Provider Bulletin September 2021

Healthy Blue Hot Tip: Topical Corticosteroids

Healthy Blue patients on nonpreferred products may experience a pharmacy claim rejection. To avoid additional steps or delays at the pharmacy, consider prescribing preferred products whenever possible. Prior authorization and step therapy may apply to select preferred products. Coverage should be verified by reviewing the Preferred Drug List (PDL) by visiting www.HealthyBlueSC.com and selecting Providers. The PDL is subject to change quarterly.

Preferred topical corticosteroids Preferred topical corticosteroids Low potency Medium potency Cream: Cream: Hydrocortisone 0.5% cream Betamethasone valerate 0.1% cream Hydrocortisone 1% cream Triamcinolone 0.1% cream Hydrocortisone 2.5% cream Triderm 0.1% cream Hydrocortisone-aloe 1% cream Mometasone 0.1% cream Anti-itch 1% cream Fluticasone 0.05% cream Cortisone 1% cream Noble formula HC 1% cream Ointment: Eczema anti-itch 1% cream Triamcinolone 0.025% ointment Hydroskin 1% cream Triamcinolone 0.1% ointment Triamcinolone acetonide 0.025% cream Mometasone 0.1% ointment

Ointment: Solution; non-oral: Hydrocortisone 0.5% ointment Mometasone 0.1% solution Hydrocortisone 1% ointment Hydrocortisone 2.5% ointment Gel: Anti-itch 1% ointment Desonide 0.05% gel

Solution; non-oral: Lotion: Scalpicin 1% anti-itch solution Betamethasone dipropionate 0.05% lotion Scalp relief 1% solution Triamcinolone 0.1% lotion

Gel: OTC Hydrocortisone 1% gel

Lotion: OTC Hydrocortisone 1% lotion OTC Hydrocortisone 2.5% lotion Triamcinolone acetonide 0.025% lotion

www.HealthyBlueSC.com BlueChoice HealthPlan is an independent licensee of the Blue Cross and Blue Shield Association. BlueChoice HealthPlan has contracted with Amerigroup Partnership Plan, LLC, an independent company, for services to support administration of Healthy Connections. To report fraud, call our confidential Fraud Hotline at 877-725-2702. You may also call the South Carolina Department of Health and Human Services Fraud Hotline at 888-364-3224 or email [email protected]. BSCPEC-2074-21 September 2021 Healthy Blue Topical corticosteroids Page 2 of 2

Preferred topical corticosteroids Preferred topical corticosteroids High potency Very high potency Cream: Cream: Betamethasone dipropionate augmented Clobetasol 0.05% cream 0.05% cream Clobetasol Emollient 0.05% cream Fluocinonide-E 0.05% cream Halobetasol 0.05% cream Fluocinonide 0.05% cream Triamcinolone 0.5% cream Ointment: Clobetasol 0.05% ointment Ointment: Halobetasol 0.05% ointment Amcinonide 0.1% ointment Betamethasone valerate 0.1% ointment Gel: Fluocinonide 0.05% ointment Clobetasol 0.05% gel Fluticasone propionate 0.025% ointment Triamcinolone 0.5% ointment Solution; non-oral: Clobetasol 0.05% solution Solution; non-oral: Cormax 0.05% solution Fluocinonide 0.05% solution

Gel: Fluocinonide 0.05% gel

If you have questions regarding this communication, call the Customer Care Center at 866-757-8286.

To view the PDL, visit www.HealthyBlueSC.com and select Providers.