Bulletins




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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.

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):

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.

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: 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

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.

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.

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.

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.

Bulletin: Children’s Private Duty Nursing Staffing Requirement Change

Post Date: 09/01/2017 - 9:37am

Effective Oct. 1, 2017, in lieu of having one year of pediatric nursing experience in a clinical setting, nursing providers may submit a pediatric nurse training program for registered nurses (RNs) and licensed practical nurses (LPNs) to SCDHHS for review and potential approval.

Bulletin: Pervasive Developmental Disorder (PDD) Waiver Termination

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.

Bulletin: Updates to the Autism Spectrum Disorder (ASD) Transition Plan

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.

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