Community Long Term Care

Community Long Term Care

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 Starts April 4; Register for Training

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) must 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.

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.

Termination of the Provision of Heaters

Effective Feb. 22, 2022, the South Carolina Department of Health and Human Services (SCDHHS) will no longer permit community long term care (CLTC) case managers to authorize heaters in the Phoenix case management system for participants enrolled in the Community Choices, HIV/AIDS, and Mechanical Ventilator Dependent waivers. The Centers for Medicare and Medicaid Services (CMS) determined that this item is of general utility and is not a coverable service. Any requests currently in process prior to the effective date of this directive cannot be fulfilled.

Payment Vendor Change for CLTC Attendant Care and Adult Companion Care Providers

Effective Oct. 8, 2021, South Carolina Healthy Connections Medicaid attendant care and adult companion care providers rendering self-directed services to Healthy Connections Medicaid members participating in the Community Long Term Care (CLTC) waiver programs (Community Choices, HIV/AIDS and Mechanical Ventilator Dependent waivers) and the Home Again program will receive payments from Morning Sun Financial Services (Morning Sun). The payment schedule and rates will remain the same.

Tobacco Cessation Coverage

Effective with dates of service on or after July 1, 2017, the South Carolina Department of Health and Human Services (SCDHHS) is enhancing tobacco cessation coverage for full-benefit Medicaid beneficiaries to align with recommendations from the Centers for Disease Control and Prevention (CDC) and the American Lung Association (ALA). This update applies to both the fee-for-service and managed care Medicaid benefits.

The following medications will be available without prior authorization or co-payment when prescribed by a Medicaid provider:

Provider Revalidation Group 5

In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Service (CMS). To avoid risk of termination in the South Carolina Department of Health Human Services (SCDHHS) Healthy Connections Medicaid program, you must complete and submit an enrollment application 30 days from the date of your official revalidation notification letter. DO NOT begin the revalidation process until you receive notification.

Pre-eligibility Medical Expenses and Calculations of Recurring Income for Long Term Care Beneficiaries

Effective Oct. 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will modify the Medicaid State Plan regarding non-covered, pre-eligibility medical expenses. Medicaid policy allows non-covered medical expenses to be used to reduce a beneficiary’s recurring income for long term care services. Currently, the Medicaid State Plan does not limit the time period from which non-covered, pre-eligibility medical expenses can be applied.

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