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Proposed Actions 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 proposed actions 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, 2017, the SCDHHS proposes to 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 using the most recent cost report data available (i.e. July 1, 2011 through June 30, 2012) and the use of the midpoint to midpoint trending methodology and application of the Centers for Medicare and Medicaid Services (CMS) Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Market Basket rates.

As a result of the above actions, the July 1, 2017 aggregate (i.e. institutional and community residences) weighted average rate is projected to be $340.62. The aggregate weighted average May 1, 2014 rate was $328.98. This represents an aggregate weighted average per diem increase of $11.64 per Medicaid patient day, or a 3.54% increase.

The SCDHHS estimates that the proposed actions will increase annual aggregate Medicaid expenditures by approximately $4.93 million (total dollars).

Copies of this notice are available for public review at each County SCDHHS Office and at for public review. Additional information regarding these actions is available upon request at the address cited below.

Written comments may be sent to the Reimbursement Methodology and Policy Department, SCDHHS, Post Office Box 8206, Columbia, South Carolina 29202-8206. Written comments must be received by June 15, 2017.

Any written comments submitted may be reviewed by the public at the SCDHHS, Reimbursement Methodology and Policy Department, Room 1226, 1801 Main Street, Columbia, South Carolina, Monday through Friday between 9 a.m. - 5 p.m.

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