Waivers

Waivers

Updates to Adult Day Health Care Service Rates

The South Carolina Department of Health and Human Services (SCDHHS) is increasing the reimbursement rate for the adult day health care (ADHC) service provided to Healthy Connections Medicaid members participating in waiver programs operated by SCDHHS and the South Carolina Department of Disabilities and Special Needs.

Updates to Personal Care and Nursing Rates for HCBS and State Plan Services

The South Carolina Department of Health and Human Services (SCDHHS) is increasing specific reimbursement rates for the personal care and nursing services included in this bulletin for State Plan and home and community-based waiver services (HCBS).

Rate Increases for State Plan Personal Care and Nursing Services

Effective July 1, 2022, reimbursement rates for the below listed services rendered to Healthy Connections Medicaid members covered by the State Plan will be increased as follows:

Updates to Adult Day Health Care Transportation

The South Carolina Department of Health and Human Services (SCDHHS) is transitioning adult day health care (ADHC) transportation for Healthy Connections Medicaid members within 15 miles of their ADHC to the state’s non-emergency medical transportation (NEMT) broker, Modivcare. Previously, transportation for trips less than 15 miles from the ADHC was provided directly by the ADHC while transportation for trips longer than 15 miles from the ADHC was provided by either the ADHC or the NEMT broker. This change is effective for dates of service on or after July 1, 2022.

POSTPONED: EVV Launch for SCDDSN-operated Waivers

To ensure a smooth transition to the electronic visit verification (EVV) system for in-home services provided by the three waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN), the South Carolina Department of Health and Human Services (SCDHHS) and SCDDSN are adjusting the EVV launch and go live timelines, initially scheduled for April 4 and May 15.

Approval of South Carolina’s Appendix K Amendment Request for Temporary Rate Increases

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 multiple waivers with the Emergency Preparedness and Response Appendix K. The request was approved Jan. 20, 2022, and will temporarily:

Rate Increase for Home Delivered Meals (S5170)

The South Carolina Department of Health and Human Services (SCDHHS) has increased the reimbursement rate for the home delivered meals (HDM) service provided to Healthy Connections Medicaid members participating in waiver programs operated by SCDHHS.

EVV Launch for SCDDSN-operated Waivers

Effective May 2022, South Carolina Healthy Connections Medicaid providers rendering in-home services to Healthy Connections Medicaid members participating in the three waivers operated by the South Carolina Department of Disabilities and Special Needs (SCDDSN) will use an electronic visit verification (EVV) system to capture in-home service delivery visits. The South Carolina Department of Health and Human Services (SCDHHS) has utilized an EVV since 2002 for its Community Long Term Care (CLTC) waivers.

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.

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