Bulletins




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Bulletin: Emergency Response: Provider Reimbursement for North Carolina Medicaid Beneficiaries

Post Date: 09/19/2018 - 9:02am

The purpose of this bulletin is to describe additional state efforts to ensure continued access to care during the emergency response to Hurricane Florence and the impact of these efforts on North Carolina Medicaid beneficiaries and South Carolina Healthy Connections Medicaid providers.

Bulletin: Emergency Response Provider Enrollment Requirements

Post Date: 09/12/2018 - 2:29pm

The purpose of this bulletin is to describe state and federal efforts to ensure continued access to care during the emergency response to Hurricane Florence and the impact of these efforts will have on Healthy Connections Medicaid beneficiaries and providers.

Bulletin: Changes in Freedom of Choice (FoC) Process and Timeframe for Inpatient Delivery of Medicaid Targeted Case Management (MTCM)

Post Date: 08/17/2018 - 3:27pm

Effective Sept. 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will no longer use the SCDHHS Phoenix System or its electronic referral portal, https://phoenix.scdhhs.gov/cltc_referrals/new, for Medicaid targeted case management (MTCM) services or require the Freedom of Choice (FoC) form.

Provider Alert: Healthy Connections Choices Enrollment Broker Training

Post Date: 08/09/2018 - 4:23pm

Provider Alert: Service Rate Increases

Post Date: 08/09/2018 - 12:09pm

Provider Alert: SCDHHS Stakeholder Survey

Post Date: 07/16/2018 - 3:34pm

Provider Alert: 2018 Provider Revalidation; Group 2

Post Date: 07/16/2018 - 9:10am

Provider Alert: Dental Manual Updates

Post Date: 06/21/2018 - 1:33pm

Bulletin: Provider Updates on ABA for Autism Spectrum Disorder (ASD) Services

Post Date: 06/15/2018 - 4:01pm

Effective with dates of service on and after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the applied behavior analysis (ABA) fee schedule and the policy manual for autism spectrum disorder (ASD) services.

Provider Alert: KEPRO Prior Authorizations

Post Date: 06/15/2018 - 3:23pm

Provider Alert: July 2018 Provider Payment Holiday Schedule

Post Date: 06/13/2018 - 12:10pm

Provider Alert: Free Provider Workshops

Post Date: 06/05/2018 - 3:09pm

Bulletin: Change in the Third Party Liability (TPL) Recovery Cycle from Quarterly to Monthly

Post Date: 06/05/2018 - 9:51am

SCDHHS has observed that nearly 16% of recovery claims are rejected by the financially liable insurer for untimely filing. This is due in-part to the length and infrequent commencement of each cycle.

Provider Alert: HCBS Statewide Transition Compliance

Post Date: 06/04/2018 - 9:35am

Bulletin: Third Party Liability (TPL)

Post Date: 06/01/2018 - 4:13pm

Effective July 2, 2018, BlueCross BlueShield of South Carolina (BCBSSC) will perform the following third party liability (TPL) services on behalf of the South Carolina Department of Health and Human Services (SCDHHS):

Provider Alert: Beneficiary Eligibility Impacts for June 2018

Post Date: 06/01/2018 - 3:31pm

Bulletin: Policy Changes to RBHS, LIP, LEA and CMHC manuals

Post Date: 06/01/2018 - 11:25am

Effective with dates of service on or after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will limit the billable units of crisis management to 80 units annually, unless otherwise prior authorized by SCDHHS. The daily limits outlined in the respective manuals will remain in place.

Provider Alert: Changes to BabyNet Services Claims Payment Process

Post Date: 05/25/2018 - 3:16pm

Provider Alert: Rate Increase for Applied Behavior Analysis (ABA)

Post Date: 05/23/2018 - 4:20pm

Provider Alert: Separating Enteral and Parenteral Nutrition Policies

Post Date: 05/16/2018 - 9:10am

Bulletin: Payment Error Rate Measurement (PERM)

Post Date: 05/04/2018 - 9:58am

The Improper Payments Information Act of 2002 directs federal agency heads, in accordance with the Office of Management and Budget (OMB) guidance, to review programs on an annual basis that are susceptible to significant erroneous payments and to report the improper payment estimates to Congress. In previous reviews, OMB identified Medicaid and Children's Health Insurance Program (CHIP) as at-risk programs for erroneous payments. As a result, the Centers for Medicare and Medicaid Services (CMS) decided to measure the accuracy of Medicaid and CHIP payments made by states for services rendered to recipients through the Payment Error Rate Measurement (PERM) program.

Provider Alert: May SC Pharmacy and Therapeutics Committee Meeting

Post Date: 04/26/2018 - 10:15am

Provider Alert: Healthy Connections Choices Enrollment Broker Training

Post Date: 04/12/2018 - 8:31am

Provider Alert: New Medicare ID Cards

Post Date: 04/06/2018 - 11:28am

Bulletin: Dental Periodicity Schedule Implementation

Post Date: 04/04/2018 - 11:22am

Effective May 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) is updating the SCDHHS Dental Periodicity Schedule. This update follows the American Academy of Pediatric Dentistry (AAPD) recommendations on Periodicity of Examination, Preventive Dental Services, Anticipatory Guidance and Oral Treatment for Infants, Children and Adolescents. The Dental Periodicity Schedule recommends a set of dental procedures and services that are applicable at each stage of a child's development, from birth through the 21st birthday, with appropriate intervals of care that meet reasonable standards of dental practice.

Provider Alert: 2018 Provider Revalidation

Post Date: 04/02/2018 - 4:09pm

Bulletin: Medicaid Periodicity Schedule

Post Date: 03/30/2018 - 2:41pm

To ensure the highest quality care to children enrolled in the South Carolina Medicaid program, the South Carolina Department of Health and Human Services (SCDHHS) adopts the following updates and reminders regarding Early and Periodic Screening, Diagnosis and Treatment (EPSDT) coverage policy. The EPSDT benefit is available to Medicaid beneficiaries under the age of 21.

Provider Alert: HEDIS® Tips

Post Date: 03/29/2018 - 4:16pm

Provider Alert: Electronic Funds Transfer (EFT) Compliance

Post Date: 03/26/2018 - 2:03pm

Provider Alert: Keystone Peer Review Organization (KEPRO) Training

Post Date: 03/14/2018 - 2:53pm

Bulletin: Early Intensive Behavioral Intervention Providers and Applied Behavior Analysts

Post Date: 03/13/2018 - 1:06pm

Effective April 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the policy manual for autism spectrum disorder (ASD) services.

Bulletin: Dental Policy Updates

Post Date: 03/02/2018 - 3:18pm

SCDHHS is issuing the following policies for dental providers effective for dates of service on and after April 1, 2018

Provider Alert: Dental Procedure Fee Inclusions

Post Date: 02/08/2018 - 1:56pm

Bulletin: Durable Medical Equipment Medicaid Certificate of Medical Necessity (MCMN) CPAP Signature Requirement Modifications

Post Date: 02/05/2018 - 11:13am

The South Carolina Department of Health and Human Services (SCDHHS) is amending physician signature requirements for continuous positive airway pressure (CPAP) and bi-level positive airway pressure (BiPAP) devices.

Bulletin: Durable Medical Equipment Medicaid Certificate of Medical Necessity Signature Requirement Modifications

Post Date: 02/01/2018 - 3:44pm

The South Carolina Department of Health and Human Services (SCDHHS) is amending current physician signature requirements for the following forms located in the Durable Medical Equipment (DME) Provider Manual:

Bulletin: Updates to the Quarterly Seclusion and/or Restraint Reporting Form

Post Date: 02/01/2018 - 3:35pm

This is to inform psychiatric residential treatment facility (PRTF) providers that the South Carolina Department of Health and Human Services (SCDHHS) will update the Quarterly Seclusion and/or Restraint Reporting Form.

Provider Alert: HEDIS and HEDIS Record Requests

Post Date: 01/19/2018 - 2:02pm

Bulletin: Benefit Limitations for Sedation Codes

Post Date: 12/20/2017 - 4:07pm

The South Carolina Department of Health and Human Services (SCDHHS) issues the following policy for all dental providers effective for dates of service on and after Jan. 1, 2018.

Provider Alert: 2018 Provider Enrollment Application Fee

Post Date: 12/18/2017 - 9:43am

Bulletin: Adding Developmental Pediatricians to the Comprehensive Diagnostic Assessment

Post Date: 12/06/2017 - 4:43pm

The South Carolina Department of Health and Human Services will be amending its autism spectrum disorder (ASD) manual to include additional providers that will be allowed to complete the comprehensive psychological assessment/testing report to determine if Medicaid beneficiaries meet medical necessity criteria for ASD services.

Bulletin: Medication Assisted Treatment Services via Telemedicine

Post Date: 12/06/2017 - 1:53pm

Effective for dates of service on or after Jan. 1, 2018, and pursuant to South Carolina Budget Proviso 117.135, Section A, the South Carolina Department of Health and Human Services (SCDHHS) will accept Act 301 Behavioral Health Centers (301 Centers) as approved referring sites for Medication Assisted Treatment (MAT) services rendered via telemedicine consultation.

Provider Alert: Free Provider Workshops: December 2017-February 2018

Post Date: 11/29/2017 - 1:51pm

Bulletin: Ventilator Guidelines

Post Date: 11/14/2017 - 4:22pm

Effective Dec. 1, 2017,SCDHHS will add criteria and prior authorization guidelines for ventilators to the Durable Medical Equipment (DME) Provider Manual for DME providers. This policy will be posted in the DME Provider Manual located on the SCDHHS website.

Provider Alert: November 2017 Provider Payment Holiday Schedule

Post Date: 11/07/2017 - 2:09pm

Provider Alert: Free Provider Workshops: November 2017 - January 2018

Post Date: 11/02/2017 - 1:53pm

Provider Alert: Over-The-Counter Aspirin Coverage

Post Date: 09/29/2017 - 10:17am

Provider Alert: October 2017 Nursing Facility Provider Trainings

Post Date: 09/13/2017 - 4:04pm

Provider Alert: Free Provider Workshops: September-November 2017

Post Date: 09/07/2017 - 10:35am

Bulletin: Updates to the Seclusion and Restraint Reporting Form

Post Date: 09/01/2017 - 4:53pm

The South Carolina Department of Health and Human Services (SCDHHS) will update the form for reporting seclusion and restraint. The form will contain an additional field indicating who ordered the restraint. The manual will also be updated to include this additional requirement. The new form must be used for all seclusion and restraint reports beginning Oct. 1, 2017.

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