Final Public Notice for Inpatient Psychiatric Coverage for Duals 65+


The South Carolina Department of Health and Human Services (SCDHHS), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following action regarding inpatient psychiatric services provided in an Institution for Mental Diseases for persons 65+ under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after July 1, 2014 SCDHHS will amend the South Carolina Title XIX State Plan for inpatient psychiatric coverage for persons 65 and older.

Medicaid regulations allow for the provision of inpatient psychiatric services in an Institution for Mental Disease (IMD) for persons under age 21 and age 65 or older. This service is currently covered for the age 21 and under beneficiaries in our State Plan but not for the senior population. Even though this service is a covered Medicare benefit, coverage is not currently available for those dual eligibles that have exhausted their Medicare hospital benefit.

SCDHHS projects that based upon the action, there will be a cost of approximately $1.6 million (total dollars) annually.

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

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Behavioral Health, 9th floor conference room, 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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