Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program (CHIP)
The South Carolina Department of Health and Human Services will amend the South Carolina State Plan to extend postpartum coverage for Medicaid-eligible pregnant women from 60 days to 12 months effective April 22, 2022. The agency is making this change consistent with federal guidance outlined in Center for Medicaid and CHIP Services SHO# 21-007 RE: Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program (CHIP), dated Dec. 7, 2021, (sho21007.pdf [medicaid.gov]).
SHO# 21-007 provided the states an option to extend postpartum coverage to pregnant women enrolled in Medicaid and CHIP to 12 months regardless of any changes in circumstances. Extended postpartum coverage shall offer an opportunity to reduce pregnancy-related deaths, severe maternal morbidity and improve continuity of care for chronic conditions such as diabetes, hypertension, cardiac conditions, substance use disorder and depression. According to the South Carolina Maternal Morbidity and Mortality Review Committee, more than 80% of pregnancy-related deaths occur in the 12-month postpartum period, and 14% occur after six weeks postpartum. Those included in extended coverage will maintain full Medicaid coverage for the 12-month postpartum period. Per CMS guidance, the state option is currently limited to a 5-year period beginning on or after April 1, 2022, and ending no later than March 30, 2027.
SCDHHS does not anticipate changes in services covered as a result of this action and therefore does not anticipate needing to make changes to any provider manuals.
SCDHHS pursued extending Medicaid coverage to 12 months postpartum in 2019 and last June supported a provision that called on the agency to pursue this policy change.
Providers should direct any questions related to this bulletin to the Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. Healthy Connections Medicaid members should direct any questions related to this bulletin to the Member Contact Center at (888) 549-0820. The Member Contact Center’s hours of operation are from 8 a.m.-6 p.m. Monday-Friday.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.