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Post date: 06/26/2017 - 2:45pm

The Centers for Medicare and Medicaid Services (CMS) issued an informational bulletin clarifying Medicaid coverage of services to children with autism on July 7, 2014. As a result of that bulletin and extensive consultation with CMS, the Pervasive Developmental Disorder (PDD) Waiver will be terminated Dec. 31, 2017.

Post date: 06/23/2017 - 4:58pm

The South Carolina Department of Health and Human Services (SCDHHS) updated the autism spectrum disorder (ASD) services transition plan for delivery of ASD services. This plan supersedes the bulletin entitled “Transition Guidelines for Autism Services,” published May 4, 2017. The following outlines the instructions for providers of ASD services for services delivered on or after July 1, 2017.

Post date: 06/22/2017 - 4:57pm

The South Carolina Department of Health and Human Services (SCDHHS) is informing all practices currently recognized by the National Committee for Quality Assurance (NCQA) as a patient-centered medical home (PCMH) or who have applied or are considering applying for PCMH certification that the following modifications are being made to its PCMH incentive program, effective July 1, 2017.

Post date: 06/15/2017 - 4:17pm

Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will no longer limit the number of prescriptions available to Medicaid beneficiaries.

Post date: 06/15/2017 - 11:41am

Post date: 06/09/2017 - 2:43pm

The South Carolina Department of Health and Human Services (SCDHHS) is updating the Autism Spectrum Disorder Services (ASD) Provider Manual. The updated ASD Provider Manual will be published on June 9, 2017 and will include three changes relative to the direct provision of services by applied behavior analysis (ABA) providers.

Post date: 06/05/2017 - 1:57pm

Post date: 06/02/2017 - 4:46pm

Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will include psychiatric residential treatment facility (PRTF) services and providers in the coordinated care benefit provided by SCDHHS-contracted managed care organizations (MCOs). MCO members will access PRTF services through the MCO they have chosen or to which they have been assigned. Individuals not choosing or not mandatorily assigned to an MCO will continue to access PRTF services through the SCDHHS Medicaid fee-for-service (FFS) benefit. PRTFs serve beneficiaries 21 years of age and younger.

Post date: 06/02/2017 - 4:29pm

Effective for dates of service on or after July 1, 2017, and as required by 1902(a) (25) of the Social Security Act, the South Carolina Department of Health and Human Services (SCDHHS) will implement cost avoidance rules for the procedure codes reflected below. Service providers will be required to file claims to any liable third-party insurer before submitting a claim to SCDHHS for payment. Claims filed with SCDHHS prior to billing all liable third-party insurers and appropriately documenting the third party filing on the claim submitted to Medicaid will receive all applicable claim edits. Resolution of applicable claim edits for the issues described above are outlined in the appendices of each SCDHHS provider manual, located at https://www.scdhhs.gov/provider-manual-list .

Post date: 06/02/2017 - 4:23pm

Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) is enhancing tobacco cessation coverage for full-benefit Medicaid beneficiaries to align with recommendations from the Centers for Disease Control and Prevention (CDC) and the American Lung Association (ALA). This update applies to both the fee-for-service and managed care Medicaid benefits.

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