SCPCSD�

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South Carolina Public Charter School District Medicaid PowerPoint

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Medicaid Updates School-Based Therapy Services ��February 23, 2023�

Deitrich Drayton

Student Services Compliance Administrator

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Agenda

• LEA School-Based Services – Overview
• Medicaid Web Portal Instructions
• Medicaid – Define the Services and SPL - Updates
• Staff / Provider Qualifications and Credentials
• Medicaid Eligibility and Updates
• Medicaid Documentation and Forms
• Clinical Records and Maintenance
• Staff Training
• Billing for Services and Manage Care Organizations
• Quality Assurance Reviews
• Resources

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LEA-School-Based Services

• This presentation is designed to enhance the understanding of the Medicaid standards regarding the Local Education Agencies Policy (LEA) Manual, all aspects and policies are not covered in this presentation. Please review the LEA Manual and the Administrative and Billing Manual.
• This meeting does not take the place of reading the provider policy and procedure manual.
• All information in this presentation pertains to the South Carolina Department of Health and Human Services (SCDHHS) Healthy Connections Medicaid beneficiaries.

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Medicaid Services Overview

• The Medicaid program, as established by Title XIX of the Social Security Act, provides quality health care to low-income, and disabled individuals by utilizing state and federal funds, to reimburse providers for approved medical services.
• The South Carolina (South Carolina or State) State Medicaid Plan allows an array of behavioral health services under the Rehabilitative Services Option, 42 CFR 440.130(d).
• Rehabilitative Services are medical or remedial services that have been recommended by a Physician or other Licensed Practitioner of the Healing Arts (LPHA) within the scope of their practice under South Carolina State Law and as further determined by the South Carolina Department of Health and Human Services (SCDHHS) for maximum reduction of physical or mental disability and restoration of a beneficiary to their best possible functional level.

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Charter School’s Contract and Subcontracts

• Schools are responsible for ensuring the staff rendering Medicaid school-based services are approved, credentialed, or licensed.
• The school must have a contract with every subcontractor.
• Schools must ensure that subcontractors meet all applicable Medicaid provider qualifications, as well as the applicable state licensure regulations, in addition to any specified requirements by the South Carolina Department of Education for the provision of Medicaid school-based services.
• The school must provide a copy of the staff and subcontractors’ credentials.

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Medicaid – DHHS Web Portal Instructions

• The staff will be given a user ID and a temporary password to access the DHHS webportal.
• You may access the South Carolina Medicaid Web-Based Claims Submission Tool at: https://portal.scmedicaid.com for claims filing, eligibility, claim status, and remittance advice. You must change the password after your initial login. Below are the rules:
• The new password must be at least 8 characters
• First character must be an upper-case letter
• Must contain a lower-case letter
• Must contain a digit
• Must contain a special character i.e. [",'!@#$%^&*().+_-{}|\></?:;](
• Cannot contain your User ID. (e.g., if your ID is “Fred,” then Fred#007” is not allowed)

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Medicaid – DHHS Web Portal

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Instructions:

• Put in your User number and password. Click log in
• See Select one and click the drop-down arrow – select South Carolina public charter school and click
• Then click select
• This will allow you to review the categories
• You can check the eligibility of the students and check the remittance under Reports.

Medicaid Therapy School-Based Services

The following services are listed under School-based services.

• Speech-Language Therapy
• Occupational Therapy
• Physical Therapy

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Staff Qualifications – Speech-Language Therapy - Update

Speech-Language Pathologist services are provided by or under the direction of a licensed speech-language pathologist.

• On October 21, 2022, a memorandum was released to all school districts regarding co-signature requirements when a Speech Language Therapist (SLT) completes a reevaluation or individualized education program (IEP). Speech reevaluations or IEPs completed by the Speech Language Therapist (SLT) must be co-signed by a licensed Speech Language Pathologist (SLP). The effective date for both requirements was November 1, 2022.
• The licensed speech-language pathologist can supervise the licensed speech-language pathology intern and speech-language pathology assistant or speech-language pathology therapist.

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Staff Qualifications – Speech-Language Therapy-Continued

• A speech-language pathology assistant is an individual who is currently licensed by the South Carolina Board of Examiners in speech-language pathology. The speech-language pathology assistant works under the direction of a qualified speech-language pathologist pursuant to 42 CFR 440.110(c)(2)(i) and (ii).
• A speech-language pathology intern is an individual who is currently licensed by the South Carolina Board of Examiners in speech-language pathology and is seeking the academic and work experience requirements established by the American Speech and Hearing Association for the Certification of Clinical Competence in speech-language pathology. The speech-language pathology intern works under the direction of a qualified speech-language pathologist pursuant to 42 CFR 440.110(c)(2)(i) and (ii).
• A speech-language pathology therapist is an individual who does not meet the credentials outlined in the 42 CFR 440.110(c)(2)(i)(ii) and (iii) that must work under the direction of a qualified speech-language pathologist.

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Speech-Language Updates- New Procedure Code

• On February 13 and February 16 (revised), SCDE- Office of Medicaid Services (OMS) submitted a memo to add a new speech and language procedure code. The new procedure code 92526 which is utilized for the treatment of swallowing dysfunction and/or oral function for feeding is available to schools for Medicaid reimbursement.
• The staff qualifications for providing services are a licensed SLP and an SLP-Intern (SLP-I) who is under the supervision of the licensed SLP.
• The method of services is reimbursed when provided in an individual setting. Group settings are not reimbursable.
• The procedure code has a frequency of one encounter per day.
• Fee rate is $42.52 per encounter

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Fee Schedule School-Based Rehabilitative �Services (SBRS)�Speech- Language �Procedure Codes

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Staff Qualifications - Occupational Therapy

Occupational Therapist

• An occupational therapist is a person licensed to practice occupational therapy by the South Carolina Board of Occupational Therapy. In accordance with 42 CFR 440.110(b)(2)(i)(ii), a qualified occupational therapist is: (i) certified by the National Board of Certification for Occupational Therapy, or (ii) a graduate of a program in occupational therapy approved by the Committee on Allied Health Education and Accreditation of the American Medical Association and engaged in the supplemental clinical experience required before certification by the National Board of Certification for Occupational Therapy.

Occupational Therapy Assistant

• An occupational therapy assistant is an individual who is currently licensed as a certified occupational therapy assistant by the South Carolina Board of Occupational Therapy who works under the direction of a qualified occupational therapist pursuant to 42 CFR 440.110(b)(2)(i) or (ii).

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Fee Schedule School-Based Rehabilitative �Services (SBRS)�Occupational Procedure Codes

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Staff Qualifications- Physical Therapy

Physical Therapist

• A physical therapist is a person licensed to practice physical therapy by the South Carolina Board of Physical Therapy Examiners. In accordance with 42 CFR 440.110(a)(2)(i)(ii), a qualified physical therapist is an individual who is (i) A graduate of a program of physical therapy approved by both the Committee on Allied Health Education and Accreditation of the American Medical Association and the American Physical Therapy Association or its equivalent; and (ii) where applicable, licensed by the State.

Physical Therapist Assistant

• A physical therapist assistant is an individual who is currently licensed by the South Carolina Board of Physical Therapy Examiners. A physical therapy assistant provides services under the direction of a qualified physical therapist.

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Fee Schedule School-Based Rehabilitative �Services (SBRS)�Physical�Therapy Procedure Codes

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Staff Supervision

• In accordance with the Centers for Medicare and Medicaid Services (CMS) directives, CMS has interpreted the term “under the direction of” to mean that the provider is individually involved with the patient and accepts ultimate legal responsibility for the services rendered by the individuals that he or she agrees to direct. The supervisor is responsible for all the services provided or omitted by the individual that he or she agrees to directly supervise.
• At no time may the individual being supervised perform tasks when the supervisor cannot be reached by personal contact, phone, e-mail, pager, or other immediate means. The supervisor must make provisions, in writing, for emergency situations including the designation of another qualified provider who has agreed to be available on an as-needed basis to provide supervision and consultation to the individual when the supervisor is not available.
• All clinical service note entries made by a staff who requires supervision must be cosigned by the supervisor unless otherwise indicated for a specific Medicaid reimbursement service.
• Note: Medicaid requires that the staff’s license be on file and checked bi-annually. A copy must be submitted to SCPCSD annually. A supervisory log must be maintained.

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Staff Credentials�

• Providers must maintain documentation that verifies that all staff is properly qualified, screened, trained, and supervised, including subcontractors, volunteers, students and/or interns, and other individuals under the authority of the provider.
• Providers must maintain a staff file, and make it available upon request, appropriate records, and documentation of such qualifications, training, and investigations.
• The staff’s credentials must be verified before rendering services. The staff’s credentials must be submitted to the Student Services Compliance Administrator for review before services are rendered.

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Medicaid Staff Credential Reports

Staff rendering Medicaid services must have the following credentialing reviewed and filed.

• An annual copy of their SCLLR License must be on file. A copy must be submitted to the Student Services Compliance Administrator annually.
• A copy of the SC-Office of Inspector General (OIG) report to be reviewed monthly and copied twice a year and filed by the school. The link is located at the Office of the Inspector General Provider Exclusion Database: https://exclusions.oig.hhs.gov/.
• A copy f the SC DHHS Excluded Providers List to be reviewed twice a year and filed by the school. The link is located on the SC-DHHS website under FOR PROVIDERS or at this link (Provider Information | SC DHHS).

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Recommendation: The SCDHHS excluded provider list is a long report. Download the file and save a copy to your computer. A copy of the staff’s OIG check must be completed twice a year, and a copy must be kept in the Medicaid file. When Medicaid reviews the file, they will request a copy of the reports.

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Staff Signature�Sheet�and a �copy of �a Professional License from the SC Department of Labor, Licensing and Regulation

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Medicaid Eligibility for Services

The South Carolina Department of Health and Human Services (SCDHHS) provides Medicaid reimbursement for medically necessary services provided to Medicaid-eligible individuals in the LEA.

Medical necessity means the need for treatment services is necessary to diagnose, treat, cure, or prevent an illness, or participation in services is reasonably expected to relieve pain, improve and preserve health, or be essential to life.

This includes, but is not limited to, children under the age of 21 years who have or are at risk of developing sensory, emotional, behavioral, or social impairments, physical disabilities, medical conditions, intellectual disabilities or related disabilities, or developmental disabilities or delays.

Note: The student’s Medicaid eligibility must be checked twice a year and copies must be kept in the student’s file. Each school will be given access to the Medicaid webportal to check eligibility. If the school does not have access, notify the Student Services Compliance Administrator.

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Medicaid Eligibility Update -

• The Department of Health and Human Services (DHHS) sent out a Medicaid Notice on February 13, to notify Medicaid members that DHHS will start reviewing Medicaid eligibility in April. The COVID-19 Federal Public Health Emergency (PHE) end date will be May 11, 2023. Medicaid members will be notified to update their information with DHHS. This project may take up to a year to complete. Schools may remind Medicaid members to update their address, phone number, and email address online at apply.scdhhs.gov.
• Also, the General Medicaid consent can be placed in the student’s registration packet for the next academic year and the school will have the Medicaid information.
• Schools may also access the Medicaid webportal to check the student’s Medicaid eligibility before school starts next academic year. Reminder, a copy should be scanned or placed in the student’s file. If the school needs a copy of the Medicaid card, please request it.

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Example of the Medicaid Edibility Form

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Third Party Billing (TPL)

“Third-party liability” (TPL) refers to the responsibility of parties other than Medicaid to pay for health insurance costs. Medicaid is always the payer of last resort, which means that Medicaid will not pay a claim for which someone else may be responsible until the party, liable before Medicaid has been billed. For the most part, this means providers are responsible for billing third parties before billing Medicaid.

Note: Always ask the parent if they have another health insurance carrier. Make a copy of the insurance card and keep it in the student’s file. When you provide insurance information about the student’s insurance for CompuGroup Medical (CGM) add this information to the student’s file.

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Medicaid Documentation Requirements

• All providers shall maintain a clinical record for each Medicaid-eligible beneficiary that fully describes the extent of the treatment services provided.
• The clinical record must contain documentation sufficient to justify Medicaid participation and should allow an individual not familiar with the beneficiary to evaluate the course of treatment.
• Each provider shall have the responsibility of maintaining accurate, complete, and timely records and ensuring the confidentiality of the beneficiary’s clinical record.
• All providers should self-monitor adherence to applicable Federal and State Laws and Regulations and in accordance with the South Carolina Plan for Medical Assistance, alerts, bulletins, SCDHHS policies, procedures, and Medicaid Provider Manuals. Any findings of non-compliance, as a result of self-monitoring activities, shall be communicated to the SCPCSD staff –Student Services Compliance Administrator.

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Copy of the Medicaid Consent Form

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Medicaid Consent Form and Annual Notification Form

Consent Form

A Release of Information form must be signed by the child’s parent or guardian to authorize the release of any medical information necessary to process Medicaid claims and request payment of government benefits on behalf of the child. (The consent form must be completed for ALL Medicaid Services.)

Annual Notification Form

The Annual notification form documents that the parent has been informed of their Medicaid rights.

• Must be signed annually, given to the parent, and a copy placed in the student’s file.

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Copy of the �Annual Notification Letter

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Medicaid Referral for Service

Referrals must be made by a licensed provider working within the scope of their licensure utilizing their knowledge, experience, and expertise.

The health professional must be currently and appropriately licensed in South Carolina and located within the South Carolina Medical Service Area (SCMSA), which is defined as the state of South Carolina and areas in North Carolina and Georgia within 25 miles of the South Carolina state border.

• NOTE: The SCDE considers the best practice is for the LPHA to only refer students for School-Based Rehabilitative Therapy Services within the scope of his or her practice under state law. This recommendation is based on the Medicaid LEA Manual which states the LPHA who makes the referral is required to explain the reason for the referral and act within the scope of his or her practice under State law.
• The presence of licensure/certification means the established licensing board in accordance with the South Carolina Code of Laws has granted the authorization to practice in the state.

The three codifying agencies responsible for licensure within South Carolina are the South Carolina

• Department of Labor and Licensing Regulation (SCLLR) www.llr.sc.us, South Carolina Department of Health and Environmental Control (SCDHEC) www.scdhec.gov, and South Carolina Area Health Education Consortium (SCAHEC) www.scahec.net.
• Licensed professionals must maintain current licensure/certification for the appropriate authority to practice in the State of South Carolina and must operate within their scope of practice.

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Who can provide a Referral for Service?

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Medicaid School-Based Forms

• Student Medicaid Eligibility Form
• Medicaid Consent and Annual Notification Letter
• Referral for Services form signed by an LPHA
• Evaluation and other assessments
• Treatment Plan (IEP, or IFSP) (when services are recommended)
• Clinical Service Notes (CSN) (document services)
• Progress Service Notes (summarize therapy services at least every 90 days)
• Other documents relevant to the care and treatment of the student (Lab reports, medical reports, additional assessments, and court orders)
• Staff Credentials

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Referral for Service Documentation Criteria

The referral documentation must follow these criteria:

• The referral(s) for service must cover the academic year of the service.
• The referral form must be signed, titled, and dated (electronically or handwritten) by a physician or other Licensed Practitioner of the Healing Arts (LPHA).
• The annual referral form must be completed by an LPHA other than the direct provider of services.
• The annual referral form must be dated prior to the evaluation or re-evaluation.
• The annual referral form must be dated prior to the annual IEP/IFSP/ITP/IPOC.
• The annual referral form must be dated prior to the first date of service rendered in the academic year.

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Example of a Referral Form

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Medicaid Evaluation or Re-evaluation

Evaluations must occur prior to the provision of the Medicaid rehabilitative therapy service. Evaluations must be completed by the enrolled Medicaid provider of services after receiving the referral from another LPHA.

Reevaluations

• A reevaluation is performed after the initial evaluation and relates to the disorder. A reevaluation must be completed after receiving an updated referral from another LPHA. A reevaluation must be conducted annually (every 12 months) for each student; however, a reevaluation can be completed within a six-month time frame, if needed.
• A reevaluation must be completed when enough time has passed to accurately assess the student’s progress. This service may be performed twice a year.
• The results of the evaluation must include a narrative summary. The documentation must justify the number of units billed.

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Evaluation Documentation Criteria

• The evaluation/re-evaluation must cover the academic year in review.
• The evaluation\re-evaluation must include the title, date, and signature (electronically or handwritten) of the Therapist.
• The evaluation must include a written report with recommendations.
• The evaluation must include diagnostic testing and assessment.
• The annual evaluation/re-evaluation must be dated prior to IEP or the IFSP and in the student’s file.
• The annual evaluation/reevaluation must be in the student’s file dated prior to the first date of service rendered in the academic year.

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Example of the Evaluation�front cover

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Evaluation Results �with Recommendations

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Evaluation with the �Staff Signature

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IDEA and Medicaid Documentation Requirements

• The development of an Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP) is a requirement of the Individuals with Disabilities Education Act (IDEA).
• Medicaid requires school-based services to be indicated on the IEP or the IFSP.
• Medicaid will not reimburse for any administrative or direct services performed for pre-IEP or IFSP activities. Medicaid will not reimburse for the IEP team member meeting, or the cost related to attendance at those meetings by medical professionals.

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Medicaid Treatment Plan Requirements

• The development of an Individualized Education Program (IEP) or an Individualized Family Service Plan (IFSP) is a requirement of the Individuals with Disabilities Education Act (IDEA). Medicaid requires school-based services to be indicated on the IEP, or the IFSP.
• If an evaluation indicates that therapy is warranted, the therapist must develop and maintain a treatment plan that outlines long-term goals and short-term objectives, as well as the recommended scope, frequency, and duration of treatment.
• If the student has medical orders prescribed by a medical practitioner, medication is provided at school, and services are billed to Medicaid, a treatment plan must develop a treatment plan.

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Medicaid Treatment Plan Documentation Requirements

The treatment plan must be reviewed and updated according to the level of progress. If a determination is made during treatment that additional services are required, these services should be added to the treatment plan. It must cover the academic year and be completed prior to the first date of service.

The treatment plan must include the following components:

• Individualized – student specific by including the student’s name must be included.
• Specific problems to be addressed (Therapy service listed from the evaluation, OT, PT, and Speech/Language.)
• Goals – Goals must address the physical and/or functional impairment, deficit, limitation, or clinical condition (Must state the Medicaid service - OT, PT Speech/Language.)
• Short-term objectives, (Only required for students on South Carolina Alternate Assessment [SC-Alt] & required when the IEP is used as the Individual Plan of Care [IPOC] for Rehabilitative Behavioral Health Services.),
• List the types of interventions to be utilized in treating the medical condition (Include the types of interventions in the assessment and goals in the IEP).

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Medicaid Treatment Plan Documentation Requirements- Continued

• Planned frequency of service delivery (example: 300 units per month)
• Estimated duration (example: 30 minutes per session)
• Criteria for achievement – (example: Johnny will achieve 70% out of 100%)
• Exact service the student should be receiving (must list the Medicaid service: Speech, OT, and PT and is the service provided in a group or individual)
• Signature, date, and title of the therapist (Electronically or handwritten) on the treatment plan, or a supplemental excusal statement signed by the therapist must be on file.
• List the student’s strengths and weaknesses in the treatment to explain the medical necessity for services.

Note: CGM will allow the user to upload the treatment plan and other documents.

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Example of the �IEP

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IEP – Explains the Medicaid Service

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IEP - Goals

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IEP – �List of �the Medicaid Services�and Frequencies

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IEP Supplemental Statement

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Speech-Language – IEP Signature Updates

On December 19, 2022, a memorandum was released to all school districts clarifying and providing the following guidance regarding the October 21, 2022, memorandum:

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• The SLPs are not required to attend IEP meetings when services are included in the IEP, the SLP must submit data to the IEP Team and sign the supplemental statement.
• A supplemental statement completed and signed by the SLP may be utilized for the co-signature of the SLP. The SLP’s completed and signed supplemental statement must clearly state that the SLP has reviewed and approved the speech therapy services/treatment, length, frequency, and type (individual or group) of service as outlined within the IEP and agreed upon by the IEP team. This form must be attached to the IEP.

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Medicaid Clinical Service Note (CSN) - Purpose

The purpose of these notes is to record the nature of the child’s treatment by capturing the services provided and summarizing the child’s participation in treatment.

CSN must be sufficient to support the number of units billed for the service.

The CSN must reflect a Medicaid billable service as identified in the evaluation notes.

The date of the service must be included in the CSN.

The CSN must reflect a Medicaid billable service and the appropriate modifier.

If the service needs to be revised during the year, the student should be re-evaluated to determine the need for service and the IEP must be amended to reflect the change. The CSN must be amended to reflect the revision.

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CSN – Requirements

Clinical Service Notes must include a narrative summary of each treatment session and must justify the number of units billed. The following are required components of the CSN:

• Provide a pertinent clinical description of the activities that took place during the session (list the objective the student is working on and a narrative on what type of therapy is being utilized).
• Student’s level of participation/response to treatment (document how the student responds to therapy).
• Reflect delivery of a specific Medicaid reimbursable service as identified in the physician’s or other LPHA’s referral, evaluation, and the IEP or IFSP. (The name of the service must be listed: Speech, OT, or PT).
• Date of service (Document the date of the service on the note).
• Type of service and number of units billed (example: OT- 2 units billed).
• Start and Stop times (example: 2:00 pm to 3:00 pm).
• Individualized and student-specific (The information cannot be cookie-cutter and must be student specific to include the student’s name in the narrative.)
• Signature, professional title, and date of the provider delivering the service. If a co-signature is required, the same requirements must be met.

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Example of the CSN

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CSN – Staff Signatures

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Example from the�CGM MediEd System

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Medicaid Progress Summary Notes - Documentation

The progress summary is a written note outlining the child’s progress that must be completed by the therapist/provider at least every 90 days from the start date of treatment. (The start date of treatment is listed on the IEP. If the service does not start on this date, the therapist must document the reason for the delay.)

The progress summary documentation must include:

• The progress summaries must be completed at least every three months from the start date of treatment or when medically necessary. (The timeline starts from the start date of treatment listed on the treatment plan. The date range should be added to the note to show the timeline of service: August 12, 22 to October 15, 22).
• Each progress summary must be dated, titled, and signed (electronically or handwritten) by the provider/therapist).
• Each progress summary must describe the student’s attendance at therapy. (Attended 23 sessions out of 30).
• Each progress summary must document the student’s progress toward treatment goals.
• Each progress summary must establish the continued need for treatment. (A narrative must be written to describe the student’s progress, and performance. A narrative must be written to explain why services must continue or be discontinued.
• Signature, professional title, and date of the provider delivering the service.

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Example of the Progress Summary

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PSN – Staff Signatures

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Clinical Records and Maintenance

Clinical Records

• As a condition of participation in the Medicaid program, providers are required to maintain and allow appropriate access to clinical records that fully disclose the extent of services provided to the Medicaid beneficiary. The maintenance of adequate records is regarded as essential for the delivery of appropriate services and quality medical care. Providers must be aware that these records are key documents for post-payment review.

The records must follow these criteria:

• The documentation must be typed or legibly handwritten in dark ink.
• Errors must be corrected according to Medicaid policy and procedures (draw a line through the error, initial the error, date the error, and document the correction, if applicable).
• The school must have an abbreviation key available in the student’s file. (List of the most common abbreviations used for each program must be available.)
• The school must have a signature sheet or logbook that identifies the staff’s name, signature, and initials in the student’s file or logbook.

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Quality Improvement and Monitoring

SCDHHS, SCDE, or the SCPCSD will conduct reviews to ensure that schools/providers comply with applicable laws, regulations, and policies.

Other authoritative entities may conduct reviews of LEA-Mental Health /RBHS providers, including the State Auditor’s Office, the South Carolina Attorney General’s Office, the United States Department of Health and Human Services, the Government Accountability Office, and/or their designees.

SCDE will conduct an annual Medicaid Quality Assurance Review on the RBHS Medicaid program. The Medicaid files which include all Medicaid documents and the staff’s credentials must be available.

SCPCSD will conduct random reviews of the program throughout the school year and provide feedback to assist the staff.

Upon request, information must be furnished regarding any claim for payment to SCDHHS.

All providers must grant access to SCDHHS, or its designees for the purpose to review and/or investigate and allow for copying and reproducing documents.

Failure of the provider to comply with this provision may result in the immediate termination of enrollment.

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SCDE-Annual Medicaid Review

Each year the SCDE Office of Medicaid Services reviews the school districts to determine if the schools are following the Medicaid guidelines. They provide technical support and interpret Medicaid policies for schools. The charter schools are under the guidance of SCDE and SCDE has a contract with DHHS to provide these services.

When will the SCDE–OMS Annual Medicaid Review?

• The SCDE-OMS has been set for April 18, 2023. The school will have 30 days to submit the Medicaid documents for review. SCDE will provide a random list of files to be reviewed. The files must be at the district office and uploaded into the system by the due date. SCPCSD will notify the schools of which files have been selected and will assist the schools in checking the files.
• The SCDE staff will be on-site at the district office during the review. A day before the review, SCDE-OMS will request two random files to be added to the review. The schools will be notified and will have to upload the files immediately.
• Note: Review the Medicaid Document slide to ensure the Medicaid student’s file has the appropriate documents. CGM has templates that provide the Medicaid criteria.

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School-Based Resources

SCDE Resources:

• SCDE OMS Webpage - Medicaid - South Carolina Department of Education - 09/14/2022 12:16 PM (sc.gov)
• SCDE – Medicaid Forms – Forms - South Carolina Department of Education - 09/14/2022 12:15 PM (sc.gov)
• SCDE School District Preparation Guide 22-23 and the QA Checklist SY 22-23 - Quality Assurance (QA) - South Carolina Department of Education - 09/14/2022 11:59 AM (sc.gov)
• SCDE- Fee/Rate Schedule - Fee Schedule

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SCDHHS Resources:

• SCDHHS website - https://www.scdhhs.gov/
• SCDHHS LEA Manual and forms website - Local Education Agencies (LEA) Services Provider Manual | SC DHHS
• SCDHHS Medicaid Provider Education webpage - Healthy Connections Medicaid E-Learning (remote-learner.net)
• SCDHHS contact for the Medicaid Provider Education - Healthy Connections Medicaid E-Learning (remote-learner.net) and contact for Provider services 1 (888) 289-0709.

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Contact Information�

Deitrich (Dee) Drayton

ddrayton@sccharter.org

(803) 212-5482

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