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Bulletins and Information for All Medicaid Providers

Managed Care Organizational Changes. Explanation of the Organizational Changes

  1. Managed Care Organizational Changes

Effective January 1, 2014, all current Medical Home Networks (MHN) Plans operating within the state will become Managed Care Organizations (MCO) either through acquisition or conversion.

Quality Improvement Organization (QIO) Training Session

The South Carolina Department of Health and Human Services (SCDHHS) will co-sponsor provider/facility training with the Medicaid QIO, Keystone Peer Review Organization, Inc., (KePRO).

Training Sessions will Include:

Enhanced Physician Payment Reimbursement

 

The South Carolina Department of Health and Human Services (SCDHHS) recently received final CMS approval for its proposed payment methodology for the Affordable Care Act (ACA) Primary Care Physician rate increase for both the Fee for Service (FFS) and Managed Care Organizations (MCOs).  SCDHHS continues its work on this project to ensure that it is implemented accurately, quickly and within the CMS mandates for these enhanced payments.  

Application of the Mental Health Parity and Addiction Equity Act (MHPAEA)

 

 

The South Carolina Department of Health and Human Services (SCDHHS) is issuing this bulletin for guidance on the application of MHPAEA in Medicaid.

History and Background

Starting in 1996, Congress enacted several laws designed to improve access to mental health and substance use disorder services under health insurance or benefit plans that provide medical/surgical benefits.

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