South Carolina News: Medicaid Revalidation Adds Personal Care

The South Carolina Department of Health and Human Services (SCDHHS) has added providers offering personal care services to its high-risk rapid revalidation category, the agency announced in Medicaid Bulletin #26-027, issued Aug. 12. ​

he update is part of a new two-track revalidation strategy under which nearly 76,000 South Carolina Healthy Connections Medicaid providers will be assigned to either rapid or routine revalidation. 
SCDHHS cited recent utilization trends and its experience administering the Medicaid program as the basis for adding personal care providers to the rapid revalidation category, which also includes durable medical equipment suppliers, home health agencies, rehabilitative behavioral health services providers, licensed independent practitioners and applied behavior analysis providers. The agency has identified 5,713 providers for rapid revalidation over the next 12 months. 
For providers selected for rapid revalidation, the process will include documentation review, site visits and fingerprint-based criminal history background checks. 
SCDHHS has begun mailing revalidation letters to providers designated as high risk, with additional letters expected in the coming weeks. Each notification will include a unique revalidation code required to begin the process. Providers should not attempt to begin revalidation until they receive official notification from SCDHHS. 
The department's existing guidance recommends that providers confirm information such as their NPI, tax ID, mailing address, service location and provider name is current so they are prepared when their revalidation period begins. Providers should also note the deadline included in their individual notification; SCDHHS generally requires the online portion of the revalidation application be completed within 30 days of notification. Failure to complete required revalidation can result in termination from the Healthy Connections Medicaid program and interruption of Medicaid payments. 
HCAOA encourages South Carolina members participating in Medicaid personal care programs to watch for correspondence from SCDHHS and begin gathering and reviewing enrollment, ownership and other documentation that may be needed for the enhanced revalidation process. Questions can be directed to the Provider Service Center at (888) 289-0709, option four, or through SCDHHS's revalidation resources. ​