All Providers

Bulletins and Information for All Medicaid Providers

Approval of South Carolina’s Appendix K Amendment Request for the Palmetto Coordinated System of Care (PCSC) Waiver

As part of the South Carolina Department of Health and Human Services’ (SCDHHS) ongoing response to the state and federal states of emergency related to coronavirus disease 2019 (COVID-19), SCDHHS submitted a request to the Centers for Medicare and Medicaid Services (CMS) to amend the Palmetto Coordinated System of Care (PCSC) waiver with the Emergency Preparedness and Response Appendix K. The request was approved on Jan. 15, 2021, and will grant providers additional flexibility in delivering services to waiver participants.

Approval of South Carolina’s Appendix K Extension Request

As part of the South Carolina Department of Health and Human Services’ (SCDHHS) ongoing response to the state and federal states of emergency related to coronavirus disease 2019 (COVID-19), SCDHHS submitted a request to the Centers for Medicare and Medicaid Services (CMS) to extend the Appendix K flexibilities for home and community-based waivers that were approved on April 21 and

New and Extended Healthy Connections Medicaid and Healthy Connections Prime Health Plan Offerings Available

Healthy Connections Medicaid Adds Contract with New Managed Care Organization
The South Carolina Department of Health and Human Services (SCDHHS) is adding an additional managed care organization (MCO) to serve Healthy Connections Medicaid members. Humana will be contracting with SCDHHS beginning July 1, 2021. Providers should expect to receive correspondence from Humana as they begin contracting with providers and continue to develop their provider network.

1099s for Calendar Year 2020

In January 2021, the South Carolina Enterprise Information System (SCEIS) will begin issuing 1099 forms to South Carolina Healthy Connections Medicaid providers. These forms will be for the calendar year 2020.

Centene/WellCare Acquisition

On Jan. 23, 2020, Centene Corporation acquired WellCare Health Plans, Inc., which included WellCare of South Carolina, a managed care organization (MCO) contracted with the South Carolina Department of Health and Human Services (SCDHHS). As a result of this acquisition, WellCare will no longer participate in SCDHHS’ Healthy Connections Medicaid managed care program. Effective April 1, 2021, existing WellCare Medicaid members will be served by Absolute Total Care. Absolute Total Care is a wholly owned subsidiary of Centene Corporation.

Upcoming Healthy Connections Medicaid Provider Trainings

The South Carolina Department of Health and Human Services (SCDHHS) offers free monthly training workshops for providers. These recurring virtual workshops cover a variety of topics including training on Medicaid basics, how to submit claims using the web-based tool and third-party liability (TPL).

December 2020 Provider 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 December 2020 to accommodate the 2020 Christmas holiday.

2021 Provider Enrollment Application Fee

The Centers for Medicare and Medicaid Services (CMS) has announced the enrollment application fee amount for calendar year 2021 will be $599. This fee is required with any applicable Healthy Connections Medicaid provider enrollment application.

November 2020 Provider 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 November 2020 to accommodate the 2020 Thanksgiving holiday.

U.S. Department of Health and Human Services Announces Expanded Pool of Providers Eligible for Additional Provider Relief Funds

The U.S. Department of Health and Human Services (HHS) recently announced it is broadening the categories of providers who are eligible to receive a Phase 3 provider relief payment provided by HHS under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Providers who render services in the following areas are eligible to apply for provider relief funding regardless of whether they accept Medicaid or Medicare.

  • Behavioral Health Providers

  • Allopathic & Osteopathic Physicians

  • Dental Providers

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