- Established by Title XIX of the
Social Security Act
- Provides quality health care to low income, disabled, and
elderly individuals by utilizing state and federal funds to
reimburse providers for approved medical services.
- South Carolina Department of Health and Human Services (SCDHHS) is the single state agency designated
to administer the SC Medicaid program.
- SCDHHS administers the traditional
fee-for-service Medicaid program and offers two (2) Medicaid
Managed Care Programs.
Medicaid Managed Care Organization (MCO) Program
- Consists of contracted MCOs that provide approved medical
services through a developed network of providers
- SCDHHS pays a capitated rate per
member per month, according to age, gender, and category of
eligibility to MCOs.
- Payments for core services provided to MCO members are the responsibility of MCOs, not
the fee-for-service Medicaid program.
- MCOs may elect to provide their members enhanced services
beyond what is offered under traditional fee-for-service
SC Federal Qualified Health Centers participate in the
traditional fee-for-service Medicaid program and the Medicaid
Managed Care programs. Please contact the center in your area about
the specific Medicaid Managed Care programs that are accepted.
Early and Periodic Screening, Diagnostic, and Treatment (EPSDT)
to the SC Department of Health and Human Services