Public Notice of Proposed Action for Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID

The South Carolina Department of Health and Human Services (Department), pursuant to the requirements of Section 1902(a)(13)(A) of the Social Security Act, gives notice of the following proposed actions regarding its methods and standards for paying providers under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

Effective for services provided on or after January 1, 2019, the Department proposes to amend the South Carolina (SC) Title XIX State Plan by updating the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) Medicaid prospective payment rates using the most recent cost report data available (i.e. July 1, 2015 through June 30, 2016) and the use of the midpoint to midpoint trending methodology and application of the CMS SNF PPS Market Basket rates. The Department also proposes to include phases one and two of the Direct Care Worker add-on relating to direct care worker salary increases provided in the July 1, 2017 and October 1, 2018 ICF/IID rates into the determination of the January 1, 2019 ICF/IID payment rates.

As a result of the above actions, the January 1, 2019 aggregate (i.e. institutional and community residences) weighted average rate is projected to be $388.51. The aggregate weighted average October 1, 2018 rate was $370.46. This represents an aggregate weighted average per diem increase of $18.05 per Medicaid patient day, or a 4.87% increase. 

The Department estimates that the proposed actions will increase annual aggregate Medicaid expenditures by approximately $7.50 million (total dollars).

Copies of this notice are available for public review at each South Carolina County Department of Health and Human Services Office and at www.scdhhs.gov for public review. Additional information regarding these actions is available upon request at the address cited below.

Written comments may be sent to the South Carolina Department of Health and Human Services, Reimbursement Methodology and Policy department, Post Office Box 8206, Columbia, South Carolina 29202-8206. Written and emailed comments must be received by December 27, 2018.

Any written comments submitted may be reviewed by the public at the South Carolina Department of Health and Human Services, Bureau of Reimbursement Methodology and Policy, 1801 Main Street, Room 1226 Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.