Healthy Connections Medicaid providers are reminded that the South Carolina Department of Health and Human Services (SCDHHS) transitioned to a single, state-directed pharmacy benefit preferred drug list (PDL) effective July 1, 2024. In support of this transition, SCDHHS developed continuity of care provisions for Medicaid members. These provisions allowed Medicaid members who had a prescription dated on or before June 30, 2024, to continue to access their prescribed drugs for up to six months or through Dec. 31, 2024, regardless of whether it is included on the single PDL. Through this bulletin, SCDHHS is reminding providers this continuity of care period ends Dec. 31, 2024.

Providers are also reminded that SCDHHS developed several resources in support of the transition to a single, state-directed pharmacy benefit PDL intended for prescribers and dispensers. These resources include a recorded training and frequently asked questions and are available in the pharmacy section of SCDHHS’ website along with the state’s current PDL.

South Carolina’s Medicaid managed care organizations (MCOs) are responsible for the authorizations, coverage and reimbursement related to the services described in this bulletin for Healthy Connections Medicaid members who are enrolled in their plan.

Name Change for Pharmacy Benefit Administrator

SCDHHS’ pharmacy benefit administrator, formerly known as Magellan Rx Management, is now Prime Therapeutics. Benefits, procedures and contact information have not changed and Healthy Connections Medicaid-related materials, including SCDHHS’ website, have been updated to reflect this new name.

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