Final Action for the Incorporation of Institutions for Mental Diseases and Opioid Treatment Program Clinics in the Coordinated Care Benefit

The South Carolina Department of Health and Human Services (SCDHHS) gives notice regarding the inclusion of benefits for inpatient psychiatric care for children delivered in institutions for mental diseases (IMDs) and for services provided in opioid treatment program (OTP) clinics to capitated managed care, pursuant to the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for service dates on and after July 1, 2019, the SCDHHS will amend the South Carolina Medicaid State Plan to include benefits for inpatient psychiatric care for children delivered in IMDs and for services provided in OTP clinics to the coordinated care benefit provided by South Carolina’s contracted Medicaid managed care organizations (MCOs).

In addition to modifications to services included in the coordinated care benefit, SCDHHS will also modify the state’s notification process, as described in Attachment 3.1 F of the South Carolina Medicaid State Plan.

SCDHHS projects that, based upon these actions, annual aggregate Medicaid expenditures will not change, because these services are currently provided through the fee-for-service (FFS) benefit.

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

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Behavioral Health, Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between 9 a.m.-5 p.m.