Interaction between the Optional Supplemental Care for Assisted Living Participants (OSCAP) service and the Hospice Benefit

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This bulletin is to provide clarification regarding the election of the Hospice benefit for beneficiaries currently receiving the Optional Supplemental Care for Assisted Living Participants (OSCAP) service.  Beneficiaries of Hospice and OSCAP may only receive personal care through one service or the other; therefore, they must choose either Hospice or OSCAP.  An OSCAP participant residing in a Community Residential Care Facility (CRCF) has the right to choose which service they receive, as well as the option to choose the provider who delivers that service, if all medical necessity criteria are met.

The OSCAP service is currently fully funded with state dollars; however, the residents are Medicaid eligible through the Optional State Supplementation (OSS) program and the Medicaid guidelines apply in this situation.  Additionally, SCDHHS has amended its Community Choices waiver to create a second tier for the OSCAP services.  This second tier waiver service will provide a higher level of personal care services for CRCF residents who meet the nursing facility level of care.  The OSS Provider Manual is in the process of being updated to include the new waiver service. This new waiver service will be funded at regular service match rates by Medicaid.

If a Provider has any questions concerning the OSCAP services please call the Division of Community and Facility Services at (803) 898-1060.  Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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