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SCAM ALERT

Healthy Connections Medicaid team members and managed care plans will never ask for money, gift cards or something else of monetary value via text, email or a phone call. If someone contacts you asking for something of monetary value to get or keep Medicaid coverage, please report it by contacting the Medicaid fraud hotline at (888) 364-3224 Monday through Friday from 8:30 a.m. to 5 p.m. or by sending an email to FraudRes@scdhhs.gov.

Final Action for Compliance with the SUPPORT for Patients and Communities Act

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following action regarding the SUPPORT for Patients and Communities (SUPPORT) Act under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or before Oct. 1, 2019, SCDHHS will amend the South Carolina Title XIX State Plan to demonstrate compliance with the SUPPORT Act. This action does not result in any changes to Medicaid coverage policy, but rather attest to preexisting compliance with the SUPPORT Act requirements. SCDHHS currently provides for:

  • Safety edits including early, duplicate, and quantity limits for opioid medications
  • Maximum daily morphine milligram equivalent (MME) safety edits for opioid medications
  • Concurrent utilization alerts for opioids with benzodiazepines and/or antipsychotics
  • Monitoring antipsychotic medications in children
  • Monitoring of fraud and abuse of controlled substances by enrollees, prescribing providers and pharmacy providers, to include lock in programs and drug monitoring

The above actions will not have any impact on Medicaid benefits or reimbursement policy.

 

Copies of this notice are available at each SCDHHS Healthy Connections Medicaid office and at www.scdhhs.gov for public review. Additional information concerning these actions is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at SCDHHS, Division of Health Programs, Room 1244, 1801 Main Street, Columbia, S.C., Monday- Friday between the hours of 9 a.m. and 5 p.m.

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