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.

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.

Due to recently enacted legislation, South Carolina retailers who sell tobacco products must notify the Department of Revenue (SCDOR) by August 14, 2023. The legislation, signed into law May 16, updates the definition of "tobacco products" to include cigarettes, products made of tobacco, electronic smoking devices, e-cigarettes, e-cigars, e-pipes, vape pens, e-hookah, e-liquid and tobacco items that may or may not contain nicotine. For more information on the definitions of tobacco products, see SC Code Section 16-17-501.

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

The Department of Health and Human Services (SCDHHS) consistently offers free training to prospective and enrolled Healthy Connections Medicaid providers. Many of these courses are available virtually. Information about the upcoming Healthy Connections Medicaid eLearning trainings for summer 2023 is listed here. These recurring virtual workshops cover a variety of topics including training on Medicaid basics, how to submit claims using the web-based tool and third-party liability (TPL). To register for a workshop, please visit the Medicaid eLearning site, www.medicaidelearning.com, or call (888) 289-0709 and select option 1. Additional training resources for providers are also available online through the Medicaid eLearning site. 

Also in South Carolina, on July 18, 2023, CVS Pharmacy reached out to the Medical University of South Carolina to authenticate a hardcopy prescription for Promethazine DM (in a 473 ml bottle) and Tessalon Perles. The medical provider listed on the prescription was Dr. Chitra Lal. During the verification process, concerns were raised regarding the signature on the prescription. It was observed that the signature was not a conventional 'wet' signature and appeared to deviate from Dr. Lal's usual signature style. This discrepancy prompted a deeper investigation into the matter. Upon further examination, it was established that the prescription in question was a forgery. Rx verification should be requested by calling 864.255.5638. 

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

A phoned-in prescription for promethazine/dextromethorphan was called into CVS, Lancaster, SC by an unknown person stating their identity as Dr. Allen Glimerm with Prisma Health Urgent Care, Greer, SC. This physician is no longer with this clinic. Rx was not called by the physician or any other authorized representative. Rx verification should be requested by calling 864.255.5638.  

Also in South Carolina, the South Carolina Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments to accommodate the Fourth of July holiday. Friday, June 30 at 5 p.m. is the deadline to submit claims for payments scheduled for Friday, July 7. Payments will be made on Monday, July 3. Electronic remittance advice will be available Thursday, July 6. Payments will be dated Friday, July 7, as usual. The schedule will return to a normal payment cycle on Friday, July 7. 

Any questions or concerns regarding this bulletin should be directed to the Provider Service Center (PSC) at (888) 289-0709. The PSC's hours of operation are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. The PSC will be closed Tuesday, July 4, in observance of the Independence Day holiday.

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

On May 16, Gov. Henry McMaster (R) signed into law NACDS’ priority PBM reform legislation Senate Bill 520. The measure takes effect January 1, 2024; however, the Department of Insurance is prohibited from performing audits of PBMs before January 1, 2025. South Carolina’s regular legislative session has adjourned Sine Die; however, Governor McMaster has called the legislature back into special session to discuss abortion legislation. 

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

Brian Clark, a South Carolina pharmacist with experience in a broad range of pharmacy roles as well as service in state and national professional associations, has been named chief executive officer of the South Carolina Pharmacy Association effective April 1. Clark, director of operations at Riley’s Drugs in Lexington, SC, will lead the association that serves as the public face and voice of all sectors of the state’s pharmacy community, from students and technicians to pharmacists.

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