Proposed actions regarding methods and standards for paying providers

PUBLIC NOTICE: 
SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

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 proposed actions regarding its methods and standards for paying providers under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective on or after October 1, 2013, SCDHHS proposes to amend the South Carolina (SC) Title XIX State Plan as follows:

  1. The agency proposes to increase the November 1, 2012 base rate component of the South Carolina Medicaid hospital specific per discharge rates by three percent. The Direct Medical Education and Indirect Medical Education rate components of the hospital specific per discharge rates will not be subject to the three percent increase. The three percent increase will only be applied to SC general acute care hospital rates. The statewide hospital per discharge rate and the out of state border hospital specific per discharge rates will remain at the November 1, 2012 payment level. The free standing short term psychiatric hospital specific per discharge rates will also remain at the November 1, 2012 payment level.
     
  2. The agency proposes to increase the November 1, 2012 hospital specific outpatient multipliers by three percent. The Direct Medical Education component of the multiplier will not be subject to the three percent increase. The three percent increase will only apply to SC general acute care hospitals. The statewide hospital specific outpatient multiplier of 93% and the out of state border hospitals’ outpatient multipliers will remain at the November 1, 2012 level. The statewide South Carolina Medicaid outpatient hospital fee schedule rates will not be impacted by this and thus will remain at their current level.
     
  3. The agency proposes to reimburse qualifying South Carolina Medicaid defined rural hospitals and qualifying burn intensive care unit hospitals at one hundred percent of its allowable Medicaid reimbursable costs on a retrospective basis for inpatient and outpatient hospital services provided to South Carolina Medicaid fee for service individuals for discharges/services incurred on or after October 1, 2013.
     
  4. The agency proposes to update the swing bed and administrative day rates to reflect the current average adjusted nursing facility rates effective October 1, 2013.

SCDHHS proposes to implement actions (1) through (3) in order to provide additional reimbursement to SC general acute care hospitals that provide inpatient and outpatient hospital services to South Carolina Medicaid fee for service individuals. SCDHHS proposes to implement action (4) to reflect the change in the swing bed and administrative day rates based upon the October 1, 2013 nursing facility rate update.

SCDHHS projects that based upon the proposed actions noted above, annual aggregate Medicaid fee for service inpatient and outpatient hospital expenditures will increase by approximately $20,700,000.

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

Written comments may be sent to the Division of Acute Care Reimbursements, South Carolina Department of Health and Human Services, Post Office Box 8206, Columbia, South Carolina 29202-8206. Comments may also be submitted to comments@scdhhs.gov Written and e-mailed comments must be received by close of business September 14, 2013.

Any written comments submitted may be reviewed by the public at the SCDHHS, Division of Acute Care Reimbursements, Room 1231, 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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