Proposed Public Notice for RBHS Inclusion in the Coordinated Care Benefit

PUBLIC NOTICE: 
SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following proposed actions regarding Behavioral Health, Community Integration Services and Therapeutic Childcare Centers under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective on or after July 1, 2016, the SCDHHS proposes to amend the South Carolina Title XIX State Plan as follows:

Managed Care Organizations covering Behavioral Health Services

SCDHHS proposes to cover all Rehabilitative Behavioral Health and associated outpatient services under the coordinated care benefit.

Community Integration Services

SCDHHS proposes to include Community Integration Services (CIS) as a covered service. This service must be provided in a program that is Commission on Accreditation of Rehabilitation Facilities (CARF) accredited. CIS includes services provided to beneficiaries 18 years and older.

Providers of CIS must be enrolled as Rehabilitative Behavioral Health Services (RBHS) providers who are approved by SCDHHS to render these service(s).

CIS must be provided consistent with approved American Medical Association (AMA) Healthcare Common Procedure Coding System (HCPCS) code sets. SCDHHS projects that based upon the proposed actions, annual aggregate Medicaid expenditures will be budget neutral as these providers were formally utilizing existing State Plan services to serve these populations.

CIS will be included in the outpatient behavioral health services covered by Managed Care Organizations. Policy changes in the RBHS Provider Manual will be forthcoming and will include more specific guidance.

Therapeutic Childcare Centers

SCDHHS proposes to include Therapeutic Childcare Centers (TCCs) as a covered service. Providers of this service must be accredited. This service must be provided in a licensed daycare center. TCC includes services provided to beneficiaries birth through 5 years of age and prior to eligibility for public school enrollment at the kindergarten level.

Providers of TCC must be enrolled as RBHS providers who are approved by SCDHHS to render these service(s).

TCC must be provided consistent with approved American Medical Association (AMA) Healthcare Common Procedure Coding System (HCPCS) code sets. SCDHHS projects that based upon the proposed actions, annual aggregate Medicaid expenditures will be budget neutral as these providers were formally utilizing existing State Plan services to serve these populations.

TCC will be included in the outpatient behavioral health services covered by Managed Care Organizations. Policy changes in the RBHS Provider Manual will be forthcoming and will include more specific guidance.

Copies of this notice are available at each county SCDHHS office and at www.scdhhs.gov for public review. Additional information regarding these proposed actions is available upon request at the address cited below.

Written comments may be sent to Division of Behavioral Health, SCDHHS, Post Office Box 8206, Columbia, South Carolina 29202-8206. Comments may also be submitted to comments@scdhhs.gov. Written and e-mailed comments must be received by March 20, 2016.

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Behavioral Health, Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between 9 a.m.-5 p.m.

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