Effective July 1, 2021, the South Carolina Department of Health and Human Services’ Program Integrity Unit (PI) announced it will resume onsite visits for provider reviews.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Centers for Medicare and Medicaid Services (CMS) has informed the South Carolina Department of Health and Human Services (SCDHHS) that the South Carolina Healthy Connections Medicaid program will participate in the Payment Error Rate Measurement (PERM) program for State Fiscal Year 2022. CMS’ PERM program was developed to measure the accuracy of Medicaid and Children’s Health Insurance Program (CHIP) payments made by states. Each state is reviewed once every three years. Samples of claims with paid dates of July 1, 2021, through June 30, 2022, will be subject to review. You can review the entire bulletin here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board issued several emergency orders to allow for the safe and effective care of patients during an unprecedented pandemic. The Board has continually reviewed these orders and made adjustments as necessary. Effective July 1, 2021, all Board-issued emergency orders are scheduled to be rescinded. Please begin planning now. Those orders pertain to Safe Harbor regarding the reuse of personal protective equipment, pickup kiosks, and remote order entry outside of a licensed facility. Those orders can be here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy published a notice to announce the reiteration of certain emergency orders issued in response to the COVID-19 public health emergency, including the suspension of the prohibition on performing remote order entry from an unpermitted site, the temporary authorization of automated pharmacy pickup kiosks, and the establishment of safe harbor provisions concerning personal protective equipment. The notice also reiterates the authorization of a one-time early refill of Schedule III, IV, and V prescriptions for valid refills, and the dispensing of Schedule II controlled substances under specified conditions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
NACDS virtually attended the 2021 SCRA Legislative Days Monday, March 29th, and Tuesday, March 30th. The legislators and state agency representatives the group heard from over two days included, Governor Henry McMaster, Senate Majority Leader Shane Massey, Senate Minority Leader Brad Hutto, and the new Director at the SC Dept. of Health and Environmental Controls (DHEC), Dr. Edward Simmer. Governor McMaster discussed the COVID19 vaccine roll-out and his appreciation for the retail partners’ efforts. He also stated that he anticipated the current State of Emergency to continue for the foreseeable future. Senator Hutto discussed possible legislation mandating the COVID19 vaccine as well as Hate Crime legislation. Dr. Simmer is hoping for continued collaboration in addressing vaccine access.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The South Carolina Department of Health and Human Services (SCDHHS) is updating guidance on how providers should submit requests and inquiries related to Medicaid eligibility. The Eligibility Administrative Support Team (EAST) will no longer process inquiries via its fax or email address. Effective immediately, all provider updates and inquiries should only be submitted via the procedures outlined in this ALERT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Joint Pharmacist Administered Vaccines Committee revised the Protocol for Pharmacist Administered Vaccines. This revision has been reviewed and approved by the SC Board of Medical Examiners. The updated protocol moves flu to age 3 and up and adds the COVID vaccine to the list of approved vaccines. The protocol can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
In January, the South Carolina Enterprise Information System (SCEIS) will begin issuing 1099 forms to South Carolina Healthy Connections Medicaid providers. These forms will be for the calendar year 2020. In July 2019, the South Carolina Department of Health and Human Services (SCDHHS) transitioned the payment of Medicaid claims to the State of South Carolina’s consolidated accounting system, SCEIS. SCEIS requires payments to be issued to a single bank account for each taxpayer identification number (TIN), either a Federal Employer Identification Number (FEIN) or a Social Security Number (SSN). To make the transition to SCEIS, the South Carolina Department of Health and Human Services (SCDHHS) required Healthy Connections Medicaid group providers with multiple National Provider Identifier (NPI) numbers and/or multiple Medicaid Provider Numbers associated with a single TIN to designate one NPI and Medicaid Provider Number combination (a specific provider) to receive payment through SCEIS. The payments for all providers associated with that TIN were then made to the designated bank account for the NPI and Medicaid Provider Number combination. For more information on this transition, visit https://vip.scdhhs.gov/sceis/. In January 2021, SCEIS will begin issuing 1099 forms for the calendar year 2020 to Healthy Connections Medicaid providers. The 1099 forms will be issued to the NPI and Medicaid Provider Number combination designated by the provider and will include payments for all NPIs, and Medicaid Provider Numbers associated with the TIN. Providers will be responsible for any additional required breakdown of 1099 information. If you have any questions regarding 1099s for the calendar year 2020, please contact the Provider Service Center at (888) 289-0709.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
On January 23, 2020, Centene Corporation acquired WellCare Health Plans, Inc., which included WellCare of South Carolina, a managed care organization (MCO) contracted with the South Carolina Department of Health and Human Services (SCDHHS). As a result of this acquisition, WellCare will no longer participate in SCDHHS’s Healthy Connections Medicaid managed care program. Effective April 1, 2021, existing WellCare Medicaid members will be served by Absolute Total Care. Absolute Total Care is a wholly owned subsidiary of Centene Corporation. WellCare will remain responsible for claims, appeals and hearings, and other administrative processes that occur before April 1, 2021. To satisfy its contractual requirements with SCDHHS, WellCare will keep administrative processes in place for at least 12 months after exiting the Healthy Connections Medicaid managed care program. Providers rendering services to WellCare members will continue to work directly with WellCare for all dates of service before April 1, 2021. Additional administrative information may be found on WellCare’s website.
All Healthy Connections members transferred to Absolute Total Care on April 1, 2021, will maintain a continuity of care period for up to 90 days during which time members will continue to receive all authorized services from their current providers. If providers have questions about how this acquisition may affect them, they should call WellCare Provider Services at (888) 588-9842 or Absolute Total Care Provider Services at (866) 433-6041.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.