2019 Provider Revalidation: Group 1

PROVIDER ALERT

The South Carolina Department of Health and Human Services (SCDHHS) is beginning 2019 provider revalidation.  

In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Services (CMS). To avoid risk of termination in the SCDHHS Healthy Connections Medicaid program, impacted providers must complete and submit an enrollment application 30 days from the date of their official revalidation notification letter. Providers should NOT begin the revalidation process until they receive notification. The notification contains pertinent information needed to start and complete the revalidation process.

In addition, the enrollment application fee is ONLY applicable to providers that CMS has identified as institutional providers. The application fee must be collected before a revalidation provider enrollment agreement is approved, unless the provider is already enrolled in Medicare, enrolled in another state’s Medicaid or Children’s Health Insurance Program (CHIP) program or has submitted and received approval for a Hardship Waiver request. South Carolina Healthy Connections Medicaid recognizes and enrolls the following institutional providers:

Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Durable Medical Equipment, End Stage Renal Disease Facilities, Federally Qualified Health Centers, Home Health Agencies, Hospices, Hospitals, Independent Clinical Laboratories, Pharmacies, Skilled Nursing Facilities and Rural Health Clinics.

The 2019 revalidation process for Group 1 begins July 29, 2019, and ends Aug. 26, 2019. Group 1 consists of selected providers listed in the provider groups below.

 

Provider Revalidation 2019: Group 1

Inpatient Hospital

Outpatient Hospital

Chiropractor Group

Dental Group

Optician Group

Optometrist Group

Physician Group

Podiatrist Group

Home Health

Hospice

Medical Clinics

Nursing Home

Pharmacy

Other Medical Professionals

Individual Chiropractor

Individual Dentist

Individual Optician

Individual Physician

Individual Podiatrist

 

 

The following provider types located within Abbeville, Aiken, Anderson, Barnwell, Beaufort, Berkeley, Charleston, Cherokee, Chester, Chesterfield, Clarendon, Colleton, Darlington, Dillon, Dorchester, Fairfield, Florence, Georgia outside Medicaid Service Area, Georgia within Medicaid Service Area, Georgetown, Greenville, Greenwood, Horry, Jasper, Kershaw, Lancaster, Laurens, Lexington, Marion, Marlboro, North Carolina other Medicaid Service Area, North Carolina within Medicaid Service Area, Newberry, Oconee, Orangeburg, Pickens, Richland, Spartanburg, Sumter, Union, Williamsburg, York and Other counties are also in Group 1 and require a site visit.

Ambulance

Durable Medical Equipment

Laboratory

Mental Health & Rehabilitation

Other Medical Professionals
(Physical Therapists)

Physician Group

(Physical Therapists)

Independent X-Ray

 

 

For more information on the revalidation process, please visit https://www.scdhhs.gov/revalidation.

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

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