The Department of Medicaid (ODM) announced that on July 1, 2023, they will transition pharmacy benefits for Medicaid Fee-for-Service (FFS) enrollees to Gainwell, their single pharmacy benefits manager (SPBM). This transition consolidates oversight of Medicaid pharmacy benefits for managed care and FFS members, giving prescribers and providers one vendor to work with regardless of how their patients are enrolled in Medicaid. Beginning July 1, Medicaid FFS prescribers and pharmacies will route claims to Gainwell’s new BIN 024251 and PCN OHRXPFFS. This information will be included on the new FFS member ID cards, but they will retain their current member ID numbers. The Pharmacy Reference Guide and Payer Sheet has been updated to reflect the changes. For questions about the transition, please email MedicaidSPBM@medicaid.ohio.gov
Also in Ohio, the Board of Pharmacy’s final rule on pharmacists’ immunizations authority was published, effective June 1. The rule reflects the passage of HB 6 of 2021 (134th GA). It updates the state’s current practice to permit pharmacists to administer: Flu and COVID vaccines by protocol or vaccines for “any other disease” with a prescription to patients aged 7 years and older; and “any disease” under a protocol. Further regulations concerning technician and intern vaccines required under HB 6 are still in the rulemaking process. NACDS continues to work with our in-state partners and the Legislature to pass legislation to bring pharmacy immunization authority in line with the PREP (Public Readiness and Emergency Preparedness) Act.
Finally in Ohio, on May 24 the Board of Pharmacy posted numerous guidance documents regarding pharmacy technician and technician trainee registration, reciprocity and training programs. To view the documents please go to Pharmacy.Ohio.Gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.