All Providers

Bulletins and Information for All Medicaid Providers

Absolute Total Care Corrective Action Plan - Completed

 

On June 13, 2012, the South Carolina Department of Health and Human Services (SCDHHS) placed the Managed Care Organization (MCO) Absolute Total Care (ATC) on notice that a Corrective Action Plan was required in accordance with Section 13.7 of its contract with SCDHHS.

 

This bulletin is to notify all service providers that effective November 9, 2012, SCDHHS determined that ATC has successfully completed its submitted Corrective Action Plan, addressing and correcting the deficiencies and/or non-compliance issues that SCDHHS had previously identified. 

 

Logisticare - Corrective Action Plan to Address Non-compliance

 

This bulletin is to notify all service providers that the South Carolina Department of Health and Human Services (SCDHHS) has placed Logisticare on notice that a Corrective Action Plan (CAP) is required in accordance with the SCDHHS Non-Emergency Medical Transportation (NEMT) contract.

 

This CAP addresses the following contractual requirements:

 

  • The call center daily performance standards
  • The daily on-time and provider no-show performance standards
  • The timely monthly reporting standard

 

BlueCross BlueShield of SC-Corrective Action Plan to Address Non-compliance

 

This bulletin is to notify all service providers that, effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) has placed BlueCross BlueShield of South Carolina (BCBSSC) Third Party Liability (TPL) Services on notice that a Corrective Action Plan (CAP) is required in accordance with the third party liability SCDHHS contract.

SCDHHS Offers Free Provider Workshops

 

Attached is a schedule of the free provider workshops offered by the
SCDHHS to include Medicaid Basics, Comprehensive Web Tool, Overview of
Third Party Liability and Overview of Claim-level Adjustments.

Home and Community Based Waivers Rate Increases. Clarification of Change in Reimbursement for Adult Day Health Care Transportation

 

This Medicaid bulletin is being re-sent because the rate cited for adult day health care transportation was incorrectly stated in the original bulletin dated October 2nd. We have corrected this information below and we apologize for any inconvenience this may have caused.

 

Effective November 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care (ADHC) services in the Community Long Term Care and Disabilities and Special Needs waiver programs. 

 

Quality Improvement Organization (QIO) Training Session

 

 

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

 

Medicaid Providers of Adult Day Health Care Services Bulletin

 

Effective November 1, 2012, the South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care (ADHC) services in the Community Long Term Care and Disabilities and Special Needs waiver programs. 

 

The following table lists the current procedure code utilized for each waiver:

 

Waiver

Procedure Code

Modification to Rehabilitative Therapy Checkpoint

Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will be modifying the rehabilitative therapy checkpoint.  The checkpoint consists of combined hours of service to include speech-language pathology, occupational, and physical therapy for all individuals under age 21.

Home and Community Based Waivers Rate Increases for Personal Care Services

 

Effective September 1, 2012, The South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Personal Care Services in the Home and Community Based waiver programs. 

 

The following table lists the current procedure code utilized for each waiver:

 

Program

Procedure Code

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