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Bulletins and Information for All Medicaid Providers

Policy Revisions to the Local Education Agency (LEA) Services Manual for Rehabilitative Behavioral Health Services (RBHS)

The South Carolina Department of Health and Human Services (SCDHHS), Division of Behavioral Health, will revise the Local Education Agency (LEA) manual for the Rehabilitative Behavioral Health Services (RBHS) policy section to discontinue use of the FORM 255 as of November 1, 2014. The Department of Education will continue to ensure the LEAs track the referral process for Psychological Testing and Evaluation.

Update to Section 1 of All Provider Manuals

The South Carolina Department of Health and Human Services (SCDHHS) currently contracts with six (6) Managed Care Organizations (MCOs). Each MCO currently operating in South Carolina has a small percentage of contracted network providers that have not enrolled directly with SCDHHS. The most recent contract between SCDHHS and each MCO requires that their contracted provider network also be enrolled directly with SCDHHS. This requirement was implemented to provide for accuracy in MCO reporting and to assist SCDHHS in monitoring and ensuring ongoing provider compliance.

Modified Claim Submission and Payment Schedule for November and December 2014

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 two weeks in November and one week in December.

New Tuberculosis Benefit

Effective for dates of service on or after November 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will implement a new program that offers Healthy Connections Medicaid coverage to persons with latent tuberculosis (TB) or active TB infection/disease who are uninsured or underinsured and who do not meet the eligibility criteria for full Healthy Connections Medicaid. This program will be administered through the South Carolina Department of Health and Environmental Control (SCDHEC).

Healthy Connections Checkup card correction

Several thousand new Healthy Connections Checkup (Checkup) member cards that were mailed to members included an error. The South Carolina Department of Health and Human Services (SCDHHS) has corrected the error and will send new, corrected cards to Checkup members.

If you encounter a patient with a Checkup member card with two identification numbers, please refer to the below illustration to determine which number to use.

ICD-10 CM/PCS Compliance Date Revision

On April 1, 2014, it was announced that the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which included language that the U.S. Department of Health and Human Services (DHHS) Secretary may not adopt ICD-10 prior to Oct. 1, 2015. Accordingly, DHHS has released a final rule that includes a new compliance date that requires the use of ICD-10 beginning Oct. 1, 2015.

Healthy Connections Checkup card distribution and letters

The South Carolina Department of Health and Human Services (SCDHHS) will begin mailing Healthy Connections Checkup (Checkup) member cards and informational letters to new and current Checkup members this month.

SCDHHS will begin mailing Checkup member cards and letters to newly-enrolled Checkup members on Sept. 8, 2014.

SCDHHS will send Checkup member cards and letters to currently-enrolled Checkup members in three batch mailings. Those mailings will take place on Sept. 15, Sept. 22 and Sept. 29.

Notification of change to Medicaid Bulletin #14-020

Coverage of New Screening Services for Healthy Connections Checkup

This alert will serve as notification of the following change to Medicaid Bulletin #14-020, “Coverage of New Screening Services for Healthy Connections Checkup.”  The revised version of this bulletin with a posting date of Aug. 11, 2014 is accessible on the SCDHHS website, located at scdhhs.gov.  This change is reflected in the SCDHHS Provider Manuals, effective Aug. 1, 2014.

Coverage of New Screening Services for Healthy Connections Checkup

Effective August 1, 2014, The South Carolina Department of Health and Human Services (SCDHHS) will implement changes to the benefit structure for the Family Planning Eligibility Category, now to be known as Healthy Connections Checkup (Checkup).  Checkup is a Medicaid limited benefit program that provides coverage for preventive health care, family planning services and family planning-related services.  Checkup is available to men and women of all ages in South Carolina whose annual family income does not exceed 194 percent of the Federal Poverty Level (FPL) and who are in

ICD-10 CM/PCS Compliance Date Strategic Planning

As previously communicated by the South Carolina Department of Health and Human Services (SCDHHS) on April 1, 2014, it was announced that the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the U.S. Department of Health and Human Services (DHHS) Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the DHHS expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015.

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