All Providers

Bulletins and Information for All Medicaid Providers

Healthy Connections Choices Enrollment Broker Training

The South Carolina Department of Health and Human Services (SCDHHS), in partnership with the state's contracted enrollment broker, MAXIMUS, will facilitate two provider training sessions in September. 

Service Rate Increases

Effective for services provided on or after July 1, 2018, the South Carolina Department of Health and Human Services (SCDHHS) increased reimbursement for qualified Adult Day Health Care Services, Personal Care I, Personal Care II and Attendant Care providers by approximately 8.2 percent. 

SCDHHS Stakeholder Survey

The South Carolina Department of Health and Human Services (SCDHHS), in partnership with Mercer Health and Benefits, LLC (Mercer), is revising and consolidating the Medicaid provider manuals to develop a more user-friendly guide for SCDHHS stakeholders.

Implementation of the project will rely on feedback from South Carolina Healthy Connections Medicaid providers. SCDHHS and Mercer have developed a survey that can be accessed by clicking on the link below.

2018 Provider Revalidation; Group 2

The South Carolina Department of Health and Human Services (SCDHHS) continues 2018 provider revalidation. Providers who enrolled as a Healthy Connections Medicaid provider between Dec. 1, 2012-Dec. 31, 2013, are scheduled for revalidation in 2018. 

KEPRO Prior Authorizations

The South Carolina Department of Health and Human Services (SCDHHS) encourages all autism spectrum disorder (ASD) providers to complete their prior authorization submissions through Keystone Peer Review Organization (KEPRO), the agency's quality improvement organization.

July 2018 Provider Payment Holiday Schedule

The South Carolina Department of Health and Human Services (SCDHHS) announces the following changes to the Healthy Connections Medicaid claims submission and payment schedule for one week in July 2018 in order to accommodate the South Carolina state holiday schedule.

During the week beginning July 1, 2018, payments will run Monday, July 2, and electronic remittance advices will be available Tuesday, July 3. Payments will be dated Friday, July 6, as usual. Saturday, June 30, at 5 p.m. is the final day to submit claims for payment date Friday, July 6.

Free Provider Workshops

Each month, the South Carolina Department of Health and Human Services (SCDHHS) offers free workshops for providers. There are a variety of in-person workshops including training on Medicaid basics, how to submit claims using the web-based tool and third party liability.

To register for a workshop, please visit Medicaid eLearning, medicaidelearning.com, or call 1 (888) 289-0709 and select option 1.

HCBS Statewide Transition Compliance

In accordance with the home and community-based services (HCBS) final rule regulations outlined in 42 CFR 441.301(c)(4)(i), the South Carolina HCBS Statewide Transition Plan will be submitted for final approval by the Centers for Medicare and Medicaid Services (CMS) no later than spring of 2019.

Third Party Liability (TPL)

Effective July 2, 2018, BlueCross BlueShield of South Carolina (BCBSSC) will perform the following third party liability (TPL) services on behalf of the South Carolina Department of Health and Human Services (SCDHHS):

 

Beneficiary Eligibility Impacts for June 2018

The Code of Federal Regulations (42 CFR 435.916) requires the state Medicaid agency to implement streamlined annual renewal processes for Medicaid beneficiaries under new modified adjusted gross income (MAGI) rules. These changes, designed to decrease the amount of paperwork received by beneficiaries and increase the use of automation, were first implemented in South Carolina in 2014. As with the traditional annual renewal process, individual beneficiaries that do not return the evidence necessary to maintain Medicaid eligibility exit the program after due notice. 

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