Hospitals

Hospitals

2013 Medicare Deductible, Coinsurance and Medicaid Blood Deductible Rates for Dually Eligible Medicaid Members

The South Carolina Department of Health and Human Services (SCDHHS) has updated its reimbursement calculations for Medicare Deductible, Coinsurance, and Blood Deductibles to reflect the new 2013 Medicare Rates for Dually Eligible Medicaid members.

Baby-Friendly Hospital Initiative - "Race to the Date"

 

Race to the Date is a South Carolina Department of Health and Human Services (SCDHHS) initiative through our Birth Outcomes Initiative project to incentivize hospitals to become “Baby-Friendly” by promoting breast milk as the standard for infant feeding.  The goal of the project is to increase the number of Baby-Friendly hospitals in South Carolina.  All infants in the facility should be considered to be breastfeeding infants unless, after giving birth and being offered help to breastfeed, the mother has specifically stated that she has no plans to breastfeed. 

Community Health Worker in Primary Care Practices

The South Carolina Department of Health and Human Services (SCDHHS) is announcing the statewide integration of the Community Health Worker (CHW) into eligible primary care practices under the Department’s Health Access at the Right Time (HeART) initiative. The objective of the CHW program is to improve patient care and health outcomes with the aid of individuals who interface between the clinical practice and the community where patients reside.

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.

Barbiturate and Benzodiazepine Coverage Changes for Dual Eligibles under Medicare Part D Plans

 

Effective January 1, 2013, the South Carolina Department of Health and Human Services (SCDHHS) will exclude coverage for barbiturates “used in the treatment of epilepsy, cancer, or a chronic mental health disorder” and benzodiazepines for dual eligible individuals (Medicare/Medicaid).  This exclusion of coverage applies only to dual eligible individuals.

Non Payment Policy for Deliveries Prior to 39 weeks: Birth Outcomes Initiative

Medicaid Agency to Stop Payment for Elective Early Deliveries

Aims to Improve Health of Newborns, Reduce Preterm Births in South Carolina

 

Additional Services Performed by KePRO

Effective with dates of service on or after January 1, 2013, the South Carolina Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for Inpatient Psychiatric Services for Children Under 21 from our Quality Improvement Organization (QIO), KePRO.  PA requests must meet the requirements for Certification of Need (CON) for Children Under 21 admitted for psychiatric services.

South Carolina Medicaid Preferred Drug List

 

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after January 1, 2013.

 

ANTIDEPRESSANTS, OTHER

Preferred

Non-Preferred

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