Elimination of the KEPRO Prior Authorization Requirement for BabyNet Services

PROVIDER ALERT

Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will recognize the Individualized Family Service Plan (IFSP) as prior authorization (PA) for all services rendered under the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as BabyNet in South Carolina. SCDHHS is making this change to no longer require providers to obtain PA from the agency's quality improvement organization vendor, KEPRO, for services exceeding private rehabilitation visit limits rendered through the BabyNet program after evaluating feedback from BabyNet providers.

Previously submitted claims that rejected due to KEPRO PA issues will be reprocessed. BabyNet providers do not need to cancel existing KEPRO PAs. The corresponding PA field recently added to the BabyNet Reporting & Intervention Data Gathering Electronic System (BRIDGES) will be disabled.

Providers with questions about this alert should email BabyNet@scdhhs.gov for assistance.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid and BabyNet programs.

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