Pharmacy

Pharmacy

Coverage of Hydroxyprogesterone Injection

On December 20, 2013, the South Carolina Department of Health and Human Services (SCDHHS) issued Medicaid Bulletin 13-047 regarding hydroxyprogesterone caproate.  On July 3, 2014, the Food and Drug Administration issued updated guidance in regards to hydroxyprogesterone caproate.  In the new guidance, the FDA provided that its March 2011 statement related to hydroxyprogesterone caproate was superseded by its June 2012 statements in which the FDA “recommended using an FDA-approved drug product, such as Makena, instead of a compounded drug except when there is a specific medical need (e.g.

Change in SC P&T Committee Meeting Date

The South Carolina Healthy Connections Medicaid Pharmacy and Therapeutics Committee meeting scheduled for Wednesday, Feb. 4, 2015, has been changed to Wednesday, Mar. 4, 2015. The meeting location and time will remain the same:

South Carolina Medicaid Pharmacy and Therapeutics Committee
Location: South Carolina Pharmacy Association (SCPhA) Office
1350 Browning Road, Columbia, SC 29210 

Wednesday, Mar. 4, 2015, 4 p.m.

South Carolina Medicaid Preferred Drug List

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

ANTIHISTAMINES, MINIMALLY SEDATING

Payment of LARCs through the Pharmacy Benefit

 

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.

Preferred Drug List Update, Exceptions to Prescription Limit, Update to Synagis® (palivizumab) Reimbursement, Preferred Brand Medications and Certificate of Medical Necessity for Home Infusion Pharmacies

I. Preferred Drug List Update

The following revisions to the South Carolina Department of Health and Human Services (SCDHHS) Preferred Drug List (PDL) are effective with dates of service on or after January 1, 2014:

 

ANTIPARASITICS, TOPICAL

Preferred

Non-Preferred

PERMETHRIN, OTC†

Synagis

 

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.

Rate adjustments

 

 

The South Carolina Department of Health and Human Services (SCDHHS) has revised reimbursement rates for the following codes:

South Carolina Medicaid Preferred Drug List

 

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

LAXATIVES & CATHARTICS

Preferred

Non-Preferred

South Carolina Department of Health and Human Services Hosts Pharmacy Services Open Forum

 

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.

 

This meeting will be held Monday, May 20, 2013 from 10:00 a.m. to 12:00 p.m. at the following address: 

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