UPDATE WellCare’s South Carolina · © WellCare 2014 SC_11_14 July 13, 2015 Dear Provider: At the June 04, 2015 WellCare Pharmacy & Therapeutics Committee meeting, ... Agents Added

Page 1 of 19

SC028307_PRO_LTR_ENG State Approved 01142015 63822 © WellCare 2014 SC_11_14

July 13, 2015

Dear Provider:

At the June 04, 2015 WellCare Pharmacy & Therapeutics Committee meeting, it was decided that the following changes will be made to the WellCare’s South Carolina Medicaid Preferred Drug List (PDL), effective August 15, 2015. Please carefully review these changes.

Key UPPER CASE = Brand Name Drugs QL = Quantity Limit

Lower case italics = Generic Drugs ST = Step Therapy

PDL = Preferred Drug List AL = Age Limit PA = Prior Authorization YOA = Years of Age

Effective date of change: August 15, 2015

Drug Name Therapeutic Class Change PDL Alternative

(if applicable)

ADDITIONS TO THE PDL

acetaminophen 650 mg suppositories

Analgesics - Nonnarcotic

Added to the PDL

aminophylline 25

mg/mL solution

Antiasthmatic And

Bronchodilator Agents

Added to the PDL

amphetamine-dextroamphetamine

extended-release capsules - all

strengths

ADHD/Anti-

Narcolepsy/Anti-Obesity/Anorexiants

Added to the PDL w/ QL (62

capsules/31 days) & AL: Min 6 YOA,

Max 20 YOA

apap 325 mg tablets Analgesics - Nonnarcotic

Added to the PDL

argyle sterile 0.9%

irrigation saline solution

Genitourinary

Agents - Miscellaneous

Added to the PDL

aspirin 81 mg enteric coated

tablets

Analgesics -

Nonnarcotic Added to the PDL

bismuth subsalicylate 262

mg/15 mL suspension

Antidiarrheals Added to the PDL

calcium Minerals & Added to the PDL

UPDATE WellCare’s South Carolina

Preferred Drug List

Page 2 of 19


carbonate/vitamin d 600 mg-400 unit

tablets

Electrolytes

Drug Name Therapeutic Class Change/Reason

for Change

PDL Alternative (if

applicable)

clozapine 12.5 mg orally disintegrating tablets

Antipsychotics/Antimanic Agents

Added to the PDL

w/ QL (31 tablets/31 days) &

AL: Min 18 YOA

delsym night time cough/cold 12.5-5 mg/5 mL liquid

Cough/Cold/Allergy Added to the PDL

delsym night time cough/cold 6.25-2.5 mg/5 mL liquid

Cough/Cold/Allergy Added to the PDL

DILANTIN 30 mg capsules

Anticonvulsants

Added to the PDL

w/ QL: 310 capsules/31 days

duloxetine 20 mg,

60 mg capsules Antidepressants

Added to the PDL

w/ QL (62 capsules/31 days) & ST (trial of

preferred SSRI, gabapentin,

amitriptyline, or venlafaxine).

duloxetine 30 mg

capsules Antidepressants


capsules/31 days) & ST (trial of

preferred SSRI, gabapentin, amitriptyline, or

venlafaxine).

fentanyl 37.5 mcg, 62.5 mcg, 87.5 mcg

patches

Analgesics - Opioid Added to the PDL w/ PA & QL (10

patches/30 days)

IN-CHECK dial flow trainer device

Medical Devices Added to the PDL

KALYDECO 50 mg,

75 mg granules

Respiratory Agents -

Misc.

Added to the PDL

w/ PA

lidocaine-prilocaine 2.5-2.5% kit

Dermatologicals Added to the PDL

lithium carbonate Antipsychotics/Anti Added to the PDL

Page 3 of 19


150 mg, 600 mg capsules

manic Agents


for Change

PDL Alternative (if

applicable)

melatonin maximum strength 5 mg

tablets

Alternative

Medicines Added to the PDL

methylphenidate hydrochloride

chewable tablets - all strengths

ADHD/Anti-Narcolepsy/Anti-

Obesity/Anorexiants

Added to the PDL

w/ AL: Min 6 YOA

morphine sulfate

preservative free 2 mg/mL, 4 mg/mL injection

Analgesics - Opioid Added to the PDL

multivitamin/fluoride

0.25 mg chewable tablets

Multivitamins Added to the PDL

naproxen enteric

coated 500 mg tablets

Analgesics - Anti-

Inflammatory Added to the PDL

norethindrone & ethinyl estradiol-fe

0.8 mg-25 mcg chewable tablets

Contraceptives Added to the PDL

ONCASPAR 750 mg/mL injection

Antineoplastics and

Adjunctive Therapies

Added to the PDL w/ PA

oticin 1-0.1% otic

liquid Otic Agents Added to the PDL

oyster shell calcium/D 250 mg-125 unit tablets

Minerals & Electrolytes

Added to the PDL

phenytoin 50 mg chewable tablets

Anticonvulsants Added to the PDL w/ QL: 372 tablets/31 days

prenatal low iron 27-

0.8 mg tablets Multivitamins Added to the PDL

risperidone tablets -

all strengths

Antipsychotics/Anti

manic Agents


tablets/31 days) & AL: Min 5 YOA


for Change

PDL Alternative (if

applicable)

Page 4 of 19


rizatriptan 5 mg, 10

mg tablets Migraine Products

Added to the PDL w/ AL: Min 6

YOA, Max 17 YOA

SANTYL 250

unit/gm ointment Dermatologicals Added to the PDL

slow release iron 160 (50 fe) mg

extended-release tablets

Hematopoietic

Agents Added to the PDL

tamoxifen 10 mg

tablets

Antineoplastics and Adjunctive

Therapies

Added to the PDL

trinate tablets Multivitamins Added to the PDL

vitamin b complex-c capsules

Multivitamins Added to the PDL

ZUBSOLV 8.6 mg-

2.1 mg sublingual tablets

Analgesics - Opioid Added to the PDL w/ PA

UTILIZATION MANAGEMENT CHANGES

ALKERAN 2 mg tablets

Antineoplastics and


Added PA

butalbital-asa-

caffeine oral capsule 50-325-40

mg

Analgesics -

Nonnarcotic Removed QL

citalopram tablets -

all strengths Antidepressants Removed QL

dextroamphetamine extended-release

capsules - all strengths

ADHD/Anti-


Updated QL: 31

capsules/31 days

EMCYT 140 mg

capsules

Antineoplastics and


Added PA

enoxaparin sodium injections - all

strengths

Anticoagulants

Updated QL: 300 mg/3 mL: QL: 93

mL/31 days 100 mg/mL: QL: 31 mL/31 days

150 mg/mL: QL: 31 mL/31 days 120 mg/0.8 mL: QL:

Page 5 of 19


24.8 mL/31 days 80 mg/0.8 mL: QL:

24.8 mL/31 days 30 mg/0.3 mL: QL: 9.3 mL/31 days

40 mg/0.4 mL: QL: 12.4 mL/31 days 60 mg/0.6 mL: QL:

18.6 mL/31 days


for Change

PDL Alternative (if

applicable)

etoposide 50 mg

capsules

Antineoplastics and


Added PA

GABITRIL 12 mg,

16 mg tablets Anticonvulsants Removed AL

INVEGA SUSTENNA

injection


Updated QL : 117 mg/0.75 mL: QL:

0.75 mL/28 days 156 mg/mL: QL: 1 mL/28 days

234 mg/1.5 mL: QL: 1.5 mL/28 days 39 mg/0.25 mL: QL:

0.25 mL/28 days 78 mg/0.5 mL: QL: 0.5 mL/28 days

LEUKERAN 2 mg tablets

Antineoplastics and


Added PA

LOMUSTINE

capsules - all strengths

Antineoplastics and


Added PA

loxapine 5 mg

capsules

Antipsychotics/Anti

manic Agents

Added AL: Min 18

YOA

LYSODREN 500 mg

tablets


Therapies

Added PA

methylphenidate 10 mg extended-

release tablets


Obesity/Anorexiants

Added AL Max:

Max 20 YOA

methylphenidate tablets - all

strengths


Obesity/Anorexiants

Remove AL Max

MYLERAN 2 mg tablets

Antineoplastics and Adjunctive Therapies

Added PA

Page 6 of 19


nicotine polacrilex 2

mg, 4 mg mint gum

Psychotherapeutic And Neurological

Agents - Misc.

Updated QL: 2016 pieces/365

days


for Change

PDL Alternative (if

applicable)

oxcarbazepine 600 mg tablets

Anticonvulsants Removed QL

PEG-3350

ELECTROL 236 gm, 240 gm solution

Laxatives QL added: 4,000 mL/31 days

risperidone 1 mg/mL solution


Updated QL &

Added AL: QL:496 mL/31 days, AL: Min 5

YOA

SAPHRIS 5 mg, 10 mg sublingual

tablets

Antipsychotics/Anti

manic agents

Updated AL: Min

10 YOA

spinosad 0.9% topical suspension

Dermatologicals Updated AL: Min 6 months of age

sumatriptan succinate 6 mg/0.5

mL solution for injection

Migraine Products Updated QL: 4

injections/31 days

TABLOID 40 mg

tablets


Therapies

Added PA

thioridazine 100 mg

tablets

Antipsychotics/Anti

manic Agents

Added AL: Min 2

YOA

REMOVALS FROM THE PDL

ACETAMIN 80 mg/0.8 mL infant

drops

Analgesics -

Nonnarcotic

Removed from

PDL

Please reference PDL

acetasol hydrocortisone 2-1%

otic solution

Otic Agents Removed from PDL


ACIDOPHILUS PROBIOTIC tablets

Laxatives Removed from PDL


ACIDOPHILUS wafer



Page 7 of 19


ACIDOPHILUS/BIFI

DUS wafer Laxatives

Removed from

PDL


Acidophilus/Pectin

capsules Laxatives

Removed from

PDL


acitretin 17.5 mg

capsules Dermatologicals

Removed from

PDL


acne wash 2 %

liquid Dermatologicals

Removed from

PDL


ADDERALL XR capsules - all strengths

ADHD/Anti-Narcolepsy/Anti-Obesity/Anorexiants

Removed from PDL

amphetamine/dextroamphetamine

extended-release capsules - all

strengths (QL, AL may apply)

ADRUCIL 500

mg/10mL injection

Antineoplastics and


Removed from

PDL

fluorouracil 500

mg/10ml solution

AFRIN 0.05% nasal

spray solution

Nasal Agents - Systemic And

Topical

Removed from

PDL


ALTARYL 12.5 mg/5

mL syrup Antihistamines

Removed from

PDL


AMITIZA 8 mcg, 24

mcg capsules

Gastrointestinal

Agents - Misc.

Removed from

PDL

lactulose oral solution;

polyethylene glycol

antifungal 1 %

aerosol Dermatologicals

Removed from

PDL


artificial tears 83-15

% ophthalmic ointment

Ophthalmic Agents Removed from

PDL


artificial tears 0.1-0.3 % ophthalmic

solution


PDL


b complex 50 tablets Multivitamins Removed from PDL


baby d-drops 400 unit/0.03 mL liquid

Vitamins Removed from PDL


Page 8 of 19


benzoyl peroxide 10%, 5% liquid

wash

Dermatologicals Removed from

PDL Please reference PDL

benzoyl peroxide 6

% cleanser lotion Dermatologicals

Removed from


beta care cream,

lotion Dermatologicals

Removed from


BP 10-1% emulsion Dermatologicals Removed from


BP 2.5 % liquid

wash Dermatologicals

Removed from


BP 4 % cleansing


Removed from

PDL


calamine 8-8 %


Removed from

PDL


calamine lotion Dermatologicals Removed from

PDL


calamine

phenolated lotion Dermatologicals

Removed from

PDL


calcitrate 315-250

mg-unit tablets

Minerals &

Electrolytes

Removed from

PDL


calcitriol 3 mcg/gm

ointment Dermatologicals

Removed from

PDL


calcium 1200-1200-1000 mg-unit

chewable tablets

Minerals &

Electrolytes

Removed from

PDL


calcium 500 + d 500-125 mg-unit

tablets


Removed from PDL


calcium 600 + minerals 600-200 mg-unit tablets


Removed from PDL


calcium 600+d 600-200 mg-unit tablets


Removed from PDL


calcium 600+d plus minerals 600-400 mg-unit chewable

tablets


Removed from PDL


Page 9 of 19


calcium 600+d plus minerals 600-400

mg-unit tablets

Minerals &

Electrolytes

Removed from

PDL


calcium 600-1500

mg tablets

Minerals &

Electrolytes

Removed from

PDL


calcium citrate 200

mg tablets

Minerals &

Electrolytes

Removed from

PDL


calcium-carbonate 600 + d 600-125

mg-unit tablets

Minerals &

Electrolytes

Removed from

PDL


calcium-magnesium-zinc 333-133-5 mg

tablets


Removed from PDL


calcium-vitamin d 600-200 mg-unit tablets


Removed from PDL


cetaphil liquid Dermatologicals Removed from PDL


chewable calcium 500-200-40 mg-unt-mcg chewable

tablets


Removed from PDL


children's complete allergy 12.5 mg

chewable tablets

Antihistamines Removed from PDL


childrens silfedrine 15 mg/5mL liquid

Nasal Agents - Systemic And Topical

Removed from PDL


citranatal dha 27-1 & 250 mg pak

Multivitamins Removed from PDL


citranatal rx 27-1 mg tablets



clemastine fumarate 0.67 mg/5 mL syrup



colloidal oatmeal bath packet

Dermatologicals Removed from PDL


complete natal dha

29-1-200 & 250 mg pak



Page 10 of 19


condoms Medical Devices Removed from


COPEGUS 200 mg tablets

Antivirals Removed from PDL

Hepatitis C drugs are now covered

by the state. Refer to Fee For

Service PDL for specifics

CORDRAN 4

mcg/sqcm tape Dermatologicals

Removed from


dermaphor ointment Dermatologicals Removed from

PDL


dexamethasone

sodium phosphate preservative free 10

mg/mL injection

Corticosteroids Removed from PDL

dexamethasone

sodium phosphate injection

solution 10 mg/ml

DIFF-STAT chewables



diltiazem

hydrochloride 100 mg reconstituted solution intravenous

Calcium Channel Blockers

Removed from PDL

diltiazem hcl intravenous

solution 125 mg/25ml, 25 mg/5ml, 50

mg/10ml

diphenhydramine

12.5 mg/5 mL elixir Antihistamines

Removed from


domeboro packet Dermatologicals Removed from


doxycycline monohydrate 100

mg tablets

Tetracyclines Removed from PDL

doxycycline monohydrate 100

mg capsules

ENDOMETRIN 100 mg suppositories

Vaginal Products Removed from PDL

progesterone 100 mg capsules

etoposide 500 mg/25 mL injection


Removed from PDL

EURAX 10% cream, lotion


permethrin external lotion 1 %; permethrin

Page 11 of 19


external cream 5 %

exemestane 25 mg

tablets


Therapies

Removed from

PDL

anastrozole oral

tablet

eye drops advanced relief 0.05-0.1-1-1 %

ophthalmic solution


PDL


fareston 60 mg tablets


Therapies

Removed from PDL

tamoxifen 10 mg tablets

FIBER THERAPY 500 mg tablets



FLORANEX chewables



flutamide 125 mg capsules


Removed from PDL

FORMULA EM 1.87-1.87-21.5 solution

Antiemetics Removed from PDL


GAVILYTE-C SOL 60/15 mL stool softener syrup



GENERESS FE chewable tablets

Contraceptives Removed from PDL

norethindrone &

ethinyl estradiol-fe 0.8 mg-25 mcg

chewable tablets

genteal 0.25-0.3 % ophthalmic gel

Ophthalmic Agents Removed from PDL


genteal mild 0.2 % ophthalmic solution



genteal mild to moderate 0.3 % ophthalmic solution



genteal severe 0.3 % ophthalmic gel



glycerin 2 gm, 2.1 gm suppositories



Page 12 of 19


glycerin liquid Dermatologicals Removed from


GNP capsaicin 0.1

% cream Dermatologicals

Removed from

PDL


goniovisc 2.5 %

ophthalmic solution Ophthalmic Agents

Removed from


haloperidol 20 mg

tablets

Antipsychotics/Anti

manic Agents

Removed from

PDL

haloperidol oral

tablet 10 mg

HARVONI 90-400 mg tablets





hemorrhoidal 0.25-

3-14-71.9 % ointment

Anorectal Agents Removed from

PDL


hemorrhoidal 0.25-3-85.5 %

suppository


PDL


homatropine hydrobromide 5 %

ophthalmic solution


atropine sulfate ophthalmic

solution

hydrocortisone-aloe 0.5%, 1% cream



INCIVEK 375 mg tablets



by the state. Refer to Fee For Service PDL for

specifics

INFERGEN

injections - all strengths




specifics

INSPIREASE bags, mouthpiece

Medical Devices Removed from PDL


Page 13 of 19


invisible acne treatment 10 %

cream


PDL


KALA tablets Laxatives Removed from

PDL


KLOR-CON 20 meq,

25 meq packets

Minerals &

Electrolytes

Removed from

PDL

KLOR-CON oral

tablets; potassium

chloride oral

solution 20meq/15ml (10%)

lactobacillus tablets, packets, wafers

Antidiarrheals Removed from PDL


LAXATIVE

W/SENNA 25 mg tablets



leuprolide 1 mg/0.2 mL injection

Antineoplastics and


Removed from PDL

LICE KILLING

maximum strength 0.33-4% shampoo


PDL

spinosad 0.9%

topical suspension

lice treatment 0.33-4

% liquid Dermatologicals

Removed from

PDL

spinosad 0.9% topical

suspension

lice treatment 1 %

liquid Dermatologicals

Removed from

PDL


suspension

loperamide-simethicone 2-125

mg tablets

Antidiarrheals Removed from PDL


lubricant eye drops 0.4-0.3 % ophthalmic solution



lubricating plus eye

drops 0.5 % ophthalmic solution



LUPRON-DEPOT

injection - all strengths

Antineoplastics and


Removed from PDL

TRELSTAR suspension

magnesium citrate

1.745 gm/30mL solution

Laxatives Removed from


Page 14 of 19


methyldopate hydrochloride 250

mg/5 mL solution

Antihypertensives Removed from

PDL

METHYLIN

chewable tablets - all strengths

ADHD/Anti-


Removed from

PDL

methylphenidate hcl chewable tabs

- all strengths (AL may apply)

metronidazole 0.75

% gel Dermatologicals

Removed from

PDL

metronidazole

external 1 %

MINERAL OIL

ENEMA Laxatives

Removed from


MODERIBA pak - all strengths


Hepatitis C drugs

are now covered by the state. Refer to Fee For


muscle relief 0.075 % cream



naproxen sodium

220 mg tablets

Analgesics - Anti-

Inflammatory

Removed from

PDL

naproxen oral

tablet 250 mg, 375 mg, 500 mg

nasal decongestant

10 mg tablets

Nasal Agents -

Systemic And Topical

Removed from


natures tears 0.4 %

ophthalmic solution Ophthalmic Agents

Removed from


NATURL FIBER

68% powder Laxatives

Removed from


NIACIN er 250 mg extended-release

tablets

Vitamins Removed from

PDL

no flush niacin

oral tablet 500 mg

NORDITROPIN flexpro solution - all

strengths

Endocrine And Metabolic Agents -

Misc.

Removed from

PDL

OMNITROPE subcutaneous

solution (PA applies)

OLYSIO 150 mg capsules





Page 15 of 19


ORAL SALINE

laxative solution Laxatives

Removed from


oyst-cal d 250-125

mg-unit tablets

Minerals &

Electrolytes

Removed from


oyster shell calcium +D 500 mg-400U

tablets

Minerals &

Electrolytes

Removed from


oyster shell calcium 250+d 250-125 mg-

unit tablets

Minerals &

Electrolytes

Removed from


oyster shell calcium/d 500-200

mgunit tablets


Removed from PDL


PAIN & FEVER 80 mg chewables

Analgesics - Nonnarcotic

Removed from PDL


parva-cal 500-200 mg-unit tablets


Removed from PDL


PEDIA-LAX 1 gm suppositories



PEGASYS kit,

injection, proclick Antivirals

Removed from

PDL

Hepatitis C drugs are now covered by the state.

Refer to Fee For Service PDL for

specifics

PEG-INTRON kit - all strengths




specifics

phenazo 95 mg tablets

Genitourinary Agents -

Miscellaneous

Removed from PDL

phenazopyridine hcl oral tablet 100

mg, 200 mg

polyvitamin/iron chewable tablets



potassium bicarbonate 25 meq

effervescent tablets

Minerals &

Electrolytes

Removed from

PDL

potassium chloride crys er oral tablet

extendedrelease 10 meq, 20 meq

Page 16 of 19


potassium citrate 5 meq (540 mg)


Genitourinary

Agents - Miscellaneous

Removed from

PDL

cytra-2 oral

solution

pr natal 400 29-1-200 & 400 mg pak



pr natal 430 29-1-200 & 430 mg pak



pr natal 430 ec 29-

1-200 & 430 mg (dr) pak



PROBIOTIC DAILY

capsules Laxatives

Removed from

PDL


promethazine 25

mg/mL injection Antihistamines

Removed from

PDL

promethazine

hydrochloride 50 mg/mL solution injection


PROMETHEGAN SUPPOSITORY 12.5

MG Antihistamines

Removed from PDL

promethazine hcl

suppository 25 mg

PSYLDEX 30% powder



pyrethins-piperonyl

butoxide 0.2-2 % liquid



QC NATURAL

VEGETABLE powder

Laxatives Removed from

PDL


RA aspirin 500 mg

tablets

Analgesics -

Nonnarcotic

Removed from

PDL


RA COL-RITE

50MG capsules Laxatives

Removed from

PDL


ra hemorrhoidal 0.25-3-12-18 %

cream


PDL


REBETOL • 40 mg/mL solution

• 200 mg capsules



by the state.

Page 17 of 19


Refer to Fee For Service PDL for

specifics

REBETRON kit - all strengths





REGONOL 5 mg/mL

injection

Antimyasthenic/Chol

inergic Agents

Removed from

PDL

renal 1 mg

capsules Multivitamins

Removed from


ribavirin 500 mg tablets





salivasure mouth/throat

lozenges

Mouth/Throat/Dental

Agents

Removed from


SB FIB LAX 33%

powder Laxatives

Removed from


sb lice treatment

0.3-3 % liquid Dermatologicals

Removed from

PDL


suspension

select-ob 29-1 mg chewable tablets



sf 5000 plus 1.1 % dental cream

Mouth/Throat/Dental Agents

Removed from PDL

PHOS-FLUR DENTAL 1.1 %

sirolimus 1 mg, 2 mg tablets

Assorted Classes Removed from PDL

tacrolimus oral capsule 0.5 mg, 1

mg, 5 mg

sm ibuprofen 100 mg junior tablets, chewables

Analgesics - Anti-Inflammatory

Removed from PDL


SMOOTH LAX 3350 NF powder packets



Page 18 of 19


sodium chloride (hypertonic) 5%

ophthalmic solution



SOVALDI 400 mg tablets





SUDAFED-12 12 hr* 120 mg


Nasal Agents -

Systemic And Topical

Removed from

PDL


sulfacetamide

sodium- sulfur 10-5% cream, lotion


PDL

sulfacetamide

sodium external suspension 10 %

tears again

ophthalmic ointment Ophthalmic Agents

Removed from


tolnaftate 1 %

solution Dermatologicals

Removed from


TUCKS 51%

suppository Anorectal Agents

Removed from


UNIVERT 32 mg

tablets Antiemetics

Removed from


verapamil

hydrochloride 2.5 mg/mL solution injection

Calcium Channel Blockers

Removed from PDL

VICTRELIS 200 mg

capsules Antivirals

Removed from

PDL

Hepatitis C drugs

are now covered by the state.

Refer to Fee For Service PDL for specifics

VIEKIRA pak tablets Antivirals Removed from

PDL

Hepatitis C drugs

are now covered by the state.

Refer to Fee For Service PDL for specifics

vitamin a 10,000 unit tablets



Page 19 of 19


vitamin a 25,000

unit capsules Vitamins

Removed from


vitamin a palmitate

15,000 unit tablets Vitamins

Removed from


vitamin c 500 mg extended-release

tablets



vitamin c 500

mg/5mL liquid Vitamins

Removed from


vitamin c tablet 1000

MG ORAL; vitamin c

tablet 100 MG


PDL


vitamin D 400 unit capsules



vitamin d3 2,000 unit super strength

tablets



vitamin d3 50,000 unit capsules



vitatrum chewable tablets



zinc 25 mg tablets Minerals & Electrolytes

Removed from PDL


ZYTIGA 250 mg tablets


Removed from PDL

If you have questions, WellCare’s Pharmacy Help Desk and its affiliated vendor, Catamaran, are available to assist providers at 1-888-588-9842.

Thank you for your care of WellCare’s South Carolina Medicaid members. Sincerely,

WellCare Health Plans, Inc.

Documents

UPDATE WellCare’s South Carolina · © WellCare 2014 SC_11_14 July 13, 2015 Dear Provider: At the June 04, 2015 WellCare Pharmacy & Therapeutics Committee meeting, ... Agents Added