Pharmacy Benefit Managers (PBMs)

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New S.C. Pharmacy Benefit Manager Law Passes

On May 16, 2019, Governor McMaster signed bill S.359 (Act No. 48), amending the South Carolina Code of Laws by adding Article 21 to Title 38, Chapter 71 (Accident and Health Insurance).  Act No. 48 establishes, among other things, a license requirement for pharmacy benefit managers and authorizes the Department of Insurance to enforce the provisions of Article 21.

The provisions of Section 38-71-2220 in Section 1 (gag clauses) and Section 3 (pharmacy audits, electronic records and documentation) of Act No. 48 took effect upon approval by the Governor.  All other provisions of Article 21 take effect on January 1, 2021, including the requirement for PBMs to obtain a license from the Department. 

S.C. Code Ann. Regulation 69-77 (Pharmacy Benefit Managers) became final on June 26, 2020. The South Carolina Department of Insurance is charged with the responsibility of enforcing the provisions set forth in the Regulation.  

Alert: Bulletin 2020-10 issued 9/15/20

The SCDOI has issued Bulletin 2020-10 to provide a timeline for initial licensure as a PBM.
*All PBMs conducting pharmacy benefit manager services in South Carolina beginning January 1, 2021 must be licensed as a PBM.

 Application Timeline for Pharmacy Benefit Manager Licensure Effective January 1, 2021:
 PBM Initial Application Begins                                                                               October 1, 2020
 PBM Initial Application Deadline*                                                                     December 1, 2020

* Applications received after December 1, 2020 may result in a delay in the review process and are not guaranteed to have a license issued by January 1, 2021.

For additional details, please refer to the full text of the bulletin by clicking here.