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S.C. Code Ann. § 38-71-1840

Exemptions

2012 Act No. 250, SECTION 1, eff January 1, 2013; 2023 Act No. 30 (S.520), SECTION 1, eff January 1, 2024.

The provisions of this article do not apply to an audit, review, or investigation:

(1) that involves alleged insurance fraud or abuse, Medicare fraud or abuse, or other fraud or misrepresentation;

(2) conducted by or on the behalf of the Department of Health and Human Services in the performance of its duties in administering Medicaid under Titles XIX and XXI of the Social Security Act; or

(3) notwithstanding the exemptions under subsections (1) and (2) of this section, contracts between the South Carolina Department of Health and Human Services and Medicaid-managed care organizations must include provisions for biannual audits of Medicaid-managed care organizations' pharmacy pricing and include limitations on any pharmacy benefits manager contract arrangements that bill the Medicaid program for more than the total price paid to pharmacies for actual claims.

Official source: South Carolina Legislature. Reproduced from public-domain South Carolina statutes; confirm against the official source for the current text. Not legal advice.