News & Updates

Healthy Connections Prime has released the June 2019 Stakeholder Update which focuses on County Coverage Expansion within the demonstration, a highlight on coverage model comparisons for members, and Medicaid Advantage Marketing Do's and Dont's. Provider specific guidance has also been released with an updated process for Nursing Facilities, Hospice, and Institutional Respite Providers. 

Click on the image below to view the full update. 

Healthy Connections Prime is authorized by the Centers for Medicare & Medicaid Services (CMS) and the South Carolina Department of Health and Human Services (SCDHHS) as a “demonstration” under the Medicare-Medicaid Financial Alignment Initiative to explore how coordination between Medicare and Healthy Connections Medicaid can improve health outcomes, create administrative efficiencies and make accessing care easier for members. With the support of CMS and all three Medicare-Medicaid plans (MMPs), Healthy Connections Prime has been granted an extension through Dec. 31, 2020.

In the April 2018 Stakeholder update, you will find information regarding a Healthy Connections Prime and Nursing Facilities Update, Healthy Connections Prime Waiver Services Appeals Process and a Healthy Connections Prime Provider Training Module. You will also find highlights about the upcoming Older Americans Month and learn how to join our distribution list!

Click on the image below to learn more:

Claims processing for Medicaid LTC nursing facility stays by an MMP has been modified to align with the Healthy Connections Medicaid fee-for-service methodology. All Medicaid LTC claims for Healthy Connections Prime members must be submitted to the MMP in which the member is enrolled.