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Public Notice of Final Action for Updating Payment Rates for the Intermediate Care Facilities for Individuals with Intellectual Disabilities

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 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 Jan. 1, 2022, SCDHHS will amend the South Carolina 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, 2018, through June 30, 2019) 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. SCDHHS will also include the last phase of the legislatively imposed direct care worker add-on relating to direct care worker salary increases that was funded by the South Carolina General Assembly for services provided on and after July 1, 2019.

As a result of the above actions, the Jan. 1, 2022, aggregate (i.e., institutional and community residences) weighted average rate is projected to be $425.34. The current aggregate weighted average rate is $400.25 and was last updated July 1, 2019. This represents an aggregate weighted average per diem increase of $25.09 per Medicaid patient day, or a 6.27% increase. The rates reflected above include an allocation of the South Carolina Department of Disabilities and Special Needs central office administrative cost.

SCDHHS estimates that the actions above will increase annual aggregate Medicaid expenditures by approximately $10.5 million (total dollars).

Copies of this notice are available for public review at each South Carolina Healthy Connections Medicaid county office and at for public review. Additional information regarding the actions above is available upon request at the address cited below.

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

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