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Public Notice of Final Action to Reword State Plan for Covered Outpatient Drug

The South Carolina Department of Health and Human Services (SCDHHS) gives notice of the following action regarding the rewording for coverage of outpatient drugs under the State Plan under Title XIX of the Social Security Act Medical Assistance Program (Medicaid).

The Centers for Medicare and Medicaid Services (CMS) reviewed SCDHHS’ State Plan and requested rewording of excluded drugs that are covered by SCDHHS. These drug categories include weight loss medications, prescription vitamins and minerals and nonprescription drugs.

Effective on or after Jan. 1, 2024, SCDHHS will update the State Plan to reflect the suggested wording from CMS in its covered outpatient drug section.

Based on the action above, SCDHHS anticipates no impact on the pharmacy benefit fee-for-service budget. These changes in the State Plan only correct the wording of policy. The reimbursement methodology for these drug categories will remain consistent with current policy.

Copies of this notice are available at each South Carolina Healthy Connections Medicaid county office and at for public review. Additional information regarding this action is available upon request at the address cited below.

Any written comments submitted may be reviewed by the public at SCDHHS, Office of Medical Directors and Pharmacy Services, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9 a.m. and 5 p.m.

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