The Department of Health and Human Services (SCDHHS) is announcing a further extension of telehealth flexibilities issued during the COVID-19 federal public health emergency (PHE). 
 
SCDHHS previously issued guidance via Medicaid bulletins announcing the status of telehealth flexibilities upon the expiration of the federal PHE (Medicaid bulletin MB# 23-018). Flexibilities were grouped as those that were made permanent, continued for one year after the expiration of the federal PHE or expired upon the end of the federal PHE May 11, 2023.  
 
Flexibilities continued for one year after the expiration of the federal PHE are now extended by SCDHHS through December 31, 2024. This extension aligns with a similar policy announced by the Centers for Medicare and Medicaid Services that extended telehealth flexibilities issued during the COVID-19 federal PHE for Medicare providers through December 31, 2024. 
 
As a reminder, these extended flexibilities, including telehealth flexibilities, were included in the applicable Medicaid provider manuals prior to the end of the federal PHE. Provider manuals can be found on the SCDHHS website. 
 
South Carolina Healthy Connections Medicaid managed care organizations (MCOs) are responsible for the coverage and reimbursement of services described in this bulletin for members enrolled in an MCO. 
 
Providers may direct any questions related to this bulletin to the Provider Service Center (PSC). PSC representatives can be reached at (888) 289-0709 from 7:30 am-5:00 pm Monday-Thursday and 8:30 am-5:00 pm Friday. Providers can also submit an online inquiry.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Beginning this week, having started on February 12, the South Carolina Pharmacy Association’s Professional Affairs Task Force asks that pharmacists track how many hours worked per week for the next four weeks. A survey will be sent out at the end of those four weeks to determine how many hours they were scheduled to work, how many hours were actually worked, the time paid for and how their well-being is based on those results. Please expect the survey during the second week of March. For all questions, please email info@scrx.org. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

DisposeRx announced a grant opportunity and is looking to identify pharmacies in the state to provide education on safe medication disposal and dispense DisposeRx packets with controlled substance prescriptions, with an emphasis on opioids. In turn, the pharmacies will receive reimbursement for educating the patients and dispensing the packets.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Health and Human Services (SCDHHS) consistently offers free Healthy Connections Medicaid training to enrolled Healthy Connections Medicaid providers and their billing agents. These recurring trainings are conducted by SCDHHS’ contracted vendors. Information about the upcoming February-April 2024 training is available online.  

Also in South Carolina, some Healthy Connections Medicaid-enrolled providers were mailed an IRS 1099-MISC form from the Department of Health and Human Services (SCDHHS). The IRS 1099-MISC form providers received in the mail in January 2024 from SCDHHS contains an error. While the dollar amount of “Medical and health care payments” listed in block six of the IRS 1099-MISC form is correct for calendar year 2023, the form indicates it is for calendar year 2022.

Corrected forms are currently being printed and will be mailed in the next two business days. Providers should receive the replacement IRS 1099-MISC forms for 2023 within the next three to seven business days.

The incorrect form showing the 2022 date should be disregarded and not used to file taxes for the 2022 or 2023 calendar years. The error occurred while printing the forms mailed to providers. The forms with the correct calendar year were submitted to the IRS.

If you have any questions, please contact the Provider Service Center at (888) 289-0709, extension four, option one. The Provider Service Center is open Monday through Thursday from 7:30 am to 5:00 pm and Friday from 8:30 am to 5:00 pm. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Legislature convened on January 9. Legislation regarding reimbursement and scope issues that carried over from the 2023 session are expected to be heard during the 2024 session. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The City of Columbia is launching a pilot program to address food deserts through subsidized delivery of groceries in certain parts of the city to eligible residents. The pilot is limited to Instacart delivery service and those retailers who operate on that platform; however, the goal of the city is to expand the program after the pilot to include more retailers and delivery services. For more information on the program, click here.  

Also in South Carolina, the Department of Health and Human Services will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments to accommodate the November 2023 state holiday schedule. Due to observance of the Thanksgiving holiday, November 17 at 5:00 pm is the deadline to submit claims for payment date November 24. Payments will run November 20 and electronic remittance advice will be available November 21. Payments will be dated November 24, as usual. The schedule will return to the normal payment cycle on the payment date December 1.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Effective October 1, 2023, the Medicaid State Plan will be updated to allow South Carolina pharmacists to bill for hormonal contraception services in accordance with the Pharmacy Access Act and as described in this bulletin.

To be eligible for reimbursement for these services, pharmacists must complete a Healthy Connections Medicaid provider enrollment application. Pharmacists may apply on or after September 18, 2023. Interested pharmacists are encouraged to apply on the providers page of the Department of Health and Human Services’ (SCDHHS) website and enroll as an “individual pharmacist” under the provider type “other medical professional.” In addition to the standard enrollment information, pharmacists must provide information on the pharmacy or pharmacies where they will be providing this service. Training on completing this application and enrollment process is available on the SCDHHS website.

Once enrolled, pharmacies will be able to bill dates of service on or after October 1, 2023, for Medicaid members. This includes members enrolled in the full-benefit Medicaid program and those enrolled in the Family Planning limited benefit program. Pharmacies will be reimbursed for the procedure and diagnosis codes listed below under the Healthy Connections Medicaid member’s medical benefit utilizing the CMS form 1500. These services will be reimbursed in parity with nurse practitioners and physician assistants at 80% of physician rates. The reimbursement rates for these services are available in the Base Physician Fee Schedule available on SCDHHS website. Covered services and billing guidance will be added to the Physicians Services provider manual by October 1, 2023.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Effective October 1, 2023, the Medicaid State Plan will be updated to allow South Carolina pharmacists to bill for hormonal contraception services in accordance with the Pharmacy Access Act and as described in this bulletin.

To be eligible for reimbursement for these services, pharmacists must complete a Healthy Connections Medicaid provider enrollment application. Pharmacists may apply on or after September 18, 2023. Interested pharmacists are encouraged to apply on the providers page of the Department of Health and Human Services’ (SCDHHS) website and enroll as an “individual pharmacist” under the provider type “other medical professional.” In addition to the standard enrollment information, pharmacists must provide information on the pharmacy or pharmacies where they will be providing this service. Training on completing this application and enrollment process is available on the SCDHHS website. 

Once enrolled, pharmacies will be able to bill dates of service on or after October 1, 2023, for Medicaid members. This includes members enrolled in the full-benefit Medicaid program and those enrolled in the Family Planning limited benefit program. Pharmacies will be reimbursed for the procedure and diagnosis codes listed below under the Healthy Connections Medicaid member’s medical benefit utilizing the CMS form 1500. These services will be reimbursed in parity with nurse practitioners and physician assistants at 80% of physician rates. The reimbursement rates for these services are available in the Base Physician Fee Schedule available on SCDHHS website. Covered services and billing guidance will be added to the Physicians Services provider manual by October 1, 2023. 

Also in South Carolina, the Joint Pharmacist Immunization Protocol has been updated to allow pharmacists to administer Respiratory Syncytial Virus (RSV) in certain populations without a patient-specific prescription.    

Pharmacists who administer vaccines under this Protocol shall maintain a current copy of this Protocol at each location at which a pharmacist administers a vaccine and an appropriate area for administering vaccines with the supplies and equipment.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Gov. Henry McMaster (R) declared a State of Emergency in South Carolina ahead of the impacts of Hurricane Idalia.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.