Final Action for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID)

The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following action regarding its methods and standards for paying providers under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after July 1, 2019, the SCDHHS will amend the South Carolina (SC) Title XIX State Plan by updating the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Medicaid prospective payment rates by providing for an add-on to their April 1, 2019, rates to account for the third of three legislatively authorized direct care worker salary increases.

SCDHHS is making this change in order to comply with the state fiscal year (SFY) 2020 General Appropriations Act as well as provide additional reimbursement to each ICF/IID for costs that were not incurred in the base year cost reports that were used to establish the April 1, 2019, payment rates. 

As a result of the above action, the July 1, 2019, aggregate (i.e., institutional and community residences) weighted average rate is projected to be $399.01. The aggregate weighted average April 1, 2019, rate was $383.25. This represents an aggregate weighted average per diem increase of $15.76 per Medicaid patient day, or a 4.11% increase. 

SCDHHS estimates this action will increase annual aggregate Medicaid expenditures by approximately $6.67 million (total dollars).

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

Any written comments submitted may be reviewed by the public at the SCDHHS, Reimbursement Methodology and Policy, 1801 Main Street, Room 1219 Columbia, South Carolina, Monday through Friday between 9 a.m.-5 p.m.