Update

Post Date: 10/15/2020 - 4:37pm

The South Carolina Department of Health and Human Services (SCDHHS) is revising agency policies related to the administration of vaccines obtained through the Vaccines for Children (VFC) program to Healthy Connections Medicaid-enrolled children. The guidance and changes to vaccine administration and counseling policy included in this bulletin replace the existing SCDHHS guidance on this topic.

Provider Alert: IDEA Part C Policy Updates

Post Date: 10/15/2020 - 1:13pm

Bulletin: Updates to the Dental Services Provider Manual

Post Date: 09/10/2020 - 11:25am

The South Carolina Department of Health and Human Services (SCDHHS) is issuing the following policy updates and clarifications for South Carolina Healthy Connections Medicaid dental providers effective for dates of service on and after Oct. 1, 2020.

Bulletin: Provider Reimbursement Available for COVID-19 Testing for the Uninsured

Post Date: 07/06/2020 - 4:48pm

The South Carolina Department of Health and Human Services (SCDHHS) today announced it will begin accepting applications for a limited-benefit Medicaid coverage group newly authorized to provide reimbursement for coronavirus disease 2019 (COVID-19) testing for those without healthcare coverage. Services and individuals covered by the new COVID-19 Limited Benefit Program are limited to COVID-19 testing and diagnostic services. Instructions for providers are available below. Additional SCDHHS COVID-19-related policy changes and resources for providers are available at www.scdhhs.gov/COVID19.

Bulletin: July 2020 Coverage and Reimbursement Changes

Post Date: 06/30/2020 - 6:02pm

Several benefit and reimbursement changes are being implemented on July 1, 2020.

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