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SCDuE Weekly Update | April 5, 2013

On Monday, April 8th at 4pm, CMS staff will join members of the SCDuE Team for a webinar on the current status of the South Carolina Dual Eligible (SCDuE) Demonstration.  The purpose of this webinar is to allow stakeholders the opportunity to hear how the SCDuE Demonstration Proposal submitted to CMS on May 25, 2012, developed with stakeholder guidance, will be changed moving forward.   

In preparation for this call, we encourage participants to review the SCDuE Demonstration Proposal, and more importantly, the three Request for Additional Information (RAIs)—SCDuE responses to CMS questions.  These materials are published on the SCDuE website.   We invite all stakeholders to attend this important session.  

Integrated Care Workgroup | April 8, 2013, 4pm – 4:30pm
Webinar | https://meet.lync.com/schhs-scdhhs/curtist/SG0LG6DB  
Audio Conference | 800-753-1965
Access Code | 898-4631
 
To join the SCDuE Webinar (online meeting), please follow each step provided below.
 

Step #1 Video
Click on the link:  https://meet.lync.com/schhs-scdhhs/curtist/SG0LG6DB
(Note:  You may need to disable your pop-up blocker)
                       

Step #2 Audio
To join the audio portion of this online meeting, please enter the conference phone number and access code provided below:
 
Audio Conference | 800-753-1965
Access Code | 898-4631
 
The webinar presentation will be available on the SCDuE website at http://msp.scdhhs.gov/scdue/  on Tuesday, April 9, 2013.

 
Public Comment Instructions and Modes:

  1. Public comments can be delivered in verbal and/or written format.
  2. Verbal public comments are limited to three (3) minutes.
  3. Written public comments can be submitted during and/or after meeting proceedings by:

(The deadline for e-mails is 5:00 PM Eastern, Friday, April 12, 2013)

  • Mail comments to:

South Carolina Department of Health & Human Services
SCDuE Demonstration
Attn:  Teeshla Curtis
1801 Main Street
Columbia, SC 29201
 
 

Integrated Care Workgroup Meeting Schedule

Special Session:  SCDuE Revised Demonstration Model
Wednesday, April 17 at 10:00am
South Carolina Department of Health and Human Services
1801 Main Street, Columbia, South Carolina, 29201
Facilitators:  SCDuE Team
 

Education Session:  Multidisciplinary Teams
Wednesday, April 24, 2013 at 10:00am
South Carolina Department of Health and Human Services
1801 Main Street, Columbia, South Carolina 29201
Facilitator:  Sam Waldrep

Education Session:  Consumer Engagement
Wednesday, May 22, 2013 at 10:00am
Location TBA
Facilitators:  Integrated Care Resource Center (CMS Technical Assistance Team)
 
 

Guidance to Interested Organizations

MMP Application and Model of Care (MOC) Review
CMS issued its first round of deficiency notices to plans last week; however, South Carolina will provide comments on state specific elements during the second round of deficiencies notices.
Please review the Cure I deficiency notice and MOC report for deficiencies on the South Carolina specific elements.  All interested organizations will be required to address any deficiencies identified by the State in the organization’s Cure II submission.  Note, although an organization may have passed the CMS portion of the MOC review, interested organizations will need to review the Cure I deficiency notice and MOC report for any deficiencies on state specific elements.
 

CICO Contracts
In order to enroll the target population of dual eligible members, CICOs must enter into a contractual arrangement with SCDHHS through the RFP process, as well as the three-way agreement with CMS.   The RFP contains the state-specific language related to the Demonstration and serves as the legal agreement between the State and the CICO.  Existing MCOs currently serving in South Carolina will maintain their current contractual arrangement to serve other populations.
 

CICO Provider Networks
Subcontractors and delegated vendors of CICOs must have MMP language in contracts with downstream providers if those providers are rendering Medicare services.  Contract amendments may be issued to subcontractors and delegated vendors to ensure the appropriate MMP provisions are incorporated into contracts.
Additional information regarding provider networks can be found in the CMS 2014 Guidance Document and March 2013 SCDHHS Managed Care Policies and Procedures Guide.

  • 2014 CMS Guidance Document | PDF
  • 2013 SCDHHS Managed Care Policies and Procedures Guide | PDF

 

Plan Selection Process
The MMP application process and South Carolina’s procurement process are both confidential.  Neither CMS nor the State will release the names of organizations that are pursuing these contracts.  Once contracts have been formalized and signed, both CMS and the State will release the names of those entities.
 

Implementation Timeline
Although South Carolina continues to progress with planning activities based on its initial timeline, CMS is offering states a choice of four timeframes in which each plan may conduct its first phase of passive enrollment:  January 1, April 1, July 1 or September 1, 2014.   These timeline options offer states opportunities to monitor and mitigate any hindrances to operations or beneficiary access during the initial stages of implementation.  Further, the State is considering the inclusion of an opt-in period which would require revising the initial timeline for passive enrollment.  The State will not formally adjust its timeline until there is an executed MOU with CMS.
 
 
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Medicare-Medicaid FAQs (Frequently Asked Questions) | PDF
Contact CMS for any questions or concerns regarding the meetings, guidance, or the MMP application. Emails can be directed to MMCOcapsmodel@cms.hhs.gov
Contact the SCDuE Team for more information, questions, and/or comments related to the SCDuE Demonstration by email at scdue@scdhhs.gov.
For additional assistance, please contact the SCDuE Program Coordinator, Teeshla Curtis by email at curtist@scdhhs.govor by telephone at (803) 898-0070.
Visit the SCDuE Website at https://msp.scdhhs.gov/scdue/
Visit the CMS-MMCO Website at https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/index.html

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