CMS approved the State Plan Amendment (SPA) to increase the professional dispensing fee from $10.02 to $10.07 effective November 1. State statute requires a cost of dispensing survey every two years. $10.07 reflects the results of the 2018 survey. More information can be found in the Department of Human Services’ Informational Letter No. 1959-MC-FFS.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Effective October 24, Medicaid fee-for-service set a quantity limit on epinephrine injections at four boxes of two syringes (eight syringes total) per rolling 365 days. The Department of Health also announced that due to the current shortage of certain products, the prior authorizations will be automatically approved.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
On October 30, NACDS, in partnership with seven pharmacy groups in Texas, hosted a Pharmacy Advocacy Training Day at the Capitol. The purpose of the meeting was to educate pharmacists on how to discuss issues with legislators and staff. The Executive Director of the Board of Pharmacy Allison Benz welcomed the 65 chain and independent pharmacists, encouraging them to be active in their various associations, and to engage both at the Capitol and the Board of Pharmacy meetings. A Senior Advisor for Gov. Greg Abbott (R) applauded the pharmacy groups for coming to the Capitol united on certain issues. Media pundits from the Quorum Report and Texas Tribune shared insights on Texas politics and the Speaker of the House’s race. Rep. Donna Howard (D) and Rep. Drew Darby’s (R) Chief of Staff offered advice on how to present issues to legislators and staff. Prior to the afternoon group meetings scheduled with 78 legislative offices, pharmacists engaged in role playing activities to hone their skills.
Also in Texas…The Health and Human Services Commission Vendor Drug Program (VDP) announced that they expanded the age range for optional coverage of the flu vaccine through the pharmacy benefit as of October 19. With this change, plans have the option to allow pharmacies to bill for flu vaccines provided to beneficiaries ages seven years and older in a pharmacy setting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Effective Thursday, November 1, the Medicaid Agency will begin implementing limits on short-acting opiates for opioid naíve recipients. Details are available on the website. Also, the override form and criteria have been posted. Additionally, prescribers and pharmacists may access the printable Recipient Information Sheet online.
Gov. Nathan Deal (R) called a special session of the legislature on Tuesday, November 13 to take immediate action and lead the way in spurring economic recovery after the heavy damage caused by Hurricane Michael.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy’s Technician Task Force will submit language to the Board recommending increasing the current 3:1 pharmacy technician to pharmacist ratio to 6:1 provided half the technicians are certified.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
On October 1, the Division of Medicaid (DOM) began requiring an FDA-approved indication or compendia-supported indication for each stimulant prescription. It has come to DOM’s attention that the MississippiCAN pharmacy claims systems do not interface with the medical claims systems and may not be able to perform a search for diagnoses in the past 24 months of medical claims. The fee-for-service system is capable of performing this look-back function. To ensure that stimulant prescriptions process without delay or the need for prior authorization, DOM advises providers to write the diagnosis and ICD-10 code on each of their patient’s ADHD (attention deficit hyperactivity disorder) prescriptions. Pharmacy providers must then enter the ICD-10 code on prescription claims. A list of FDA-approved or compendia-supported indications covered by DOM, along with corresponding ICD-10 codes, can be found on DOM’s Pharmacy Resource webpage.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gov. Michael L. Parson (R) named Rep. Todd Richardson (R), currently Speaker of the House, to become Medicaid Director effective Thursday, November 1. Speaker Richardson will be replaced by House Speaker Pro Tem Elijah Haahr (R), who was already selected to succeed Speaker Richardson in 2019 but will assume the interim speaker role in the meantime.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
This week, Gov. Tom Wolf (D) signed two pharmacy-backed bills into law, including HB 353 and HB 270. HB 353 requires e-prescribing for all controlled substances effective one year from the date of governor’s signing on October 28. Wolf also signed HB 270, which expands income guidelines for the Pharmaceutical Assistance Contract for the Elderly (PACE) program, estimated to make an additional 14,500 senior citizens eligible for the PACENET pharmacy benefit. NACDS participated in negotiations with the Wolf Administration that resulted in an amendment to the bill that would allow retail pharmacies to perform medication synchronization for PACE beneficiaries and includes a provision that allows for a pro-rated co-pay and requires the payment of the full dispensing fee for partial fills to synchronized medications.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.