Report Fraud

Community Long Term Care

Community Long Term Care

CLTC Case Management Scope Revisions

The following revisions will be incorporated into the South Carolina Department of Health and Human Services (SCDHHS) Community Long Term Care (CLTC) Scope of Service for Case Management effective November 1, 2014.

CLTC is broadening the qualifications for case managers to include: (1) individuals with a bachelor's or master's degree in a health or human services field (2) Certified Case Managers. All individuals will be required to have two (2) or more years of experience in assessment and care planning with clients. (Section E.)

Estate Recovery

Effective October 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) Estate Recovery Department will increase the minimum estate asset value upon which SCDHHS can file claims to $25,000 or more. Currently, SCDHHS files claims against estates with assets valued at $10,000 or more. SCDHHS has determined that it is not cost effective to pursue estates with total assets of less than $25,000 after all priority expenses (funeral, attorney fees, etc.), have been paid.

Inpatient Psychiatric Coverage for beneficiaries 65 or older

Effective for services provided on or after July 1, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will allow for coverage of inpatient psychiatric care for beneficiaries of Medicare and Medicaid who are 65 or older.

Incontinence Supplies Updates

Effective July 1, 2014, incontinence supply providers will be responsible for obtaining the Physician Certification of Incontinence SCDHHS Form 168IS prior to delivering Incontinence supplies.  This policy replaces the June 18, 2013, memo titled Changes in Incontinence Supplies Authorizations, section 2 Physician’s Orders.

ADHC Service Rate Increase

 

Effective for services provided on or after July 1, 2013, The South Carolina Department of Health and Human Services (SCDHHS) will increase reimbursement for Adult Day Health Care Services. 

The following table lists the waiver program, current procedure codes,and rate utilized for each waiver:

 

Waiver

Program

Procedure Code

Increase in Hours for Nurse Aide Training & Programs New Timeframe Policy for Nurse Aide Program Testing

 

South Carolina Department of Health and Human Services (SCDHHS) will be making important changes to the South Carolina State-approved Nurse Aide Training Program (NATP) requirements. These changes will be effective as of July 1, 2013.

Referrals to Community Long Term Care (CLTC)

 

ffective January 7, 2013, the Division of Community Long Term Care (CLTC) will centralize intake activities for all programs operated by CLTC.  This includes referrals for nursing home placement, nursing home conversion, Pre-Admission Screening Resident Review (PASRR), home and community based waiver services, children’s personal care and nursing services, and Katie Beckett Medicaid Program (TEFRA).  When intake activities are centralized, referrals will no longer be accepted at the CLTC Regional Offices.  Referrals will only be accepted by one of the methods below.

Home and Community Based Waivers Rate Increases for Community Long Term Care waiver programs

 

Effective September 1, 2012, the South Carolina Department of Health and Human Services will increase reimbursement for case management services in two (2) Community Long Term Care waiver programs. 

 

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

 

Program

Procedure Code

Change in Ramp Specifications for Community Long Term Care Waivers

 

Effective September 1, 2012, the South Carolina Department of Health and Human Services will change the specifications for building ramps in the Community Long Term Care waiver programs.  These modifications include new requirements for all ramp construction.  There will no longer be separate requirements for heavy duty and regular ramps. 

 

Pages

Subscribe to RSS - Community Long Term Care