Patient Centered Medical Home (PCMH) Incentive Update

The South Carolina Department of Health and Human Services (SCDHHS) is informing all practices currently recognized by the National Committee for Quality Assurance (NCQA) as a patient-centered medical home (PCMH) or who have applied or are considering applying for PCMH certification that the following modifications are being made to its PCMH incentive program, effective July 1, 2017.

  • Practices that have been in application status for less than 18 months as of July 1, 2017, may continue to receive application-level incentive payments from managed care organizations (MCOs) until their application status reaches 18 months or until July 1, 2018, whichever comes first. Practices that have been in NCQA PCMH recognition application status for longer than 18 months will no longer be eligible to continue receiving application-level incentives beginning July 1, 2017.
  • Practices not currently recognized by NCQA as a PCMH that would like to receive the application-level PCMH incentive in 2017, for a maximum period of 12 months must apply no later than July 17, 2017, to be eligible to receive the application-level incentive. The application-level PCMH incentive will no longer be recognized for incentive payments after July 1, 2018.

Individuals interested in learning more about NCQA's recognition program should visit www.ncqa.org; NCQA offers PCMH-related information, including educational opportunities, on its website.

If you have any questions regarding this bulletin, please contact Sharon Mancuso via email at quality@scdhhs.gov.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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