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Post date: 01/20/2015 - 4:38pm

Post date: 06/23/2014 - 3:01pm

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after August 1, 2014.

Post date: 02/28/2014 - 10:49am

Beginning with dates of service on or after March 17, 2014, the South Carolina Department of Health and Human Services (SCDHHS) will reimburse for outpatient utilization of long acting reversible contraceptives (LARC) through the pharmacy program. Any LARC billed to SCDHHS by a pharmacy will be shipped directly to the provider’s office for insertion. Providers should take extra care to ensure that they bill Medicaid only for reimbursement of the insertion of the device, and not the device itself, when it is obtained and billed through the pharmacy benefit.

Post date: 12/20/2013 - 10:56am

Effective immediately, the South Carolina Department of Health and Human Services (SCDHHS) will cover both Makena® and compounded hydroxyprogesterone caproate without prior authorization. SCDHHS will provide reimbursement directly to pharmacy providers for these products ordered by a prescriber.

Post date: 12/02/2013 - 9:13am

I. Preferred Drug List Update II. Exceptions to Prescription Limit III. Update to Synagis® (palivizumab) Reimbursement IV. Preferred Brand Medications V. Certificate of Medical Necessity for Home Infusion Pharmacies

Post date: 09/13/2013 - 5:11pm

Effective for dates of service on or after October 15, 2013, the South Carolina Department of Health and Human Services (SCDHHS) will increase the rate for Synagis® to the current Average Wholesale Price (AWP) minus 18%. The new rate for the 100mg vial will be $2,429.18. The 50mg vial will be reimbursed at $1,286.44.

Post date: 08/08/2013 - 1:49pm

The South Carolina Department of Health and Human Services (SCDHHS) has revised reimbursement rates for the following codes: • 90791 – Psychiatric Diagnostic Evaluation without Medical • 90792 – Psychiatric Diagnostic Evaluation with Medical • 90785 – Interactive Complexity Add-On

Post date: 06/17/2013 - 8:38am

The following revisions to the Preferred Drug List (PDL) are effective with dates of service on or after July 22, 2013.

Post date: 05/02/2013 - 10:01am

The South Carolina Department of Health and Human Services will host an open forum to receive input on the administration and management of the Medicaid Pharmacy program. The current Administrative Services contract with Magellan Health will expire on March 18, 2014.

Post date: 01/28/2013 - 4:18pm

Effective immediately the following National Drug Codes (NDCs) may be billed through the Point of Sale (POS) system and do not require Prior Authorization:

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