South Carolina Medicaid Update
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1 South Carolina Medicaid Update Camie Patterson Deputy Director for Finance and Chief Financial Officer (CFO) South Carolina Department of Health and Human Services (SCDHHS) 2019 Annual HFMA Reimbursement Summit March 21,
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3 Community Engagement Demonstration Waiver The South Carolina Department of Health and Human Services (SCDHHS) will apply for a section 1115 demonstration waiver to the Centers for Medicare & Medicaid Services (CMS) to implement a community engagement model to improve the health and wellbeing of Healthy Connections Medicaid beneficiaries. 3
4 Demonstration Waiver Sections The waiver consists of five key changes to the state s Medicaid program: 1. Seeks to identify individuals eligible for community engagement activities and assist them with accessing necessary employment and community engagement support programs; 2. Seeks a solution to mitigate financial disincentives for employment created by the Affordable Care Act s (ACA) all-or-nothing Medicaid expansion; 3. Modernize eligibility thresholds for children participating in the Title XIX Medicaid and Title XXI Children s Health Insurance Program (CHIP), including creating a pathway to treatment and employment for the justice-involved population; 4
5 Section 1115 Demonstration Waiver Sections (continued) 4. Provide medically necessary addiction treatment services to the state s lowest-income individuals to combat the ongoing opioid crisis; 5. Improve customer service and reduce artificial administrative barriers to benefit coordination among social service agencies by updating legacy information systems and improving data sharing between Medicaid and other programs such as the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF), Unemployment Insurance (UI) and other programs. 5
6 Public Comment The agency is currently in its third public comment period, and the revised application incorporates initial feedback received in the first two public comment periods Six public hearings and a webinar scheduled during this public comment period Public comment period closes 5 p.m. April 3, 2019 Comments may be submitted online, through mail or Website: Mail: CEWaiver@scdhhs.gov South Carolina Department of Health and Human Services Attn: Community Engagement Waiver P.O. Box 8206, Columbia, SC For more information, to view the waiver application or to submit a public comment visit, 6
7 Waiver Implementation SCDHHS plans to implement the provisions outlined in this waiver at least six months after CMS approval, but not before July 1, 2020 This time period allows sufficient time to communicate with participants the changes in the program and for the state to prepare and implement operational and administrative changes 7
8 Disproportionate Share Hospital (DSH) Payments Update Expect to wrap up 2014 DSH payments and recoupments in March Will work on 2015 DSH immediately after Plan to redesign DSH program in 2020 Will collaborate with the South Carolina Hospital Association (SCHA) to host regional meetings to receive suggestions from hospitals 8
9 Full-Benefit Membership 9-100, , , , , , , , ,000 1,000,000 1,100,000 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16 May-16 Jul-16 Sep-16 Nov-16 Jan-17 Mar-17 May-17 Jul-17 Sep-17 Nov-17 Jan-18 Mar-18 May-18 Jul-18 Sep-18 Nov-18 Full Benefits - 100, , , , , , , , ,000 1,000,000 1,100,000 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16 May-16 Jul-16 Sep-16 Nov-16 Jan-17 Mar-17 May-17 Jul-17 Sep-17 Nov-17 Jan-18 Mar-18 May-18 Jul-18 Sep-18 Nov-18 Full Benefits - 100, , , , , , , , ,000 1,000,000 1,100,000 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16 May-16 Jul-16 Sep-16 Nov-16 Jan-17 Mar-17 May-17 Jul-17 Sep-17 Nov-17 Jan-18 Mar-18 May-18 Jul-18 Sep-18 Nov-18 Full Benefits - 100, , , , , , , , ,000 1,000,000 1,100,000 Mar-15 May-15 Jul-15 Sep-15 Nov-15 Jan-16 Mar-16 May-16 Jul-16 Sep-16 Nov-16 Jan-17 Mar-17 May-17 Jul-17 Sep-17 Nov-17 Jan-18 Mar-18 May-18 Jul-18 Sep-18 Nov-18 Jan-19 Full Benefits Full-benefit membership continues to hold around 1 million.
10 Eligibility Case Processing Focused efforts to improve MAGI case processing led to 90% reduction in pending MAGI applications Creating seven statewide processing centers Increase staffing by half Processing centers focused solely on case processing, no walk-in traffic County offices will continue to receive walk-in traffic and assist customers in-person as needed Establishing performance standards for employees Improving and expanding quality assurance plan 10
11 Operating Principles > Technologies Control your data, control your destiny Working, useful software over high-concept design Choose the right tool for the job Never a moment without the business owners Governance by the project, for the project 11
12 Transition of Medicaid Payments to SCEIS Beginning July 2019, the South Carolina Department of Health and Human Services (SCDHHS) will issue payment to Medicaid providers through the State of South Carolina s consolidated accounting system the South Carolina Enterprise Information System (SCEIS) This change impacts Healthy Connections Medicaid group providers with more than one National Provider Identification (NPI) number and/or SCDHHS Medicaid Provider Number SCEIS requires that payments are issued to a taxpayer identification number (TIN) and to a single bank account 12
13 Transition of Medicaid Payments to SCEIS (continued) To make the transition to SCEIS in July 2019, each group with multiple NPIs/Medicaid Provider Numbers must designate a specific provider (an NPI/Medicaid Provider Number combination) to receive payments from SCEIS for all providers that share the same TIN Payments will be issued to the bank account of the provider designated to receive payments for the group 13
14 Transition of Medicaid Payments to SCEIS (continued) ACTION: Impacted providers are required to submit information to SCDHHS via a secure portal, by May 1, 2019 There are 1,752 TINS and approximately 10,000 providers/locations associated with these TINS that need to make a selection to get paid in July Providers should have received s and a mailed packet with information about their billing and claims practices and a login code to the secure portal Questions? Visit or call the Provider Service Center at (888)
15 Contact Information Camie Patterson Deputy Director for Finance and Chief Financial Officer South Carolina Department of Health and Human Services (803) (Christy Napper, Administrative Assistant) 15
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