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Updates to the Seclusion and Restraint Reporting Form

The South Carolina Department of Health and Human Services (SCDHHS) will update the form for reporting seclusion and restraint. The form will contain an additional field indicating who ordered the restraint. The manual will also be updated to include this additional requirement. The new form must be used for all seclusion and restraint reports beginning Oct. 1, 2017.

The updated form will be available in the Psychiatric Hospital Manual beginning Oct. 1, 2017.

Updates to the Autism Spectrum Disorder (ASD) Transition Plan

The South Carolina Department of Health and Human Services (SCDHHS) updated the autism spectrum disorder (ASD) services transition plan for delivery of ASD services. This plan supersedes the bulletin entitled “Transition Guidelines for Autism Services,” published May 4, 2017. The following outlines the instructions for providers of ASD services for services delivered on or after July 1, 2017.

 

1.      State Plan Beneficiaries with an Existing ASD Prior Authorization (PA)

Updates to Autism Spectrum Disorder (ASD) Provider Manual

The South Carolina Department of Health and Human Services (SCDHHS) is updating the Autism Spectrum Disorder Services (ASD) Provider Manual. The updated ASD Provider Manual will be published on June 9, 2017 and will include three changes relative to the direct provision of services by applied behavior analysis (ABA) providers.

Therapeutic Child Care (TCC) Requirements

Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will allow therapeutic child care (TCC) providers to fulfill the requirement of parallel work with the primary caregiver by rendering family psychotherapy twice per month in conjunction with the TCC service. Family psychotherapy services provided to meet this requirement must be rendered within the stated frequency limits as outlined in the Rehabilitative Behavioral Health Services manual.

Autism Services

Effective on or after July 1, 2017, Autism Spectrum Disorder (ASD) treatment services will be added to the South Carolina Medicaid State Plan.

ASD treatment services will be available both for fee-for-service (FFS) beneficiaries and for managed care organization (MCO) members.

Medical Necessity

Medically necessary ASD treatment services are available for Medicaid beneficiaries between the ages of 0 to 21 who have an established ASD diagnosis via a comprehensive psychological assessment.

 

Inclusion of Advanced Practice Registered Nurses in ordering Medical Management Only

Effective Jan. 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) will include Advanced Practice Registered Nurses (APRNs) as ordering providers of Medical Management Only (MMO) for providers under the Community Mental Health provider manual.

Should you have any questions regarding this bulletin, please contact the SCDHHS Division of Behavioral Health at (803) 898-2565.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

Autism Spectrum Disorder Services Interim Process – Phase Two

Effective Feb. 1, 2016, the South Carolina Department of Health and Human Services (SCDHHS) will initiate an improved interim process by which its members are evaluated for and receive Autism Spectrum Disorder (ASD) services that are identified as medically necessary based on an Early and Periodic Screening Diagnosis and Treatment (EPSDT) encounter.

Healthy Connections Prime Passive Enrollment Scheduled to Begin April 2016; Seniors in South Carolina now have a new health care option

 

Healthy Connections Prime is a new program for South Carolina seniors age 65 and older with Medicare and Medicaid. This demonstration program is jointly administered by the Centers for Medicare and Medicaid Services (CMS) and the South Carolina Department of Health and Human Services (SCDHHS) and is designed to integrate all the services of Medicare, Medicare Part D and Medicaid under a single Medicare-Medicaid plan. In South Carolina these Medicare-Medicaid plans are offered by Coordinated and Integrated Care Organizations (CICO).

Topical Fluoride Varnish Change In a Primary Care Setting

The South Carolina Department of Health and Human Services (SCDHHS) is notifying all providers of an update in coding related to the application of fluoride varnish in a primary care setting (excluding Convenient Care Clinics). Effective for dates of service on or after July 1, 2015, trained staff in a primary care setting must begin billing Current Procedural Terminology (CPT) code 99188 on the CMS-1500 form when applying fluoride varnish. This code replaces the American Dental Association (ADA) code of D1206 when the service is provided in a primary care setting.

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