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Post date: 07/18/2016 - 1:33pm

Post date: 07/11/2016 - 11:47am

The new card, effective August 1, 2016, will no longer contain a magnetic data strip on the backside.

Post date: 06/28/2016 - 2:43pm

Post date: 06/23/2016 - 8:58am

Effective for all claims submitted on or after Aug. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will lower the age limitation for the codes listed in the table below. This change is to adhere to best practice guidelines.

Tags: Dental
Post date: 06/17/2016 - 8:48am

Post date: 06/13/2016 - 1:44pm

Post date: 06/08/2016 - 1:32pm

SCDHHS will expand the bariatric surgery benefit to include coverage of sleeve gastrectomy.

Post date: 06/01/2016 - 2:35pm

Changes will be effective with dates of service on or after July 1, 2016. This bulletin provides notice and an overview of revisions effective July 1, 2016; it is not intended to reflect all revisions in the manual. The RBHS manual may be subject to further change.

Post date: 05/05/2016 - 2:08pm

Post date: 04/29/2016 - 11:19am

The Centers for Medicare and Medicaid Services (CMS) will measure the accuracy of Medicaid and CHIP payments made by states for services rendered to recipients through the Payment Error Rate Measurement (PERM) program.

Post date: 04/12/2016 - 11:58am

Post date: 04/11/2016 - 1:34pm

Post date: 04/11/2016 - 10:14am

Post date: 03/11/2016 - 4:44pm

Effective immediately the South Carolina Department of Health and Human Services (SCDHHS) is imposing a moratorium on the enrollment of Medicaid Targeted Case Management (MTCM) providers.

Post date: 03/11/2016 - 2:32pm

Post date: 03/04/2016 - 1:41pm

Post date: 03/02/2016 - 1:25pm

Post date: 03/01/2016 - 1:59pm

The South Carolina Department of Health and Human Services (SCDHHS) is revising the Rehabilitative Behavioral Health Services (RBHS) Policy Manual. Changes will be effective on or after April 1, 2016.

Post date: 02/24/2016 - 11:42am

Post date: 02/23/2016 - 2:45pm

Beginning with dates of service on or after April 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will require that providers verify Medicaid members' controlled substance prescription history through the South Carolina Reporting & Identification Prescription Tracking System (SCRIPTS) before issuing a prescription for any Schedule II through IV controlled substance.

Post date: 02/19/2016 - 2:36pm

Post date: 02/02/2016 - 10:07am

An update to sections three and four of the Ambulance Services Provider Manual will make a clear distinction between the current requirements for submitting claims with modifiers and origin/destination codes.

Post date: 02/01/2016 - 8:49am

Post date: 01/28/2016 - 5:12pm

Effective Feb. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will initiate an improved interim process by which its members are evaluated for and receive Autism Spectrum Disorder (ASD) services that are identified as medically necessary based on an Early and Periodic Screening Diagnosis and Treatment (EPSDT) encounter.

Post date: 01/27/2016 - 10:28am

Effective Jan. 1, 2016, Section 1 of all South Carolina Medicaid Provider Manuals have been updated to reflect changes to the following policies: SC Medicaid program, Records/documentation requirements, Medicaid program integrity, & Appeals

Post date: 01/26/2016 - 4:33pm

Post date: 01/22/2016 - 11:54am

Post date: 12/15/2015 - 4:23pm

Post date: 12/14/2015 - 3:43pm

Post date: 12/11/2015 - 4:59pm

Effective immediately the South Carolina Department of Health and Human Services (SCDHHS) is rescinding the policy, bulletin 14-001 released Feb. 6, 2014, that allowed services delivered to recipients 21 years and over in place of service (62) Outpatient Rehabilitation Facility. Beneficiaries will continue to receive outpatient physical, occupational and speech therapies (PT/OT/SP) services in an outpatient hospital, clinic or office setting.

Post date: 12/11/2015 - 4:49pm

Post date: 12/10/2015 - 9:30am

The Centers for Medicare and Medicaid Services (CMS) recently amended policies regarding Medicaid reimbursement to Medicaid providers for the delivery of state plan-approved services that are available to Medicaid eligible beneficiaries, without charge to the beneficiary (including services that are available without charge to the community at large, or “free care”).

Post date: 12/04/2015 - 4:46pm

Changes will be effective on or after Jan. 1, 2016. The intent of this bulletin is to provide notice of general revisions; it is not intended to reflect all revisions in the manual.

Post date: 11/17/2015 - 1:53pm

Providers may use one of the methods listed below to verify Medicaid enrollment or verify the status of an individual’s application.

Post date: 11/12/2015 - 10:58am

SCDHHS will implement the following one-time change to the Rehabilitative Behavioral Health Services (RBHS) prior authorization (PA) schedule for beneficiaries age 0-21.

Post date: 10/29/2015 - 4:48pm

Post date: 10/29/2015 - 4:42pm

Post date: 10/28/2015 - 4:53pm

Post date: 10/26/2015 - 12:51pm

All licensed Physician Assistants (PAs) providing services to Healthy Connections beneficiaries must be enrolled as providers with the South Carolina Department of Health and Human Services (SCDHHS). PAs providing services to Medicaid Managed Care enrolled members must also be enrolled and credentialed with the member’s Managed Care Organization (MCO).

Post date: 10/01/2015 - 10:00am

Effective Nov. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will implement modifications to the Rehabilitative Behavioral Health Services (RBHS) Policy Manual. These manual revisions will strengthen fee-for-service Medicaid requirements related to several areas of the provider manual including:

Post date: 09/29/2015 - 2:10pm

Update to the Hospital Services Provider Manual to reflect the Medicaid policy for immediate inpatient insertion of Long Acting Reversible Contraceptives (LARCs)

Tags: Hospitals
Post date: 09/28/2015 - 10:23am

The South Carolina Department of Health and Human Services (SCDHHS) will implement a review process on Medicaid Targeted Case Management Services (MTCM) rendered by private providers of MTCM. Effective Nov. 1, 2015, SCDHHS will reimburse for no more than 24 units per calendar quarter per beneficiary unless medical necessity has been demonstrated and approved through the prior authorization process defined in the Oct. 1, 2015, edition of the MTCM Provider Manual. The 24-unit allowance applies to any combination of face to face or telephonic MTCM. For the October-December 2015 calendar quarter, payment for services incurred in October 2015 in excess of the 24-unit limit will not be retroactively denied due to this change.

Post date: 09/24/2015 - 5:45pm

Post date: 09/16/2015 - 4:58pm

Post date: 09/15/2015 - 8:35am

Post date: 09/07/2015 - 1:58pm

Pre-eligibility Medical Expenses and Calculations of Recurring Income for Long Term Care Beneficiaries

Post date: 08/28/2015 - 10:44am

Effective Oct. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will require providers to submit the 2012 American Dental Association (ADA) claim form, or its corresponding Electronic Data Interchange (EDI) format, when filing dental or oral surgical claims services using Common Dental Terminology (CDT) procedure codes. Previously used ADA claim forms and their accompanying EDI formats will be rejected for all claims submitted on or after Oct. 1, 2015.

Tags: Dental
Post date: 08/17/2015 - 6:46pm

Post date: 08/10/2015 - 10:57am

Post date: 07/31/2015 - 2:37pm

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