Erica Joyner – Page 14 – In The States

Alabama

Reminder, Alabama Administrative Rule 420-4-1-.04 requires pharmacists to report to the State Health Officer or designee the dispensing of anti-tuberculosis medications and dispensing of antiretroviral medications to an infant.

Also in Alabama, all previously published expiration dates related to the COVID-19 public health emergency (PHE) are once again extended by the Alabama Medicaid Agency. The new expiration date is the earlier of November 30, 2022, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2022-10-28T11:03:41-04:00October 28, 2022|Alabama|

California

The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.

Coverage of Sterile Syringes with Needles (Non-Insulin) (October 26)
Reminder for Providers Regarding Patient Privacy (October 26)
Historical Pricing and Reimbursement Corrections for Ixinity, Alprolix, Eloctate, and NovoSeven 4Q 2021 through Q3 2022 (October 25)
Bivalent COVID-19 Vaccines Administration Now a Benefit (October 21)
Medical Rx Weekly Wrap-Up for October 14-21 (October 21)

Also in California, the Board of Pharmacy issued its Annual Notice of Availability of Precedential Decisions Index. The index and the text of the precedential decisions are available on the Board’s webpage.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2022-10-28T11:02:58-04:00October 28, 2022|California|

Kentucky

Patients and pharmacies in the Commonwealth took a giant leap forward this week when Anthem announced they will be enrolling pharmacists as network providers. The move is a result of the enactment of a law that provides for pharmacy payment parity; HB 48 of 2021 required Kentucky health plans to reimburse pharmacists for services within a pharmacist’s scope of practice that are otherwise covered by the plan, if provided by another healthcare provider. Coupled with a pharmacist’s current authority to provide more than a dozen clinical services under Board of Pharmacy Protocols, Anthem members will have widespread convenient access to treatment at pharmacies for ailments such as flu, strep and tobacco cessation. Pharmacies interested in enrolling in the network should contact kyprovidercontracting@anthem.com. For more information, please see the Kentucky Pharmacists Association’s (KPhA’s) latest news release. NACDS applauds KPhA for its work with Anthem and its leadership in our joint support for HB 48.

Also in Kentucky, Medicaid has proposed a rule that may make it easier for pharmacies to provide vaccine services to kids with Medicaid coverage. The rule change eliminates the requirement to use Vaccines for Children (VFC) stock and strikes current language that states Medicaid will not reimburse for the cost of any vaccine if already available through the VFC program. NACDS interprets this to mean that pharmacies do not have to be enrolled in VFC to immunize and be reimbursed for Medicaid-covered kids. NACDS is seeking member feedback to determine whether this change would be significant to your vaccination efforts. Please review this rule and send Jill McCormack your comments by November 18.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2022-10-28T11:01:20-04:00October 28, 2022|Kentucky|

Massachusetts

Latest edition of MassHealth Pharmacy Facts has been distributed to MassHealth Pharmacy providers.

Also in Massachusetts, MassHealth has issued the attached corrected bulletin #352 relative to the reporting and payment of overpayments received from MassHealth. The original bulletin was issued in September 2022.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2022-10-28T11:00:10-04:00October 28, 2022|Massachusetts|

Nebraska

The Department of Health and Human Services (DHHS) posted the COVID-19 Fee Schedule Bivalent Booster Updated (revised 10.27.2022).

Also in Nebraska, the DHHS announced Medicaid’s next COVOID update call will be held on November 2 at noon (Central). To join the call, dial 408-418-9388 (access code) 2492 610 1342 or use the meeting link:
https://sonvideo.webex.com/sonvideo/j.php?MTID=m3aab184252403e62a6ff312be38e9d54

Also in Nebraska, the Board of Pharmacy posted its agenda for the November 7 meeting.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2022-10-28T10:59:16-04:00October 28, 2022|Nebraska|

North Carolina

To help providers, the Department of Health and Human Services updated its Provider Guidance on Therapeutics to include detailed up-to-date information. Providers are encouraged to read the guidance. More information is available on the Therapeutics Information for Providers webpage.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2022-10-28T10:58:10-04:00October 28, 2022|North Carolina|

New York

NACDS will be attending the annual meeting for the Community Pharmacy Association of New York in Albany on November 15^th. At this meeting, the priorities and strategies for the 2023 legislative session will be reviewed.

Also in New York, our comments, that were reviewed by New York members will be submitted to the Department of Financial Services for the October 31^st deadline. If your company is also submitting your own comment letter, please be sure to place PBM2022-06 in the subject line.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Erica Joyner2022-10-28T10:57:15-04:00October 28, 2022|New York|

Ohio

This week, Ohio Medicaid announced the payment schedule for the Supplemental Managed Care Dispensing Fee and that the fee has been increased due to the compressed schedule of payments. The payment schedule is:

Payment 5 – Between November 1 – 15, 2022 (July – Sept 2022 claims)

Payment 6 – Between February 1 – 15, 2023 (Oct – Dec 2022 claims)

Payment 7 – Between May 1 – 15, 2023 (Jan – March 2023 claims)

Payment 8 – No later than August 15, 2023 (April – June 2023 claims)

Note that the November payment will be issued by the Medicaid MCOs (Managed Care Organizations) and, as in the past, will be included in your weekly claim payments. However, the balance of the payments will come from Gainwell, the SPBM (Single Pharmacy Benefit Manager), as a separate payment. The FAQ document includes more detail.

Also in Ohio, Medicaid has prepared a toolkit for providers to prepare for the expiration of the federal Public Health Emergency (PHE). The materials are focused on the “unwinding” patient eligibility that will result at the end of the PHE.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2022-10-28T10:56:17-04:00October 28, 2022|Ohio|

Oregon

The Oregon State Pharmacy Association announced the results of its PBM study conducted by 3 Axis Advisors to review reimbursement trends between payers and retail pharmacies between 2019 and 2021.

Also in Oregon, the Board of Pharmacy posted its agenda for its Strategic Planning Meeting scheduled to be held on November 10.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2022-10-28T10:54:51-04:00October 28, 2022|Oregon|

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