SCDHHSSouth Carolina Department of Health and Human Services
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"Helping inmates to preserve access to health care during the transition back into the community is both a matter of public health and public safety," an SCDHHS representative said.
For the past decade, there had only been one Medicaid eligibility worker from SCDHHS stationed on-site at SCDC.
With the clear-cut need for additional eligibility workers, SCDHHS decided to create a dedicated eight-member team to handle these applications.
Even though the leadership of SCDC and SCDHHS were committed to the project, the agreement took months to negotiate and execute.
This represented little financial risk for those who were enrolled as "fee-for-service" members--for whom the state directly pays providers for billed services--however, 85 percent of those actively covered prisoners were still enrolled in one of the state's contracted managed care plans, which meant that SCDHHS had been making monthly premium payments to those plans, even though the plans were not paying for any services.
The tougher questions are often escalated to Beth Hutto, deputy director of SCDHHS, who is responsible for eligibility and enrollment services.