All Providers

Bulletins and Information for All Medicaid Providers

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.

Upcoming Healthy Connections Medicaid Provider Trainings – Spring 2022

The South Carolina Department of Health and Human Services (SCDHHS) regularly offers free trainings to prospective and enrolled Healthy Connections providers. Information about an upcoming training opportunity for spring 2022 is listed below.

Maximus Enrollment Training

In partnership with the state's contracted enrollment broker, Maximus, SCDHHS is offering virtual enrollment trainings. The trainings will take place each Friday in May 2022. The dates and times for the trainings are:

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.

Upcoming PERM Cycle 2 Provider Education Webinars

A South Carolina Healthy Connections Medicaid provider alert dated Feb. 24, 2022, announced the Centers for Medicare and Medicaid Services (CMS) will host informational webinars for Medicaid-enrolled providers related to the administration of its Payment Error Rate Measurement (PERM) program.

Upcoming PERM Cycle 2 Provider Education Webinars

The Centers for Medicare and Medicaid Services (CMS) will host informational webinars for Medicaid-enrolled providers related to the administration of its Payment Error Rate Measurement (PERM) program. PERM measures and reports a national improper payment rate for Medicaid and the Children’s Health Insurance Program (CHIP) to comply with the requirements of the Payment Integrity Information Act (PIIA) of 2019. Each state takes part in the PERM program once every three years as part of the selected cycle.

Prior Authorization for Transplant Services

Effective Jan. 1, 2022, the South Carolina Department of Health and Human Services (SCDHHS) will accept prior approval of an organ transplant by the agency’s quality improvement organization (QIO) as approval for a Healthy Connections Medicaid member to be treated out of state, if applicable. The agency’s QIO is Keystone Peer Review Organization (KePRO). Providers must continue to contact KePRO for prior authorization before rendering transplant services.

2022 Provider Enrollment Application Fee

The Centers for Medicare and Medicaid Services (CMS) has announced the enrollment application fee amount for calendar year 2022 will be $631. This fee is required with any applicable Healthy Connections Medicaid provider enrollment application.

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