Other Medical Professionals

Other Medical Professionals

Change in SC P&T Committee Meeting Date

The South Carolina Healthy Connections Medicaid Pharmacy and Therapeutics Committee meeting scheduled for Wednesday, Feb. 4, 2015, has been changed to Wednesday, Mar. 4, 2015. The meeting location and time will remain the same:

South Carolina Medicaid Pharmacy and Therapeutics Committee
Location: South Carolina Pharmacy Association (SCPhA) Office
1350 Browning Road, Columbia, SC 29210 

Wednesday, Mar. 4, 2015, 4 p.m.

Intensive Family Services (Procedure Code H0046)

The South Carolina Department of Health and Human Services (SCDHHS) issued a bulletin Nov. 17, 2014, announcing the addition of Intensive Family Services (IFS) to the Rehabilitative Behavioral Health Services (RBHS) manual and the Licensed Independent Practitioners (LIP) Rehabilitative Services manual with an effective date of January 1, 2015. This effective date is postponed. SCDHHS will issue a Medicaid bulletin 30 days in advance of the new effective start date.

If you have any questions, please contact the Provider Service Center at (888) 289-0709.

Intensive Family Services (Procedure code H0046)

IFS is provided both within the beneficiary’s home and in community settings. IFS targets the family unit to promote positive treatment outcomes. 

IFS is goal-directed and supports solution-focused interventions intended to achieve identified goals or objectives as set forth in the child or youth’s plan of care. The purpose of this service is to improve youth and family functioning and prevent out-of-home placement, or to reunify children into their homes when out-of-home placement has occurred. IFS is available to eligible beneficiaries ages 0-21.

Pulse Oximetry Policy

Effective on or after July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will update its policy to recognize the South Carolina Department of Health and Environmental Control (DHEC) Pulse Oximetry Screening test on newborns to detect congenital heart defects.  Pulse oximetry is a noninvasive test that estimates the percentage of hemoglobin in blood that is saturated with oxygen.   

Inpatient Psychiatric Coverage for beneficiaries 65 or older

Effective for services provided on or after July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will allow for coverage of inpatient psychiatric care for beneficiaries of Medicare and Medicaid who are 65 or older.

Psychiatric and Psychotherapy Services section of the Physicians, Laboratories, and Other Medical Professionals Manual

Effective July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) has reinstated the Psychiatric and Psychotherapy Services section of the Physicians, Laboratories, and Other Medical Professionals Manual.  This section applies to all physicians, psychiatrists, and psychiatric nurse practitioners providing psychiatric services, as well as allied professionals who may provide psychotherapy services under the supervision of these professionals.

Medicaid RBHS and PRFT Referral Training

 

In May, South Carolina Healthy Connections Medicaid will host a series of training sessions on  upcoming changes in the referral process for RBHS and PRTF. The training will cover the changes to the manual including the new referral processes for RBHS and PRTF services. A Medicaid Bulletin announcing the new policy change will be published prior to the trainings.  Please monitor the SCDHHS website at https://www.scdhhs.gov/Medicaid-Bulletins for this proposed change. 

Payment of LARCs through the Pharmacy Benefit

 

Beginning with dates of service on or after March 17, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will reimburse for outpatient utilization of long acting reversible contraceptives (LARC) through the pharmacy program. Any LARC billed to SCDHHS by a pharmacy will be shipped directly to the provider's office for insertion. Providers should take extra care to ensure that they bill Medicaid only for reimbursement of the insertion of the device, and not the device itself, when it is obtained and billed through the pharmacy benefit.

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