Effective May 24, 2024, South Carolina will be requesting additional information that must be included within the Pharmacy Benefits Manager (PBM) licensing application for resident and nonresident Third Party Administrators. 

-The phone number and any other contact information  provided to pharmacies and pharmacists under SC ST § 38-71-2235(B) through which the pharmacy may:

ask questions regarding networks, patient benefits, appeals, and other contractual or service issues and

obtain answers during normal business hours within a reasonable time

-The notice provided to pharmacies upon the denial of an internal appeal notifying the pharmacy or pharmacist of the right to request an external review of the internal appeal and the supporting documents describing the external review process

Our compliance experts are constantly searching for and analyzing industry updates. Their findings are then recorded in the Regulatory Updates section of the Compliance Library to explain how the update impacts the insurance industry. If a change impacts an AgentSync product, this will be highlighted to inform you that the product is being updated to ensure you remain in compliance.