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CMS Requirement for Fingerprint-based Criminal Background Checks of High-Risk Medicaid Providers

The Centers for Medicare and Medicaid Services (CMS) classifies certain types of health care providers as “high risk” and requires them to submit fingerprint-based criminal background checks (FCBC). Beginning July 2022, the South Carolina Department of Health and Human Services (SCDHHS) will proactively work with all South Carolina Healthy Connections Medicaid-enrolled providers who are categorized as high-risk to ensure they are in compliance with federal regulations.

Feedback Requested on South Carolina Medicaid Quality Strategy

The South Carolina Department of Health and Human Services (SCDHHS) today announced it is seeking feedback on its draft “South Carolina Medicaid Quality Strategy.” The draft document is available here on SCDHHS’ website. The agency will collect public comments on the draft document until June 18, 2022.

Upcoming Healthy Connections Medicaid Provider Trainings – Summer 2022

The South Carolina Department of Health and Human Services (SCDHHS) regularly offers free trainings to prospective and enrolled Healthy Connections Medicaid providers. Many of these trainings are available virtually. Information about the upcoming Healthy Connections Medicaid eLearning trainings for summer 2022 is listed below.

Medicaid eLearning Provider Workshops

May 2022 Payment Schedule

The South Carolina Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments for one week in May 2022 to accommodate the state holiday observed May 10, 2022.

Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program (CHIP)

The South Carolina Department of Health and Human Services will amend the South Carolina State Plan to extend postpartum coverage for Medicaid-eligible pregnant women from 60 days to 12 months effective April 22, 2022. The agency is making this change consistent with federal guidance outlined in Center for Medicaid and CHIP Services SHO# 21-007 RE: Improving Maternal Health and Extending Postpartum Coverage in Medicaid and the Children’s Health Insurance Program (CHIP), dated Dec.

Rate Increase for Home Delivered Meals (S5170)

The South Carolina Department of Health and Human Services (SCDHHS) has increased the reimbursement rate for the home delivered meals (HDM) service provided to Healthy Connections Medicaid members participating in waiver programs operated by SCDHHS.

Pharmacy Coverage of Over-the-Counter Diagnostic Antigen Tests for COVID-19

The South Carolina Department of Health and Human Services (SCDHHS) will reimburse for Food and Drug Administration-approved coronavirus disease 2019 (COVID-19) over-the-counter (OTC) tests for home use. SCDHHS will reimburse SCDHHS-enrolled pharmacy providers for these tests as authorized within sections 9811 and 9821 of the American Rescue Plan Act, and further delineated within the August 30, 2021, letter from the Centers for Medicare and Medicaid Services (SHO# 21-003).   

Changes to Third-Party Liability Policy

Effective on or after Dec. 31, 2021, the South Carolina Department of Health and Human Services (SCDHHS) will make changes to its claims processing policy as it relates to third-party liability (TPL) coverage as described in the bulletin below. The changes being made are required by federal law to comply with provisions of the Bipartisan Budget Act of 2018 and Medicaid Services Investment and Accountability Act of 2019.

Update to Coronavirus Disease 2019 (COVID-19) Vaccine Administration Coverage to include Pediatric Coverage, Updated Booster Eligibility

The Centers for Disease Control and Prevention (CDC) has recently updated its recommendations regarding who is eligible to receive a COVID-19 vaccine to include children ages 5-11 years. The CDC has also updated its recommendations on who is eligible to receive a COVID-19 vaccine booster shot. The South Carolina Department of Health and Human Services (SCDHHS) will reimburse enrolled providers for the administration of COVID-19 vaccines, including additional doses of the COVID-19 vaccine consistent with the CDC’s guidance.

SCDHHS Urges CMS to Maintain Healthy Connections Community Engagement Initiative

SCDHHS Urges CMS to Maintain Healthy Connections Community Engagement Initiative

Medicaid Waiver Program Approved in 2019 Tailors Healthcare Resources to Vulnerable Populations,
Provides Targeted Solution to Support Low-income Workers’ Ability to Achieve Financial Independence

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