Arkansas
The Insurance Department issued a Proposed Amended Rule 118: Pharmacy Benefit Manager Regulations in advance of the Public Hearing on September 10, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for July 5-11.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Register now for the August 27 Department of Health Care Policy & Financing (HCPF) Stakeholder Webinar on Medicaid priority initiatives for Fiscal Year 2024-2025 and Public Health Emergency Unwind insights and opportunities going forward.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Agency for Health Care Administration (Agency) scheduled a hearing on July 29, 2024, at 1:30 pm for new Rule 59G-4.252, Diabetic Supply Services at the Agency for Health Care Administration (2727 Mahan Drive, Building 3, Tallahassee, FL 32308).
A virtual option or call-in number will not be available for this meeting.
Official notice of the meeting published in Vol. 50/No. 131, of the Florida Administrative Register (FAR) on July 5, 2024. A copy of the notice may be found at www.flrules.org. Please note that a preliminary draft of the reference material, if available, will be posted prior to the meeting on the Rules webpage.
Also in Florida, updated versions of the Medicaid Provider Agreements utilized in initial enrollment and renewal have been created. Starting July 15, 2024, these 2023 versions will be replacing the 2013 versions of the forms that are currently in use and available on the Medicaid web portal in the Enrollment Forms section.
There will be a two-month grace period from July 15, 2024, to September 15, 2024, during which either version of the forms will be accepted when submitting a new application or renewal. Starting September 15, 2024, only the 2023 version will be accepted.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
Gov. JB Pritzker (D) has signed SB 3268 Medicaid Omnibus legislation which includes a large expansion in the practice of pharmacy which will allow pharmacists to test and treat for influenza, SARS-COV 2, RSV, Group A Strep and adult-stage head louse. The bill also includes PBM transparency provisions.
Also in Illinois, please see the updated Department of Healthcare and Family Services Pharmacist Fee Schedule (updated July 11, 2024).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2605-MC-FFS Spravato® (Esketamine Nasal Spray) Billing & Coding Update
- INFORMATIONAL LETTER NO. 2597-MC-FFS Medical Foods Update
- INFORMATIONAL LETTER NO. 2587-MC-FFS Clinical Trials
- INFORMATIONAL LETTER NO. 2577-MC-FFS Services After Death Date
- INFORMATIONAL LETTER NO. 2594-MC-FFS-D Clarification to Medicaid Enrollment Options for Individual Practitioners
- INFORMATIONAL LETTER NO. 2599-FFS Medicaid Pharmacy Copayments Reinstatement
- INFORMATIONAL LETTER NO. 2596-MC-FFS New Vaccine for Children (VFC) Codes
- INFORMATIONAL LETTER NO. 2595-MC-FFS-D July 2024 Medicaid Pharmacy Program Changes
Also in Iowa, a Presidential Disaster Declaration for individual assistance was approved for four additional Iowa counties affected by extreme rainfall and flooding beginning on June 16, 2024. This declaration allows the Iowa Department of Health and Human Services to offer the Disaster Food Assistance, also known as Disaster Supplemental Nutrition Assistance Program (D-SNAP) for Iowans in Buena Vista, Cherokee, O’Brien and Woodbury counties. Disaster Food Assistance uses different qualifying rules than regular SNAP. Those who may not normally qualify for SNAP, based on income, may qualify for Disaster Food Assistance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact issued an invitation and online access instructions to the 3rd Quarter session of the KY Medicaid Pharmacy Network Provider Webinar Forum on July 31 from 10:00-11:00 am EST. The meeting is meant as an open forum to ask questions or raise issues and all pharmacy providers are invited.
Also in Kentucky, MedImpact announced that they will be reprocessing claims that were inadvertently paid at NADAC or WAC when they should have been a MAC claim.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Walmart pharmacist Jeremy Moffett was chosen by his colleagues as the 2024 Louisiana Chain Pharmacist of the Year. He received recognition during the awards ceremony at the annual meeting of the Louisiana Pharmacy Association in Lafayette on July 12.
Also in Louisiana, the Department of Health’s Medicaid Director Kimberly Sullivan issued a pharmacy provider memorandum on the diagnosis code policy.
Also in Louisiana, the Board published Bulletin No. 24-01 which contains notice and guidance in regard to Act 246 of the 2024 Legislative Session.
Finally in Louisiana, the Department of Health’s (LDH) Medicaid team and Myers and Stauffer held a Zoom stakeholder meeting on July 15, sharing its plans for conducting a pharmacy cost of dispensing (COD) study. The survey will be emailed to a key point of contact for each chain pharmacy on August 7. The survey results will be used to evaluate the Medicaid pharmacy reimbursement methodology.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Department of Health and Human Services issued two bulletins announcing the upcoming termination of coverage for certain pharmacy services due to the upcoming expiration of the federal PREP Act.
- 2419-Lab – Termination of COVID-19 Home Test Kit Coverage and Special Reimbursement for COVID-19 Specimen Collection and Clinic Vaccine Administration. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.
- 2424-Pharmacy – End of the Federal Public Health Emergency (PHE) and Final Unwinding of Pharmacy COVID-19 Response Policies. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.