Update to Section 1 of All Provider Manuals


The South Carolina Department of Health and Human Services (SCDHHS) currently contracts with six (6) Managed Care Organizations (MCOs). Each MCO currently operating in South Carolina has a small percentage of contracted network providers that have not enrolled directly with SCDHHS. The most recent contract between SCDHHS and each MCO requires that their contracted provider network also be enrolled directly with SCDHHS. This requirement was implemented to provide for accuracy in MCO reporting and to assist SCDHHS in monitoring and ensuring ongoing provider compliance.

As a result of the contractual change, SCDHHS will update Section 1, pages 1-10 of all provider manuals to reiterate that all providers who offer services to Healthy Connections Medicaid members through either or both the Medicaid Fee For Service (FFS) or Medicaid Managed Care programs must enroll directly with SCDHHS. To view the revised policy in its entirety, please refer to Section 1 of your provider manual after December 1, 2014, which can be found on the SCDHHS website at scdhhs.gov. This change only affects MCO network providers who are not directly enrolled with SCDHHS and the Healthy Connections Medicaid FFS program.

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