Action Regarding Vision Services for children under the age of 21.



The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirement of 42 CFR 447.205, gives notice of the following action regarding Vision Services for children under the age of 21.

Effective on or after January 1, 2014, SCDHHS will update the Vision Services policy to allow Medicaid enrolled retail optical establishments or self-employed ophthalmic dispenser (Optician) to be reimbursed by the Fee For Service program for eyeglass lenses, frames and other services as outlined in the Physician, Laboratories, and Other Medical Professionals Manual for recipients under the age of 21.  Currently, the state retains a single source vendor for these services.  This change will allow any willing and qualified provider to provide these services.  

This change is expected to have a minimal financial impact on Medicaid Fee For Service expenditures.

Effective January 1, 2014, any Medicaid recipient under the age of 21 and enrolled with a Managed Care plan, will have their ophthalmic benefits managed by the plan.  Ophthalmic services may vary depending on the Managed Care plan in which the recipient is enrolled.  Providers should always check Medicaid eligibility to determine if a recipient is enrolled in a Managed Care plan.

Copies of this notice are available at each County Department of Health and Human Services office and at www.scdhhs.govfor public review.  Additional information concerning this action is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at the Department of Health and Human Services, Division of Medical and Health Services, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.

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