Update on COVID-19 Regulatory and Reimbursement Flexibilities for Nursing Facilities

Wednesday, September 9, 2020

On April 30, 2020, the South Carolina Department of Health and Human Services (SCDHHS) issued a Medicaid Alert announcing it was granting certain temporary regulatory flexibilities related to admissions to skilled nursing facilities and participation in the Medicaid nursing home program. These flexibilities were designed to support discharges from hospitals and preserve valuable inpatient capacity in anticipation of a potential surge of hospitalizations related to the coronavirus disease 2019 (COVID-19) pandemic. The temporary flexibilities also allowed certain nursing facilities to be reimbursed for services delivered to Medicaid beneficiaries in excess of a facility’s permitted allowance.    

At the time of this alert, the state has not exhibited sufficient and concurrent shortfalls of licensed hospital and skilled nursing facility beds to warrant enrolling additional skilled nursing facilities on a provisional basis. The temporary flexibilities announced on April 30 remain available to SCDHHS should such a need arise. Unenrolled skilled nursing facility providers who admit Healthy Connections Medicaid beneficiaries are not guaranteed reimbursement for services rendered, and such admissions continue to be discouraged at this time.

Please refer any questions or concerns regarding this alert to COVID@scdhhs.gov.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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