Ground Ambulance Upper Payment Limit (UPL) Supplemental Payment Program (Fee-For-Service)

updates the base year used to determine payments under the Average Commercial Rate (ACR) method for the Supplemental Teaching Payment (STP) Program. It is also noted that this plan amendment excludes Greenville Hospital System (GHS), Palmetto Health Richland Hospital, and University of South Carolina College of Medicine d/b/a Prisma Health as eligible participants in the STP program.

Care Coordination Organization/ Health Home (CCO/HH) Program

This amendment adds a new community-based behavioral health services under section 1915i authority

Nursing Facility reimbursement

Mental health crisis and withdrawal management services.

Update the buy-back provisions for county health department reimbursement. 

Allow permanent waiver of the annual recertification of level of care requirement in accordance with
441.510(c)(1) & (2) and allow a temporary waiver for other specific situations