2010 Archived Bulletins

This page has Archives Only. Please be certain to check the date of each release.

Billing Change For End Stage Renal Disease (ESRD) Reimbursement
Description: Effective With Dates Of Service On Or After January 1, 2011, The South Carolina Department Of Health And Human Services (Scdhhs) Will Change The Billing Requirements For Claims Submitted To Medicaid As Secondary To Medicare For ESRD Patients.
Posted: 12/29/2010

Provider Service Center
Description: On January 4, 2011, the South Carolina Department of Health and Human Services' (SCDHHS) new Provider Service Center (PSC) will offer the following groups an expanded opportunity for assistance with Medicaid questions.
Posted: 12/22/2010 3:45:06 PM

Administrators Of Medicaid Certified Nursing Facilities, Intermediate Care Facilities For The Mentally Retarded, Hospice Agencies, Hospitals And Physicians
Description: South Carolina Medicaid Hospice Service

In a Medicaid Bulletin dated December 14, 2010, the South Carolina Department of Health and Human Services (SCDHHS) communicated upcoming reductions to several optional state Medicaid services. The purpose of this bulletin is to clarify policy changes to the Medicaid hospice service. Changes will impact persons who do not have dual (Medicare and Medicaid) coverage. Effective with dates of service February 1, 2011, Medicaid will discontinue hospice care services for adults. An adult is defined as a person who is age 21 and older. Children will remain eligible to receive the service.
Posted: 12/22/2010 3:41:34 PM

Medicaid Beneficiary
Description: Beneficiary Newsletter
The South Carolina Department of Health and Human Services must make changes to the Medicaid program because it no longer has enough funds to continue to offer the same services. We regret if any of these changes cause you difficulties. Many of the following changes may not affect you. Please read the entire newsletter carefully and call the Medicaid Resource Center at 1-888-549-0820 if you have any questions.
Posted: 12/22/2010 3:11:08 PM

Physicians, Psychologists, And Licensed Independent Practitioners (LIPs) Of Behavioral Health
Description: Changes To The Prior Authorization Process For Lips Rehabilitative Behavioral Health Services

Effective January 1, 2011, Alliant Health Solutions, South Carolina Department of Health and Human Services (SCDHHS) Quality Improvement Organization (QIO), will assume the Medicaid Utilization Review of all professional services rendered by enrolled Licensed Independent Practitioners (LIPs).
Posted: 12/22/2010 2:50:56 PM

Medicaid Reductions
Description: The South Carolina Department of Health and Human Services (SCDHHS) projects a budget shortfall of $228 million during the current fiscal year. This is a result of a combination of significant enrollment increases and budget reductions. In order to safeguard the financial viability of the Medicaid program and meet statutory requirements for the operation of Medicaid, SCDHHS must take prompt action to contain Medicaid costs. Current state and federal restrictions largely limit the agency's ability to make reductions apart from reducing optional state Medicaid services.
Posted: 12/14/2010 12:38:37 PM

Reporting Patient Liability On Claims
Description: Effective with claims and provider error correction forms (ECFs) received on or after January 10, 2011, the South Carolina Department of Health and Human Services (SCDHHS) will require providers to include the "patient responsibility" amount on all claims where a beneficiary has third party coverage, including Medicare. The third party payment plus the "patient responsibility" can not exceed the amount the provider has agreed to accept as payment in full from the third party payer, including Medicare.
Posted: 12/13/2010 12:53:14 PM

Requests For Duplicate Remittance Packages
Description: Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will begin charging for requests of duplicate remittance advice(s) including Edit Correction Forms (ECF).
Posted: 12/10/2010 7:10:51 AM

Information On NCCI Edits
Description: The South Carolina Department of Health and Human Services (SCDHHS) is issuing this bulletin regarding implementation of NCCI edits for information purposes. More specific bulletins will follow as SCDHHS formalizes its implementation plan to incorporate NCCI edits into the Medicaid claims processing system.
Posted: 12/9/2010 10:08:29 AM

South Carolina Medicaid Preferred Drug List
Description: The Preferred Drug List (PDL) has been revised. Attached to this bulletin is a comprehensive listing of products within all therapeutic classes that comprise the PDL.
Posted: 12/9/2010 8:22:28 AM

South Carolina Nurse Aide Clinical (Skills) Examination
Description:
Effective January 1, 2011, nurse aide candidates must pass all five of the skills on the National Nurse Aide Assessment Program Examination. In addition, the skills testing time will increase from 25 minutes to 30 minutes. Candidates who do not pass will be required to retake the skills portion of the examination.
Posted: 12/3/2010 3:16:23 PM

Minimum Data Set 3.0 Training On Resident Interviews And Section Q
Description: The South Carolina Department of Health and Human Services is offering regional trainings on the new requirements for resident interviews and Section Q of the Minimum Data Set (MDS) 3.0. for nursing facility and swing bed hospital providers. Providers are encouraged to send the facility’s social service staff and any other staff involved in the completion of resident interviews and Section Q.
Posted: 11/30/2010 5:04:00 PM

Medicaid Reimbursement Training
Description: The South Carolina Department of Health and Human Services (SCDHHS) is offering Medicaid reimbursement training for providers of nursing facility services and Intermediate Care Facilities for the Mentally Retarded. Two dates are provided from which to choose: Wednesday, December 1 from 9:30 A.M. to 3:00 P.M. or Thursday, December 2 from 9:30 A.M. to 3:00 P.M. Both sessions will be held in Columbia at the Blue Cross Blue Shield training center on 17 Technology Circle (directions will be provided upon confirmation of your registration).
Posted: 11/15/2010 4:44:26 PM

Provider Service Center
Description: Beginning January 4, 2011, The South Carolina Department Of Health And Human Services (SCDHHS) Will Open A Centralized Provider Service Center (PSC) To Offer Providers An Expanded Opportunity To Have Medicaid Questions Answered.
Posted: 11/9/2010 2:33:38 PM

Free Provider Workshops November 2010
Description: SCDHHS Offers Free Provider Workshops
Attached is a schedule of the free workshops offered by the SCDHHS to include Comprehensive Web Tool and Overview of Third Party Liability.
Posted: 11/5/2010 3:52:33 PM

Medical Homes Network Changes
Description:
The South Carolina Department of Health and Human Services (SCDHHS) is currently reviewing applications for two new Medical Homes Network (MHN) entities. If approved, beneficiaries will have two additional choices from which to consider for their Healthy Connections services.
Posted: 11/3/2010 4:43:02 PM

Medicaid Payments And Third Party Coverage
Description:
The Medicaid program makes payments to providers on behalf of beneficiaries for medical services rendered, but only to the extent that the beneficiary has a legal obligation to pay. If the beneficiary does not have a legal obligation to pay, then Medicaid will not make a payment.
Posted: 10/27/2010 1:43:24 PM

Nursing Facility Staff
Description: MDS 3.0 Is Here!
Posted: 10/20/2010 4:55:21 PM

South Carolina Medicaid Preferred Drug List
Description: The Preferred Drug List (PDL) has been revised. Attached to this bulletin is a comprehensive listing of products within all therapeutic classes that comprise the PDL.
Posted: 10/18/2010 4:40:01 PM

Providers Indicated
Description: Effective November 1, 2010, the Medical Homes Network (MHNs) will require its Primary Care Physicians (PCPs) to make all referrals to Private Rehabilitative Therapy Providers. Rehabilitative Therapy services include physical, occupational and speech language therapy.
Posted: 10/18/2010 9:03:38 AM

All Medicaid Providers
Description: Providers and other interested stakeholders are encouraged to submit Medicaid costsaving ideas to the South Carolina Department of Health and Human Services (SCDHHS) as part of the agency’s Medicaid Sustainability Project.
Posted: 10/12/2010 8:36:35 AM

SCDHHS Offers Free Workshops Oct. - Nov. 2010
Description: The free workshops offered by the SCDHHS will include Medicaid Basics, Comprehensive Web Tools, an Overview of Third Party Liability and an Overview of Claim-level Adjustments.
Posted: 10/1/2010 3:17:54 PM

SC Health Information Exchange (SCHIEx)
Description: Medicaid and Medicare providers who wish to participate in the federal Electronic Health Record incentive program are invited to review and comment on several documents related to the South Carolina Health Information Exchange, called SCHIEx.
Posted: 9/24/2010 8:43:39 AM

Health Plan Choices For TEFRA Children
Description: On September 19th, it was brought to our attention that families with children who are eligible for Medicaid through TEFRA have been receiving letters indicating that they needed to choose a health plan for their child and that, if they failed to choose a plan, their child would be assigned to a managed care plan.
Posted: 9/22/2010 2:55:05 PM

Information Regarding Reducing Medicaid Waste, Fraud And Abuse
Description: The South Carolina Department of Health and Human Services (SCDHHS) strives to ensure the integrity of the Medicaid Program and seeks to reduce waste, fraud and abuse in the use of Medicaid funds through the activities carried out by the Division of Program Integrity and the Division of Audits.
Posted: 9/20/2010 3:38:35 PM

Clinical Lab Reimbursement Methodology
Description: In order to comply with Title XIX of the Social Security Act, Section 1903(i)(7), Medicaid reimbursement for clinical lab services must not exceed the rates established by Medicare.
Posted: 9/20/2010 8:55:54 AM

Policy Change For Synagis® Injectable
Description: Effective for dates of service on or after October 15, 2010, and no later than date of service on March 31, 2011, the South Carolina Department of Health and Human Services (SCDHHS) will adopt the American Academy of Pediatric (AAP) 2009 guidelines for the administration of Synagis®.
Posted: 9/20/2010 8:53:51 AM

Changes To The Third Party Liability Health Insurance Recovery Cycle
Description: At the beginning of each quarter, the Medicaid Management Information System (MMIS) generates letters that the Medicaid Information Verification Services (MIVS) mails to institutional providers.
Posted: 9/16/2010 8:46:34 AM

Physician Administered Injectable Drugs Fee Schedule Update
Description: Effective with dates of service on or after October 1, 2010, the South Carolina Department of Health and Human Services (SCDHHS) will change the reimbursement methodology for injectable drugs administered in an office, clinic, or outpatient hospital setting.
Posted: 9/15/2010 2:54:35 PM

South Carolina Healthy Connections Choices Training Opportunities
Description: South Carolina Healthy Connections Choices (SCHCC), in collaboration with the South Carolina Department of Health and Human Services (SCDHHS), is offering workshops in regional locations across the state to provide updated information.
Posted: 9/15/2010 2:51:43 PM

Changes to the Third Party Liability Medicare Recovery Cycle
Description: Changes To The Third Party Liability Medicare Recovery Cycle
Posted: 9/14/2010 8:40:31 AM

Pharmacy Providers
Description: I. Changes In The Submission Of Coordination Of Benefits (COB) Claims By Pharmacy Providers
II. Prior Authorization for Antibiotics Marketed for the Treatment of Dermatological Indications
Posted: 9/9/2010 3:57:10 PM

Family Planning Waiver Providers
Description: Centers For Medicare And Medicaid (CMS) Approval Of South Carolina’s Request To Enroll Women With Health Insurance In The Family Planning Waiver (FPW)
Family Planning Waiver (FPW) Billing Reminders
Posted: 9/8/2010 5:03:35 PM

SCDHHS Offers Free Provider Workshops
Description: Free Workshops Offered By The SCDHHS To Include Medicaid Basics, Comprehensive Web Tool, Overview Of Third Party Liability And Overview Of Claim-Level Adjustments.
Posted: 9/1/2010 1:42:37 PM

Hospitals And Ambulatory Surgery Centers
Description: Dental Administrative Service Organization (ASO)

Posted: 8/31/2010 5:00:08 PM

All Medicaid Providers
Description: Healthy Connections Choices Expansion Information
Posted: 8/23/2010 8:36:18 AM

All Medicaid Providers
Description: Changes To The Healthy Connections Kids (HCK) Program
Posted: 8/17/2010 4:19:08 PM

Durable Medical Equipment Providers
Description: Incontinence Supplies For Home And Community Based Waiver Participants
Posted: 8/4/2010 8:14:23 AM

Hospitals, Physicians And Ambulatory Surgery Centers Description: Quality Improvement Organization (QIO) Activities
Posted: 7/30/2010 4:42:31 PM

SCDHHS Offers Free Provider Workshops
Description: SCDHHS Offers Free Provider Workshops Aug -Sept - Oct 2010
Posted: 7/30/2010 12:04:48 PM

The Provider Perspective Newsletter
Description: Inside this issue:
I   Healthy Connections Choices Expansion
II   Federal EHR Incentive Payment Program Takes Shape
III   Minimum Patient Volume Threshold
IV   Notice: Prescription Limit Change
Posted: 7/28/2010 3:39:12 PM

Licensed Independent Practitioner (LIP) Rehabilitative Service Providers
Description: Medicaid Policy Manual For Licensed Independent Practitioner (LIP) Rehabilitative Services
Posted: 7/23/2010 1:47:22 PM

All Medicaid Physicians
Description: (CITIA) Center for Information Technology Implementation Assistance In South Carolina
Posted: 7/22/2010 3:43:52 PM

Providers Indicated
Description: Prescription Limit
Posted: 7/21/2010 8:17:18 AM

For Immediate Release
Description: S.C. Medicaid To Expand Healthy Connections Choices Care Coordination Program
Posted: 7/20/2010 12:28:01 PM

All Medicaid Providers
Description: Healthy Connections Choices Expansion
Posted: 7/16/2010 3:39:11 PM

Targeted Case Management Providers
Description: Medicaid Policy Manual for Targeted Case Management
Posted: 7/14/2010 2:12:27 PM

QTIP: Quality Through Technology And Innovation In Pediatrics
Description: Fifteen Primary Care Pediatric Practices Across South Carolina Will Have The Opportunity To Join A Pilot Program To improve patient care through the use of clinical quality measures and health information technology.
Applications will be available through July 28, 2010.
Posted: 7/9/2010 11:27:02 AM

All Dental Providers
Description: Claims Related Issues for the Dental Administrative Service Organization (ASO)
Posted: 7/8/2010 4:37:25 PM

Providers Indicated
Description:
I. South Carolina Medicaid Preferred Drug List

II. First Health Services Corporation Name Change
Posted: 7/2/2010 3:29:12 PM

All Dental Providers
Description: Implementation Of The Dental Administrative Service Organization (ASO)
Posted: 7/2/2010 8:57:24 AM

SCDHHS Free Provider Workshop
Description: SCDHHS Free Provider Workshop July - Sept 2010
Posted: 7/2/2010 8:54:05 AM

Physicians, Psychologists, And Licensed Independent Practitioners Of Behavioral Health
Description:
I. On-Line Pre-Enrollment Orientation & Medicaid Enrollment

II. Prior Authorization requirements for Licensed Independent Practitioners
Posted: 6/23/2010 3:39:31 PM

Hospitals, Physicians And Managed Care Providers
Description: Contingency Plan For Prior Authorization And Medical Support Documentation
Reviewed By Qualis Health
Posted: 6/11/2010 4:16:19 PM

Managed Care And Hospital Providers
Description: Newborns
Posted: 6/1/2010 3:57:36 PM

Nursing Facilities And Swing Bed Hospitals
Description: Minimum Data Set 3.0 Training
Posted: 5/26/2010 3:10:38 PM

Current Behavioral Health Services Providers And State Agencies
Description: Rehabilitative Behavioral Health Services (Rbhs) Workshop
Posted: 5/14/2010 2:31:09 PM

Providers Indicated
Description: Essure Policy Update
Posted: 5/12/2010 8:44:53 AM

All Dental Providers
Description:
I. Dentaquest Awarded Contract To Serve As The South Carolina- Medicaid Dental Administrative Service Organization (ASO)

II. Changes in the Dental Services, Policies and Guidelines
Posted: 5/5/2010 8:37:59 AM

Medicaid Bulletin
Description: Revised Billing Procedures For The Vaccine Assurance For All Children (Vafac) Program
Posted: 5/3/2010 5:02:28 PM

SCDHHS Offers Free Provider Workshops May - June 2010
Description: Free Provider Workshops May - June 2010
Posted: 5/3/2010 10:01:25 AM

Physicians
Description: Allied Health Professionals Policy
Posted: 4/21/2010 8:35:20 AM

Providers Indicated
Description: Prescription Origin Code
Posted: 4/7/2010 8:41:22 AM

SCDHHS Free Provider Workshops April - June 2010 Description: Free Workshops April - June 2010
Posted: 3/31/2010 2:10:55 PM

Providers Indicated
Description: Discontinuation of Providerlink
Posted: 3/23/2010 8:37:54 AM

All Medicaid Providers
Description:
I. Managed Care Organizational Change
II.Clarification of Changes
Posted: 3/18/2010 10:57:27 AM

All Providers
Description: Provider Newsletter
Posted: 3/3/2010 9:32:01 AM

All Providers
Description: Managed Care Organizations (MCOs) Contract Changes For Vision Services
Posted: 2/26/2010 4:48:25 PM

Private Rehabilitative, Speech, Physical, and Occupational Therapists
Description: Speech-Language Pathology Services Training Opportunities
Posted: 2/26/2010 4:40:43 PM

SCDHHS Free Provider Workshops March - May 2010
Description: March - May 2010
Posted: 2/26/2010 12:18:42 PM

Providers Indicated
Description: Dispense As Written (DAW) Code For Brand Medically Necessary Prescriptions
Posted: 2/2/2010 10:09:54 AM

Durable Medical Equipment (DME) Providers
Description: Clarification And Revision Of Medicaid Certificate Of Medical Necessity (MCMN) Policy And Forms.
Posted:

Hospitals, Physicians And Managed Care Providers
Description: Update To Procedure/Drug Codes Requiring Prior Approval Or Support Documentation
Posted:

SCDHHS Offers Free Provider Workshops
Description: SCDHHS Offers Free Provider Workshops February - April 2010
Posted: 1/29/2010 10:18:17 AM

All Providers
Description: Reminder- Hard Copy Remittance Advices To End Soon!
Posted: 1/28/2010 8:27:59 AM

Physicians, Hospitals, Pharmacy and Managed Care Providers
Description: 17 Alpha Hydroxyprogesterone Caproate
Posted: 1/26/2010 12:01:38 PM

Dental Providers
Description: Children’s Health Insurance Program Reauthorization (CHIPRA) Act of 2009 and Insure Kids Now (IKN) Information
Posted: 1/20/2010 10:30:44 AM

All Providers
Description: Please Join Us For This Free Informative Webinar. "Influenza Vaccination With LAIV Dispelling the Myths"
Posted: 1/15/2010 3:27:13 PM

Appropriate Utilization Of Antipsychotic Medications For Children 6 (Six) Years Of Age And Younger
Description: In An Effort To Ensure Against The Improper Use Of Antipsychotics In Children,
South Carolina Medicaid will require clinical evaluation for all prescriptions for antipsychotics prescribed
for children 6 years of age and younger.
Posted: 1/12/2010 4:24:49 PM

Physicians Indicated
Description: Allied Health Professionals Policy
Posted: 1/12/2010 8:35:32 AM

Providers Indicated
Description: South Carolina Medicaid Preferred Drug List
Posted: 1/11/2010 9:24:06 AM

All Medicaid Providers
Description: South Carolina Healthy Connections Choices Training Opportunities
Posted: 1/11/2010 9:23:20 AM

SCDHHS Offers Free Provider Workshops
Description: January - March 2010
Posted: 1/5/2010 9:41:56 AM

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