All Providers

South Carolina Medicaid managed care organizations (MCOs) request medical records from providers to comply with the requirements the South Carolina Department of Health and Human Services (SCDHHS) has for reporting Healthcare Effectiveness Data and Information Set (HEDIS®). Please cooperate with the MCOs' medical record requests and ensure that any medical record vendors do so as well, and/or provide the means through which an MCO may access medical records of Medicaid members. Generally, access to medical records is included in network contracts.

The Centers for Medicare and Medicaid Services (CMS) has announced the enrollment application fee amount for calendar year 2019 will be $586. This fee is required with any applicable Healthy Connections Medicaid provider enrollment application submitted on or after Jan. 1, 2019, and on or before Dec. 31, 2019.

The South Carolina Department of Health and Human Services (SCDHHS) Pharmacy and Therapeutics (P&T) Committee meeting scheduled for Wednesday, Dec. 5, 2018, is canceled. 

An updated schedule of meeting dates for 2019 will be posted at a later date. 

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

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 November in order to accommodate the 2018 holiday schedule.

Due to the Thanksgiving holiday, Saturday, Nov. 17, at 5 p.m. is the final day to submit claims for payment date Friday, Nov. 23. Payments will run Monday, Nov. 19, and electronic remittance advices will be available Tuesday, Nov. 20. Payments will be dated Friday, Nov. 23, as usual.

The South Carolina Department of Health and Human Services (SCDHHS) Pharmacy and Therapeutics (P&T) Committee meeting scheduled for Wednesday, Nov. 7, 2018, is canceled. The committee's next meeting is scheduled for Wednesday, Dec. 5, 2018. Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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