Bulletins




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Bulletin: Changes to Applied Behavioral Analysis Provider Credentialing Requirements

Post Date: 08/15/2019 - 4:45pm

As part of the ongoing effort to improve the quality and delivery of services for infants and toddlers with disabilities and payment process to providers through the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as “BabyNet,” the South Carolina Department of Health and Human Services (SCDHHS) is integrating IDEA Part C and Healthy Connections Medicaid policies. SCDHHS is informing the provider and beneficiary community about all actions necessary to implement this realignment through a series of alerts and bulletins. This bulletin announces changes to credentialing requirements for IDEA Part C providers who render Applied Behavioral Analysis (ABA) therapy pursuant to an approved Individualized Family Service Plan (IFSP).

Bulletin: Updates in BRIDGES

Post Date: 07/12/2019 - 6:13pm

As part of the South Carolina Department of Health and Human Services’ (SCDHHS) integration of BabyNet and Healthy Connections Medicaid services, BabyNet service coordinators may see changes to information in some areas of the BabyNet Reporting & Intervention Data Gathering Electronic System (BRIDGES) case management system. This includes, but is not limited to, demographic information; third-party liability (private insurance) information; managed care organization (MCO) information; and, Medicaid ID number, and associated eligibility and referral dates. Please note that as a part of this integration process, the BRIDGES system will be unavailable between 6 p.m., July 12 and 6 p.m., July 13 as system upgrades are made

Bulletin: Changes to Individuals with Disabilities Education Act Part C Program (BabyNet) Services

Post Date: 07/10/2019 - 4:02pm

As part of the ongoing effort to improve the quality and delivery of services for infants and toddlers with disabilities through the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as “BabyNet,” the South Carolina Department of Health and Human Services (SCDHHS) is aligning BabyNet with the Healthy Connections Medicaid program through a series of policy and technology initiatives. Throughout the alignment process, SCDHHS has received feedback and questions from families, providers, and stakeholders about changes they will experience. SCDHHS is issuing this consolidated informational bulletin to address common questions and issues based on this feedback.

Provider Alert: Hepatitis A Outbreak

Post Date: 05/15/2019 - 3:25pm

Provider Alert: HEDIS® Tips

Post Date: 04/15/2019 - 1:19pm

Bulletin: Temporary or Protective Restorative Services

Post Date: 04/05/2019 - 11:11am

Effective for services rendered on or after May 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will no longer reimburse for Current Dental Terminology (CDT) code D2940 (Protective Restoration) as a separate service. Reimbursement rates for restorative services will include the costs of providing temporary or protective fillings as a component of permanent restorative care.

Bulletin: Changes to Program Integrity Prepayment Claims Review Policy

Post Date: 03/01/2019 - 3:15pm

Effective April 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will amend the Prepayment Claims Review Policy to allow the submission of electronic claims. Unless otherwise specified, claims subject to program integrity prepayment claims review may be submitted electronically. This includes both the claims and the supporting documentation. Providers should carefully review the current manual for compliance with policy guidelines.

Bulletin: Medicaid Coverage of Opioid Treatment Programs and SCDHHS Efforts to Address the Opioid Crisis

Post Date: 12/07/2018 - 3:26pm

In January 2019, the South Carolina Department of Health and Human Services (SCDHHS) will begin to enroll opioid treatment programs (OTPs) in the Medicaid provider network and begin to reimburse for medication-assisted treatment (MAT) provided in OTPs. The addition of this benefit will make the full spectrum of pharmacotherapies approved for the treatment of opioid use disorder (OUD) available to Medicaid members. Additional details regarding the enrollment procedures for OTPs will be provided this month.

Bulletin: Dental Providers

Post Date: 11/09/2018 - 4:25pm

Effective for dates of service on and after Jan. 1, 2019, the South Carolina Department of Health and Human Services (SCDHHS) will limit reimbursement for moderate sedation or deep sedation/general anesthesia ("sedation services") in dental offices to providers with a sedation permit from the State Board of Dentistry. For sedation services in a dental office to be reimbursed, a valid dental sedation permit must be on file with DentaQuest, and both the authorized office location and administering provider must be clearly documented in the patient's record.

Bulletin: South Carolina Emergency Response Provider Registration

Post Date: 09/24/2018 - 9:33am

SCDHHS is committed to ensuring reimbursement for services rendered by qualified providers, in good faith, during the Hurricane Florence emergency response period.

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: Service Rate Increases

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

Provider Alert: SCDHHS Stakeholder Survey

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

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: 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.

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