Bulletins




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Provider Alert: Obtaining Infant Medicaid ID Numbers on Provider Web Tool

Post Date: 05/21/2015 - 1:31pm

Provider Alert: Provider Revalidation

Post Date: 05/21/2015 - 1:17pm

Provider Alert: Update to Nondiscirmination Portion of the State Plan

Post Date: 05/14/2015 - 10:37am

Bulletin: Revised Family Planning Examination/Visits

Post Date: 05/06/2015 - 11:11am

SCDHHS no longer requires a physical examination during an initial Family Planning visit in order to prescribe hormonal contraception.

Provider Alert: Rehabilitative Behavioral Health Services Changes Updates

Post Date: 04/30/2015 - 3:38pm

Bulletin: Autism Spectrum Disorder Services Interim Process

Post Date: 04/22/2015 - 12:54pm

Members 0-21 years old are eligible to submit requests for ASD services, including members currently on the Pervasive Developmental Disorder (PDD) Waiver waiting list as well as those whose PDD Waiver services have expired.

Bulletin: Provider Enrollment Revalidation

Post Date: 04/20/2015 - 2:41pm

Providers enrolled in the South Carolina Healthy Connections Medicaid program must have their enrollment revalidated by SCDHHS on or before March 25, 2016.

Provider Alert: HCBS C4 Individual Facilities/Settings Assessment Process

Post Date: 04/14/2015 - 11:31am

Bulletin: Rehabilitative Behavioral Health Services Changes

Post Date: 04/13/2015 - 7:12pm

The South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only and are effective May 1, 2015, unless otherwise specified in this bulletin.

Provider Alert: Change in SC P&T Committee Meeting Date

Post Date: 04/13/2015 - 9:52am

Bulletin: EPSDT Pediatric Screening Tools

Post Date: 03/31/2015 - 4:47pm

Effective January 1, 2015, SCDHHS added Current Procedural Terminology (CPT) code 96127 to break out the services of emotional and behavioral assessments from developmental screening reported with CPT code 96110.

Provider Alert: Deemed Baby Claims 712 Edit Code

Post Date: 03/26/2015 - 12:49pm

Provider Alert: ICD-10 Introductory Classes

Post Date: 03/13/2015 - 3:57pm

Bulletin: Rehabilitative Behavioral Health Services Frequently Asked Questions

Post Date: 03/13/2015 - 12:38pm

On Feb. 20, the South Carolina Department of Health and Human Services (SCDHHS) released a bulletin on changes to the Rehabilitative Behavioral Health Services (RBHS) policy, effective March 1, 2015. These changes, which only apply to fee for service, include medical necessity and prior authorizations, staff credentials, staff to client ratio, frequency limits and reimbursement rates and modifier changes.

Bulletin: Modification to Federally Qualified Healthcare Center (FQHC) Claims Submission Criteria

Post Date: 03/02/2015 - 3:24pm

Changes to Federally Qualified Healthcare Centers (FQHCs) enrollment and claims submission criteria.

Provider Alert: Change in SC P&T Committee Meeting Date

Post Date: 02/24/2015 - 1:27pm

Provider Alert: Primary Care Physician Fee Schedule Enhancement

Post Date: 02/23/2015 - 10:49am

Bulletin: Rehabilitative Behavioral Health Services Changes

Post Date: 02/20/2015 - 7:20pm

Effective March 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will implement the following changes to the Rehabilitative Behavioral Health Services (RBHS) policy. These changes apply to fee for service RBHS only.

Provider Alert: 642 Edit Claims Update; Partial Solution Implemented

Post Date: 02/20/2015 - 11:24am

Bulletin: Healthy Connections Checkup: Colorectal Cancer Screening Benefits

Post Date: 02/13/2015 - 4:11pm

Effective immediately, the following codes are now billable under the Healthy Connections Checkup (Checkup) colorectal cancer screening benefit. These services are available once every 10 years for patients 50-75 years old. An FP modifier must be appended to the following Current Procedural Terminology (CPT) codes.

Bulletin: RBHS Provider Enrollment Moratorium

Post Date: 02/06/2015 - 3:28pm

Effective immediately the South Carolina Department of Health and Human Services (SCDHHS) is imposing a moratorium on the enrollment of Rehabilitative Behavioral Health Services providers.

Provider Alert: 642 Edit Claims

Post Date: 02/04/2015 - 5:06pm

Bulletin: Coverage of Hydroxyprogesterone Injection

Post Date: 02/04/2015 - 10:33am

On July 3, 2014, the Food and Drug Administration issued updated guidance in regards to hydroxyprogesterone caproate.

Bulletin: Behavioral Health Providers

Post Date: 01/27/2015 - 1:40pm

New Billing Procedure Code for Child and Adolescent Level of Care Utilization System (CALOCUS) & Procedure Code Change for Initial Assessment

Provider Alert: Deemed Baby Process and Assumptive Eligibility for Pregnant Women

Post Date: 01/26/2015 - 8:02pm

Provider Alert: Change in SC P&T Committee Meeting Date

Post Date: 01/20/2015 - 4:38pm

Bulletin: 2015 Medicare Deductible, Coinsurance and Medicaid Blood Deductible Rates for Dual-Eligible (Medicaid and Medicare) Members

Post Date: 01/16/2015 - 10:03am

SCDHHS’ payment for dual-eligible (Medicaid and Medicare) members is equal to the allowed amount minus the Medicare payment or the sum of the Coinsurance, Deductible and Blood Deductible (up to three units), whichever is less.

Provider Alert: FREE WORKSHOPS: January-March 2015

Post Date: 01/05/2015 - 5:00pm

Provider Alert: FINAL NOTICE Address Change for SFTP-Based Medicaid Claims

Post Date: 12/30/2014 - 1:08pm

Provider Alert: Intensive Family Services (Procedure Code H0046)

Post Date: 12/19/2014 - 11:23am

Provider Alert: Provider Enrollment and Screening

Post Date: 12/18/2014 - 4:46pm

Bulletin: Sickle Cell Disease Management Program

Post Date: 12/18/2014 - 12:44pm

Effective on or after January 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will update its Disease Management program to include sickle cell disease. Sickle Cell Disease Management (SCDM) is available to Medicaid eligible individuals determined to have a confirmed diagnosis of sickle cell disease as defined by the Centers for Disease Control and Prevention (CDC) and are not simultaneously receiving Targeted Case Management or any other coordination/management service for sickle cell disease.

Provider Alert: SCDHHS and KEPRO to Hold Provider Quality Improvement Training

Post Date: 12/10/2014 - 3:47pm

Bulletin: SCDHHS Offers Free Provider Workshops

Post Date: 12/08/2014 - 11:43am

Medicaid Basics, Comprehensive Web Tool, Overview of Third Party Liability and Overview of Claim-level Adjustments.

Provider Alert: Deemed Baby Process

Post Date: 12/05/2014 - 5:14pm

Bulletin: Healthy Connections Now Provides Adult Dental Benefits

Post Date: 12/01/2014 - 4:17pm

Dental health is a key part of improving and maintaining your health. The health of your teeth and gums can affect the health of the rest of your body.

Provider Alert: Co-payments

Post Date: 12/01/2014 - 10:03am

Bulletin: ACA Enhanced Physician Payment Reimbursement Discontinued. Primary Care Fee Schedule Enhancement

Post Date: 12/01/2014 - 9:38am

Effective January 1, 2013, the South Carolina Department of Health and Human Services (SCDHHS) implemented a portion of the final rule under the Affordable Care Act (ACA) that increased Medicaid reimbursements for evaluation, management and immunization procedure codes for two years. The increase applied to both fee-for-service (FFS) and Medicaid Managed Care Organizations (MCOs).

Provider Alert: Intensive Family Services Contact

Post Date: 11/26/2014 - 1:28pm

Bulletin: Intensive Family Services (Procedure code H0046)

Post Date: 11/17/2014 - 3:50pm

The South Carolina Department of Health and Human Services will add Intensive Family Services (IFS) to the Rehabilitative Behavioral Health Services Manual and the Licensed Independent Practitioners Rehabilitative Services Manual effective January 1, 2015.

Bulletin: Claim Reconsideration Policy-Fee For Service (FFS) Medicaid

Post Date: 11/14/2014 - 9:11am

Effective January 1, 2015 the South Carolina Department of Health and Human Services (SCDHHS) will implement a Claim Reconsideration Policy.

Bulletin: Policy Revisions to the Local Education Agency (LEA) Services Manual for Rehabilitative Behavioral Health Services (RBHS)

Post Date: 11/13/2014 - 4:45pm

1. Discontinue the requirement of the FORM 255 2. Relocate the Psychological Testing and Evaluation policy to the RBHS section of the manual

Bulletin: Update to Section 1 of All Provider Manuals

Post Date: 11/03/2014 - 9:26am

The South Carolina Department of Health and Human Services (SCDHHS) currently contracts with six (6) Managed Care Organizations (MCOs). Each MCO currently operating in South Carolina has a small percentage of contracted network providers that have not enrolled directly with SCDHHS. The most recent contract between SCDHHS and each MCO requires that their contracted provider network also be enrolled directly with SCDHHS. This requirement was implemented to provide for accuracy in MCO reporting and to assist SCDHHS in monitoring and ensuring ongoing provider compliance.

Bulletin: Adult Preventative Dental Service

Post Date: 10/23/2014 - 11:43am

Effective with dates of service beginning December 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will implement an Adult Preventative Dental benefit. Medicaid enrolled dentists may seek reimbursement from the Fee-for-Service Healthy Connections program for preventative dental benefit services. These services are available to members age 21 and over that have full Healthy Connections benefits. Covered services include diagnostics, extractions, fillings and an annual cleaning, up to a maximum benefit of $750 per state fiscal year (July 1 through June 30). The $750 maximum benefit will be based on claim payments under the SCDHHS dental fee schedule.

Bulletin: New Tuberculosis Benefit

Post Date: 10/17/2014 - 11:01am

Effective for dates of service on or after November 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will implement a new program that offers Healthy Connections Medicaid coverage to persons with latent tuberculosis (TB) or active TB infection/disease who are uninsured or underinsured and who do not meet the eligibility criteria for full Healthy Connections Medicaid. This program will be administered through the South Carolina Department of Health and Environmental Control (SCDHEC).

Bulletin: SCDHHS Offers Free Provider Workshops

Post Date: 10/07/2014 - 4:11pm

Medicaid Basics, Comprehensive Web Tool, Overview of Third Party Liability and Overview of Claim-level Adjustments.

Bulletin: CLTC Case Management Scope Revisions

Post Date: 09/30/2014 - 5:04pm

The following revisions will be incorporated into the South Carolina Department of Health and Human Services (SCDHHS) Community Long Term Care (CLTC) Scope of Service for Case Management effective November 1, 2014.

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