South Carolina Pharmacy Services

NPI-related Bulletins

The National Provider Identifier (NPI) is part of the HIPAA mandate requiring a standard unique identifier for healthcare providers. Effective May 23, 2007, providers who are covered entities under HIPAA may only use their unique NPI to identify themselves in standard transactions where an NPI is required, such as filing electronic health care claims, eligibility inquiries, and claims status inquiries.

IMPORTANT NOTE: For Pharmacy Services providers, South Carolina Medicaid will begin the transition to the NPI requirement effective April 16, 2007. Since SC Medicaid will require the NPI on transactions before the 5/23/08 date, in order to avoid any last minute compliance issues, providers are strongly urged to implement whatever systems changes are needed so that the NPI may be accommodated on claim submissions beginning April 16th.

FHSC NPI Contingency Plan

Date	Title
Date	Title
12/20/2007	Medicaid Bulletin - South Carolina Medicaid Preferred Drug List, National Provider Identification (NPI) Requirement for Pharmacy Services Claims, Third Party Liability (TPL) Claims Submission Requirement
04/23/2007	Medicaid Bulletin - National Provider Identifier Contingency
02/26/2007	Medicaid Bulletin - National Provider Identifier (NPI) Requirements for South Carolina Medicaid Pharmacy Claims
02/09/2007	Medicaid Bulletin - The May 23, 2007 Deadline Is Approaching! Are You Ready to Use Your National Provider Identifier (NPI)?
11/2006	Don't Get Caught Without Your NPI
09/26/2006	National Provider Identifier (NPI): Get It. Share It. Use It. Getting an NPI is free. Not having one can be costly.

Pharmacy Bulletins

Date	Title
Date	Title
10/08/2009	Policy Change and Rate Increase for Synagis® Injectable
10/05/2009	Policy and Procedures for Influenza A (H1N1) and Seasonal Influenza
08/14/2009	Coverage of Rabies Vaccine and Immune Globulin
06/26/2009	South Carolina Medicaid Preferred Drug List
06/08/2009	Screening for Excluded Providers
04/28/2009	Revised South Carolina Medicaid Diabetic Meters and Strips Program effective May 1, 2009
02/11/2009	South Carolina Medicaid Diabetic Meters and Strips
01/28/2009	Delays to SCDHHS Service Changes
01/02/2009	South Carolina Medicaid Preferred Drug List, Hepatitis C Care Coordination Program, Web Based Prior Authorization (WebPA)
01/01/2009	Medicaid Changes
12/17/2008	Important Notice of Medicaid Changes
11/03/2008	Pharmacy Lock-In Program for Beneficiaries Using Multiple Pharmacies
10/16/2008	Final Paper Medicaid Bulletin
09/22/2008	Rate Increase for Synagis® Injectable
09/10/2008	Budget Reductions
08/26/2008	Electronic Medicaid Bulletins and Electronic Funds Transfer
08/18/2008	South Carolina Medicaid Managed Care Pharmacy Information Grid
08/18/2008	Medicaid Managed Care Pharmacy Services Contact Information
06/11/2008	South Carolina Medicaid Preferred Drug List, Prior Authorization Required for Actiq® and Fentora®
03/21/2008	Family Planning Waiver Renewal
12/20/2007	South Carolina Medicaid Preferred Drug List, National Provider Identification (NPI) Requirement for Pharmacy Services Claims, Third Party Liability (TPL) Claims Submission Requirement
10/01/2007	Medicaid Tamper Resistant Prescription Requirement Delayed
08/30/2007	Rules for Medicaid Tamper-Resistant Prescription Pads
04/19/2007	Medicare Part B Drugs and Secondary Billing Through the Pharmacy Point-Of-Sale System, South Carolina Medicaid Preferred Drug List
01/09/2007	Dose Optimization Program, S. C. GAPS Program and Medicare Part D Prescription Drug Plans, South Carolina Medicaid Preferred Drug List
11/07/2006	Tobacco Cessation Programs in South Carolina
10/03/2006	Rate Increase for Synagis® Injectable
06/21/2006	Synagis® Added to Listing of Physician-Injectable Products Billable By Pharmacy Providers, Coding Changes for Coordination of Benefits (COB) Claims Submitted by Pharmacy Providers, South Carolina Medicaid Preferred Drug List
03/16/2006	Medicare Part B Drugs - Clarification Of Pharmacy Provider Billing Instructions For "Secondary Payer" Pharmacy Claims, South Carolina Medicaid Preferred Drug List
11/29/2005	Certain Physician-Injectable Products - New Option for Medicaid Bill
11/21/2005	Clarification on Medicaid Coverage of Over-the-Counter Pharmaceuticals, Coverage and Billing Policy for Multi-Ingredient Compounds
09/02/2005	Temporary Evacuee Assistance
06/03/2005	Implementation of NCPDP Version 5.1 Multi-Ingredient Compound Segment and “Partial Fill” Functionality
02/07/2005	Medical Homes Local Network (MHLN)

PDL Related Bulletins

Date	Title
Date	Title
10/07/2009	South Carolina Medicaid Preferred Drug List
06/26/2009	South Carolina Medicaid Preferred Drug List
01/02/2009	South Carolina Medicaid Preferred Drug List, Hepatitis C Care Coordination Program, Web Based Prior Authorization (WebPA)
09/17/2008	South Carolina Medicaid Preferred Drug List
06/11/2008	South Carolina Medicaid Preferred Drug List, Prior Authorization Required for Actiq® and Fentora®
12/20/2007	South Carolina Medicaid Preferred Drug List, National Provider Identification (NPI) Requirement for Pharmacy Services Claims, Third Party Liability (TPL) Claims Submission Requirement
09/27/2007	South Carolina Medicaid Preferred Drug List
06/14/2007	South Carolina Medicaid Preferred Drug List
04/19/2007	Medicare Part B Drugs and Secondary Billing Through the Pharmacy Point-Of-Sale System, South Carolina Medicaid Preferred Drug List
01/09/2007	Dose Optimization Program, S. C. GAPS Program and Medicare Part D Prescription Drug Plans, South Carolina Medicaid Preferred Drug List
06/21/2006	Synagis® Added to Listing of Physician-Injectable Products Billable By Pharmacy Providers, Coding Changes for Coordination of Benefits (COB) Claims Submitted by Pharmacy Providers, South Carolina Medicaid Preferred Drug List
03/16/2006	Medicare Part B Drugs - Clarification Of Pharmacy Provider Billing Instructions For "Secondary Payer" Pharmacy Claims, South Carolina Medicaid Preferred Drug List
12/15/2005	South Carolina Medicaid Preferred Drug List
07/20/2005	South Carolina Medicaid Voluntary Preferred Drug List for Mental Health Drugs
07/11/2005	Non-Coverage Of Erectile Dysfunction Drugs For Impotence, South Carolina Medicaid Preferred Drug List
04/15/2005	Submission of Correct Days’ Supply on Pharmacy Claims, Billing Metric Decimal Quantities for Dispensed Pharmaceuticals, “Brand Medically Necessary” Prescriptions Billed to Medicaid, South Carolina Medicaid Preferred Drug List – Additional Therapeutic Classes
02/14/2005	Prescriber Identification Numbers, South Carolina Medicaid Preferred Drug List – Additional Therapeutic Classes
12/21/2004	Clinical Call Center for Prior Authorization Requests, South Carolina Medicaid Preferred Drug List – Additional Therapeutic Classes, Prior Authorization of Growth Hormone Products
09/21/2004	Medicaid Coverage of Tobacco Cessation Products, South Carolina Medicaid Preferred Drug List – Additional Therapeutic Classes
08/25/2004	South Carolina Medicaid Preferred Drug List – Additional Therapeutic Classes
05/19/2004	South Carolina Medicaid Preferred Drug List