COVID-19 Federal PHE End Date Announced; Planned Restart of Medicaid Member Annual Reviews
President Joe Biden has announced the coronavirus disease 2019 (COVID-19) federal public health emergency (PHE) will end May 11, 2023. Healthy Connections Medicaid-enrolled providers are reminded the South Carolina Department of Health and Human Services (SCDHHS) created many policy changes using emergency authorities derived from the federal PHE. View a comprehensive list of the COVID-19-specific policy guidance SCDHHS issued during the PHE.
SCDHHS previously issued guidance via Medicaid bulletins announcing the status of these flexibilities once the federal PHE has expired. Generally, flexibilities will either be made permanent, continue for one-year after the expiration of the federal PHE or expire upon the end of the federal PHE on May 11, 2023. These bulletins are described below and available via the links included with their descriptions.
- Medicaid Bulletin 22-005 regarding the temporary telemedicine flexibilities issued during the COVID-19 PHE;
- Medicaid Bulletin 23-003 regarding other temporary flexibilities issued during the COVID-19 PHE; and,
- Medicaid Bulletin 23-005 regarding flexibilities specific to nursing facilities
The flexibilities being extended beyond the PHE, both those that are being extended permanently and those that will be extended for one year beyond the end of the current federal PHE, will be added to their respective provider manuals prior to the end of the federal PHE (May 11, 2023).
Home and Community-based Services (HCBS) Appendix K Flexibilities
For temporary policy changes made through SCDHHS’ approved Appendix K waiver, including services delivered through the state’s HCBS waivers, SCDHHS was granted an extension for these authorities that will extend them to no later than six months beyond the end of the federal PHE, unless SCDHHS determines they should sunset at an earlier date. SCDHHS will announce updates regarding these flexibilities during this six-month extension. Affected HCBS waivers include:
- Intellectual Disability/Related Disabilities (ID/RD);
- Community Supports (CS);
- Head and Spinal Cord Injury (HASCI);
- Community Choices (CC);
- HIV/AIDS;
- Mechanical Ventilator Dependent (VENT);
- Medically Complex Children (MCC); and
- Palmetto Coordinated System of Care
Providers with questions about the policy flexibilities issued during the PHE should submit their questions to COVID@scdhhs.gov.
Restart of Annual Eligibility Reviews for Medicaid Members
To comply with the provisions of the Families First Coronavirus Response Act (FFCRA), SCDHHS paused the standard Medicaid eligibility annual review process effective March 2020. The Consolidated Appropriations Act, 2023, which was passed by Congress and signed into law by President Joe Biden on Dec. 23, 2022, provided state Medicaid agencies with a date of April 1, 2023, to resume their standard annual eligibility review processes.
SCDHHS is preparing for the resumption of its standard Medicaid member annual review process beginning April 1, 2023, in accordance with the Consolidated Appropriations Act, 2023. This does not mean all cases are up for review on April 1. The agency will review groups of cases each month over the 12-month period beginning April 2023. This means some members will not receive their notice or annual review form until March 2024. SCDHHS has published a website with information about this process on our Annual Reviews page.
SCDHHS’ goal, as it works toward the restart of annual reviews, is to minimize the burden on our members and promote continuity of health coverage. Providers and other stakeholders can help the agency achieve these goals by relaying consistent and simple messages to Healthy Connections Medicaid members.
It is important for SCDHHS to have up-to-date contact information for members. Providers can help us ensure we have accurate contact information for members by encouraging them to update their contact and household info now. Members can update their address, phone number and email address online. They can also change it by phone at (888) 549-0820. They can call Monday through Friday from 8 a.m. to 6 p.m. For in-person help, members can visit their local eligibility office. Member(s) will need their Medicaid card or Social Security number, date of birth, phone number and new address to make changes.
SCDHHS has produced a provider fact sheet about the restart of the annual review process and other material to help communicate with Medicaid members in its communications toolkit located.
Providers or stakeholders with questions about the annual review process can also email AnnualReviews@scdhhs.gov with questions or if they would like someone from the agency to present to their organization about this process.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.