Report Fraud

Services

Medicaid Coordinated Care Improvement Group

Examines the current Medicaid coordinated care system to determine what is working and not working and develop policies that improve health outcomes, cost efficiency, and patient and provider satisfaction.

Read More

CHIPRA

South Carolina was one of 10 grantees selected to participate in this federal quality demonstration grant. The grant is aimed at establishing and improving the quality of children’s healthcare through measures of quality, promotion of health information technology, and evaluation of provider-based models. South Carolina was awarded $9.2 million for this demonstration project.

Health Access at the Right Time (HeART)

 

Community Health Worker application deadline extended

The CHW application deadline is extended to January 31st by 12 pm (noon).HeART is comprised of a variety of initiatives developed to identify alternative methods and providers of health care delivery to Medicaid recipients. It is a collaborative effort of over 50 stakeholders from across the state that has a vested interest in promoting improved population health outcomes. 

Provider Manuals

Please click the "REFRESH" button on your browser to ensure that the most current version of a manual is displayed.

Health Insurance Premium Payment (HIPP) Program

The Health Insurance Premium Payment (HIPP) program is a South Carolina Department of Health and Human Services (SDHHS) cost containment initiative, which maintains premium payments for eligible Medicaid beneficiaries who retain their private health insurance.  Through this initiative, eligible Medicaid beneficiaries who satisfy HIPP program requirements may qualify for monthly reimbursements for health insurance premiums that they have paid for themselves and/or their eligible dependents.

Targeted Case Management

The South Carolina Department of Health and Human Services (SCDHHS) submitted a State Plan Amendments (SPAs) for Targeted Case Management (TCM) to the Centers for Medicare and Medicaid Services (CMS), April 20, 2012. Pending CMS approval, January 1, 2013 is the proposed effective date for all Targeted Case Management SPAs.  Below are all related documents for public information:

Targeted Case Management Frequently Asked Questions

Healthy Connections Prime

As part of the State Demonstrations to Integrate Care for Dual Eligible Individuals, South Carolina is one of fifteen states selected to design new coordinated care approaches for individuals dually eligible for Medicare and Medicaid. The goals of Healthy Connections Prime are to:
  • Improve health outcomes
  • Delay the need for nursing facility care
  • Reduce avoidable emergency department visits and hospital readmissions
  • Increase access to home and community based services

Waiver Management / Field Management

Community Long Term (CLTC) operates home and community-based waiver programs for persons eligible for nursing home care but who prefer to receive their services in the community. Through a process of case management and an individualized service package, waiver clients are able to successfully remain at home at a cost to Medicaid that is substantially less than the cost of institutional care.

The CLTC program began statewide in 1983 after a three-year pilot program in the Upstate.

South Carolina Birth Outcomes Initiative

An effort by SCDHHS & partners to improve health of newborns in the Medicaid program.

EHR Incentives

 

 

SC Medicaid EHR Incentive Program, paid through week ending 04/12/13.

EMR, Provider Incentives, Health Record Incentives, HIT

 

HIT/EHR Incentive Program