The Department of Health and Human Services (SCDHHS) will cover, for a limited time, imported benzathine benzylpenicillin (Extencilline) for use in outpatient medical drug claims when billed with HCPCS code J0561 and at an outpatient pharmacy (point-of-sale). This policy change to provide temporary coverage is to address the ongoing shortage of Bicillin® L-A (penicillin G benzathine injectable suspension). A letter with important prescribing information for Extencilline has been provided to healthcare providers.   

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

The General Assembly adjourned sine die on May 10 as required by South Carolina law. Per the sine die resolution, bills with conference committees appointed can meet to work on conference reports. NACDS' priority legislation, H. 3988 (PREP (Pre exposure Prophylaxis) codification) was amended in the Seante, but the House did not concur with Senate changes, sending the bill to conference committee. Assigned Conferees are Senators Cromer, Martin and Hutto and Representatives Mark Smith, Davis, and W. Jones.  

Also in South Carolina, on May 8, the Department of Health and Human Services (SCDHHS) announced it will implement a single, state-directed pharmacy benefit preferred drug list (PDL) for all providers enrolled in the Healthy Connections Medicaid program. This change, which was announced in Medicaid bulletin MB# 24-016, is effective July 1, 2024.

As announced in MB# 24-016, SCDHHS will host two live provider training webinars on May 22 from 7:30 am-9:00 am and from 12:30 pm -2:00 pm. These provider training sessions will be geared toward prescribers and dispensers. The training will include subject matter expert panelists to answer questions about the transition to the single PDL.

Providers can register for the training webinars at this registration link. Providers can submit questions about the transition to the single PDL when registering for one of the webinars.  

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

Effective July 1, 2024, the South Carolina Department of Health, and Human Services (SCDHHS) will implement a single, state-directed pharmacy benefit preferred drug list (PDL) for all providers enrolled in the Healthy Connections Medicaid program. SCDHHS currently operates a PDL exclusively for Medicaid members who are enrolled in the fee-for-service (FFS) Medicaid program, while each managed care organization (MCO) maintains and operates its own independent PDL. 

The single PDL that will become effective July 1, 2024, will be based on SCDHHS' current FFS PDL, which is available on the pharmacy section of SCDHHS' website. A list of frequently asked questions (FAQs) is also available on pharmacy section of SCDHHS' website. SCDHHS will host two live provider training sessions via online seminar on May 22 from 7:30 am-9:00 am and from 12:30 pm-2:00 pm. Registration information for the provider training webinars, updates to the FAQs and other provider training resources will be announced via a provider bulletin. Providers should email any questions related to this bulletin to SCDHHS' Office of Pharmacy Services. 

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

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.