South Carolina FQHC Intelligence

A July 31 SCDHHS bulletin says the Medicaid State Plan will add coverage of the Intercept intensive in-home model on or after August 1. The model serves eligible youth through age 20 and their families in home or community settings, includes 24/7 on-call crisis support, and requires provider organizations to obtain licensing and training from the model developer before delivery.

The bulletin sets a bundled $309.56 daily rate and 48 encounters over 120 days before additional authorization. This documents the coverage design, not the exact activation date, enrolled-provider or statewide geographic availability, utilization, FQHC participation, access gains, or outcomes.

New Horizon Family Health Services, which identifies itself as a Federally Qualified Health Center, tells patients who become sick without an appointment to call or ask for a same-day sick appointment or work-in time at any of its locations; patients may also request a call if a cancellation occurs. Its current FAQ says extended-hours illness services are offered and an on-call nurse answers questions after hours through 864-729-8330.

These are request and assistance pathways, not guaranteed appointment availability, walk-in access, a response-time standard, clinical advice by telephone, provider or FTE capacity, emergency-department or inpatient service, utilization or outcomes; the operator directs emergencies to 911 or an emergency room.

The current healthinsurance.org guide reports 587,567 South Carolina marketplace plan selections for 2026, about 7% below 631,948 in 2025. It says more than 89% received premium subsidies, averaging $579 per month and reducing the average subsidized premium to $76.

The guide also reports an average approved gross rate increase of about 21% and estimates that 65,000 adults remain in the state's Medicaid coverage gap. It does not measure a resulting increase in FQHC uninsured visits, so that causal claim has been removed.

Peterson-KFF reviewed 77 marketplace insurers in 16 states and the District of Columbia with public filings and found a median proposed 14% premium increase for 2027, after a 20% median finalized increase for 2026. The analysis reports a 10% median medical-cost trend and says insurers that adjusted for expiration of the enhanced tax credits projected that dynamic to add roughly 4 percentage points in 2027.

South Carolina is not among the jurisdictions in the reviewed filing set, so these figures are an early national benchmark rather than a South Carolina rate estimate. The reported 58% rise in average after-subsidy payments is also a marketplace-wide figure, not a South Carolina-specific result.

WRDW reported that South Carolina entered the fiscal year on July 1 without a final state budget. A continuing resolution kept agencies funded at the prior year's levels.

The article identifies the principal dispute as roughly $240 million in Senate-backed senior property-tax relief versus more than $300 million in House earmarks and says the conference committee was scheduled to return July 14. It does not quantify a Medicaid appropriation, identify health-center funding, or say that particular health investments were frozen; those earlier inferences have been removed.

The official page for H.5126 lists the general appropriations bill as residing in conference. It records House passage on March 11, Senate passage on April 23, House amendments on May 6, Senate nonconcurrence, and appointment of House and Senate conferees on May 7.

The page does not support the earlier claims that the bill totaled roughly $15 billion or that particular Medicaid and FQHC appropriations remained unsettled. This item is therefore limited to the legislature's procedural record.

SCDHHS posted the $27 million Leveling Up request for applications on April 2, 2026, named federally qualified health centers among eligible rural health-care providers, and closed applications June 1. The RFA says SCDHHS anticipates communicating award status by July 31, 2026.

That date is an anticipated notice milestone, not a published award result: the source does not name recipients, determine the number of awards, or guarantee any allocation to an FQHC.

On April 2, 2026, SCDHHS announced a June 1 application deadline for one-time infrastructure and capacity-building grants under Connections to Care, Leveling Up, Wellness Within Reach, and Shoring Up to Sustainability. Eligible applicants included health-care providers, community organizations, nonprofits, local governments, and public-health entities.

The page identifies $200,030,252.32 in total financial assistance funded 100% by CMS. It does not reserve awards for FQHCs or state a September 30 project deadline, so those earlier claims have been removed.

SCDHHS's final-action notice says South Carolina Medicaid will reimburse FQHCs through the prospective payment system or a mutually agreed alternative payment methodology that pays at least the PPS amount. The PPS baseline is tied to 1999 and 2000 cost reports, adjusted annually by the Medicare Economic Index, and participating centers remain subject to cost reporting.

The notice is effective April 1, 2026. It does not discuss managed-care contracts, subcapitation, or revenue leakage.

NACHC's April 2026 update says mandatory Community Health Center Fund support is $4.6 billion and expires December 31, 2026. It describes mandatory funding as about 70% of federal health-center funding.

The same page lists $1.858 billion in discretionary funding, about 30% of the federal total, through September 30, 2026. NACHC warns that funding uncertainty can affect services, recruitment, and projects.

The page does not support the earlier claims about a February 3 signing date, a decade-high increase, or the number of South Carolina organizations.

The CMS 2026 Open Enrollment Period state-level public-use file reports 587,567 South Carolina plan selections. It records an average monthly premium of $655, with 524,034 consumers receiving advance premium tax credits averaging $579.

For recipients of those credits, the average premium after the credit was $76. These are direct state-file measures; the earlier national comparison and asserted downstream FQHC demand are not established by this source.

SCDHHS announced on December 30, 2025 that CMS awarded South Carolina $200,030,252 for federal fiscal year 2026 under the Rural Health Transformation Program. The page describes five major initiatives and says the state received more than 350 proposals while developing its application.

It does not identify four initiatives, promise awards to FQHCs, or describe a schedule of later funding tranches. Those claims belonged to a separate funding-opportunity page or were unsupported and have been removed here.

South Carolina Public Radio reported that state-directed Medicaid payments would decline 10% per year for ten years beginning in 2028. Citing KFF, it said South Carolina could lose up to $5 billion in Medicaid funding and have 60,000 fewer enrollees over that period.

The report describes Allendale County Hospital as operating near a zero margin; about three-quarters of its patients are self-pay or covered by Medicaid, and it does not offer surgery, maternity care, or advanced services. The source does not support the earlier claims about six hospital closures or quantify a resulting shift to FQHCs.

South Carolina's June 23, 2025 application requests a limited five-year Medicaid demonstration for adults ages 19 to 64 who meet the parent or caretaker-relative definition, have income effectively between 67% and 100% of the federal poverty level, and complete at least 80 hours per month of qualifying community engagement. The state estimated up to 17,700 people were potentially eligible but proposed an enrollment cap of 11,400.

The application says the demonstration would not modify other components of the state's Medicaid and CHIP programs.

H.4383 was introduced on April 23, 2025 and referred to the House Ways and Means Committee, with no later action shown on the official page. The bill would extend eligibility to people with income through 138% of the federal poverty level, subject to a 90% federal matching rate, and create a Medicaid Stability Fund.

It also proposes a twice-yearly assessment involving hospitals, FQHCs, rural health clinics, nursing facilities, and other listed providers. The bill does not create the advisory referendum described in H.3377.