Individuals with Disabilities Education Act Part C Program (BabyNet) Updates and Important Dates

PROVIDER ALERT

Reminders for Continuity of Care Period, which Begins Oct. 1

The continuity of care period for the integration of the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as “BabyNet,” and South Carolina Healthy Connections Medicaid program begins Oct. 1. Providers and service coordinators are reminded that several changes will take place during the continuity of care period (Oct. 1-Dec. 31, 2019):

 

  • Managed care organizations (MCOs) will be required to pay all Medicaid-enrolled providers listed on the Individualized Family Service Plan (IFSP) during the continuity of care period, regardless of the providers’ credentialing status with that MCO.

  • In order to receive payment through an MCO for services during the continuity of care period, BabyNet providers must submit to the MCO:

  • Service coordinators must identify BabyNet beneficiaries who are enrolled in an MCO and receiving services from a non-credentialed provider.

 

In addition, when the continuity of care period begins, providers may not accept a new MCO-enrolled beneficiary unless the provider is also credentialed with the MCO in which the beneficiary is enrolled.

Contact Information for MCOs for Prior Authorizations and IFSPs

During the continuity of care period, providers should fax or email documentation to MCOs regarding prior authorizations and updates to IFSPs. Providers and service coordinators should remember that IFSPs will count as clinical documentation during the continuity of care period. Contact information for each Healthy Connections Medicaid MCO is available here:

 

MCO Plan Name

Fax Number

Email Address

Absolute Total Care

866-912-3606

Natalie.D.Crumpton@centene.com

First Choice by Select Health of South Carolina

866-368-4562

Email submission not available.

Healthy Blue by BlueChoice of SC

800-823-5520

Angie.Morales@anthem.com;

Margo.Roberts@amerigroup.com

Molina Healthcare of SC

866-423-3889

MHSCPriorAuth@MolinaHealthCare.com

Wellcare

855-591-7136

Tracy.Green@wellcare.com;

Addy.Fama@wellcare.com

 

Reminder: Updates to Applied Behavioral Analysis Provider Credentialing 

As announced in an Aug. 15, 2019, Medicaid bulletin, effective Oct. 1, 2019, Applied Behavioral Analysis (ABA) providers within the BabyNet network, including supervisory and direct therapy providers, must meet the provider qualifications specified in the Autism Spectrum Disorder (ASD) Medicaid State Plan. Requiring ABA providers to credential with the Behavioral Analyst Certification Board (BACB) aligns BabyNet provider qualifications with Healthy Connections Medicaid qualifications and current industry standards. Families electing to receive services from non-credentialed providers may continue to do so; however, SCDHHS will no longer reimburse them for dates of service after Sept. 30, 2019.

ABA providers employing non-credentialed staff must contact service coordinators to ensure children who are covered by Healthy Connections Medicaid, including BabyNet, are receiving services from appropriately credentialed staff. Service coordinators serving children who need to transition to a different provider should contact Gail Shelley at Joyce.Shelley@scdhhs.gov to transition the child to a provider who meets the credentialing standards. Non-credentialed providers can learn more about BACB credentialing on the BACB website .

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

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