Public Notice of Final Action for the Coverage of COVID-19 Vaccines, Testing and Treatment
The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following actions regarding the coverage of COVID-19 vaccines, testing and treatment under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).
Pursuant to sections 9811 and 9821 of the American Rescue Plan Act of 2021, effective on or after March 11, 2021, SCDHHS will amend the South Carolina Title XIX State Plan to extend coverage of COVID-19 vaccines, testing and treatment without cost sharing.
The American Rescue Plan Act requires state Medicaid programs to cover a broad array of COVID-19 testing, including all types of U.S. Food & Drug Administration (FDA)-authorized COVID-19 screening and diagnostic tests without cost-sharing obligations. This coverage requirement also includes testing for the optional COVID-19 eligibility group.
The American Rescue Plan Act further requires state Medicaid programs to cover treatments for COVID-19, including specialized equipment and therapies, and preventative therapies, without cost sharing obligations. This coverage also includes the treatment of a condition that may seriously complicate COVID-19 treatment.
For full-benefit Medicaid members, there is no change in current coverage for COVID-19 vaccines, testing and treatment other than the removal of limitations on amount, duration or scope that would otherwise apply when covered for purposes outside of the treatment or prevention of COVID-19. These coverage requirements and cost-sharing prohibitions generally end on the last day of the first calendar quarter that begins one year after the last day of the COVID-19 emergency period. Those who are enrolled in the optional COVID-19 testing group shall be covered for COVID-19 treatment in addition to testing and vaccinations only through the last day of the federal COVID-19 public health emergency (PHE).
Based on the actions above, SCDHHS anticipates a budget impact of approximately $9,600,000 (total dollars).
Copies of this notice are available at each South Carolina 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, Office of Health Programs, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9 a.m. and 5 p.m.