Updated Prior Authorization Expansion on Physician-administered Drugs
The South Carolina Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for additional physician-administered medications to ensure use is consistent with the medication’s indication(s) and appropriate clinical guidelines. This change only applies to medications administered to Healthy Connections Medicaid members enrolled in the fee-for-service (FFS) Medicaid program.
The list of additional drugs and the date by which they will require PA is available here. These drugs will be added to the Procedure Codes section of the Physicians Services provider manual on the SCDHHS website.
Requests for PA and questions about this bulletin should be submitted to Magellan RX Management at https://MRxGateway.com or by calling 1-800-424-8219 between 8 a.m.-5 p.m. Monday-Friday.
Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.