Page 15

To the extent necessary to require qualifying hours and activities as a condition of eligibility as described in this application and to the extent necessary to limit enrollment to parents and caretaker relative adults aged 19-64. 2. Provision of Medical Assistance SSA Section1902(a)(8) To the extent necessary to suspend and terminate eligibility for individuals who fail to comply with the qualifying hours and activities requirement as described in this application. 3. Hospital Presumptive Eligibility SSA Section 1902(a)(47)(B) To permit the state not to provide hospital presumptive eligibility to individuals in the demonstration. 4. 133% Income Level SSA Section 1902(a)(10)(A)(i)(VIII) To the extent necessary to enable South Carolina to implement a lower income level for the Demonstration group. To provide medical assistance to individuals who meet the definition of parents and caretaker relatives between 67% and 95% of the FPL with a 5% income disregard. 5. Reasonable Promptness SSA Section 1902(a)(8) To the extent necessary to place a cap on enrollment numbers and maintain a waitlist for qualified individuals who apply for coverage while the program exceeds the enrollment cap. Section 11: Public Notice and Comments In accordance with 42 CFR section 431.408, SCDHHS provided the public and other interested parties with the opportunity to review and provide input on the waiver through a formal, 30-day public notice and comment process which ran from April 30, 2025, to May 31, 2025. During this time, the state also held two dedicated public hearings, one of which was held at a Medicaid Advisory Commission (MAC) meeting where meetings are open to the public. Public Notice The state verifies that beginning on April 30, 2025, SCDHHS formally began the public comment period and published public notice of the waiver application in the state’s major newspapers with widest circulation in each city with a population of at least 100,000, specifically The State, the Greenville News and the Post and Courier newspapers. The full public notice was also published on a dedicated webpage on the SCDHHS website. In addition, the state used an electronic mailing list, comprised of nearly 220,000 interested individuals and organizations, to notify the public of the waiver, hearings, and opportunity to comment on the waiver draft. To encourage feedback and compliance with accessibility, a copy of the draft waiver was also made accessible at a public web link and available in hard copy format as well. A copy of the full public notice is attached as Appendix C and a copy of the abbreviated public notice document is attached as Appendix B. Both documents are also available for viewing on the state’s website: https://www.scdhhs.gov/CEwaiver 15