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  Supplemental Rebates 

In an effort to reduce pharmaceutical expenses, the Department of Health and Human Services (DHHS) is moving forward to negotiate supplemental rebates with pharmaceutical companies and create an enhanced prior authorization program for South Carolina Medicaid pharmacy services. DHHS is pursuing this cost-saving idea for the state since an earlier plan to pool purchasing power with other state Medicaid beneficiaries has been stalled, awaiting approval from the Centers for Medicare and Medicaid Services (CMS). The delay by CMS to approve the pool concept has prevented South Carolina from realizing any savings from a supplemental rebates/enhanced rebated program, which is expected to save the state about $5 million a year.

In April, South Carolina obtained CMS approval to implement a single state supplemental rebate program, but then decided to join Michigan and Vermont in an effort to enhance the potential savings with the increased purchasing power of the combined states. This multi-state plan is still being reviewed by CMS. However, South Carolina cannot afford any further delays by CMS in approving the multi-state "pooling" concept. While DHHS believes that the pooling concept may be a viable option in the future, South Carolina must move forward with implementing its own state-specific supplemental rebate agreement plan that was approved by CMS in April of this year.

To this end, South Carolina is contacting pharmaceutical manufacturers that have expressed interest in negotiating supplemental rebate agreements directly with South Carolina to have their products covered by Medicaid without prior approval. Pharmaceutical companies can negotiate supplemental rebates to insure coverage of their products without prior approval.

Contact Info


Bryan Kost

P.O. Box 1801 Main Street

Columbia, SC 29202

803-898-2865


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