Hepatitis C Virus (HCV) Pharmacy Benefit Carve Out

Effective with dates of service on or after July 1, 2015, the South Carolina Department of Health and Human Services (SCDHHS) will carve out coverage for medications used to treat Hepatitis C Virus (HCV) from the Managed Care Organization (MCO) benefit. Pharmacy claims for these medications for Medicaid members enrolled in a Medicaid Managed Care Organization (MCO) will be covered through the Fee-For-Service (FFS) pharmacy program. All FFS coverage rules, prior authorization requirements and preferred drug classifications will apply. More information about these coverage parameters is available at http://southcarolina.fhsc.com.

Questions regarding this bulletin should be directed to Magellan Medicaid Administration’s Call Center at (866) 254-1669.

Thank you for your continued support of the South Carolina Healthy Connections Medicaid program.

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