Effective January 1, 2020, Medicaid will process pharmacy claims for the Healthy Steps (CHIP) program as well as Medicaid Expansion. For more information, please contact Alexi Murphy, PharmD, at 701-328-4061.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
On November 1, the Bureau of Workers’ Compensation began reimbursing pharmacies for dispensing a drug disposal system to patients receiving an opioid prescription for the first time in the last 12 months. The Bureau’s October 2019 issue of the Provider eNews includes an overview of the program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HEB pharmacist Doug Read was appointed to serve a three year term on the newly created Prescription Monitoring Program Advisory Committee charged with making recommendations to the Texas State Board of Pharmacy regarding operational improvements to the Prescription Monitoring Program, resolutions to identified data concerns, methods to improve data accuracy, integrity and security, and ways to reduce technical difficulties, as well as the addition of any new data sets or services to the information provided or the access to that information.
Also in Texas… House Speaker Dennis Bonnen (R) issued a press release announcing the creation of an 11-member House Select Committee on Statewide Healthcare Costs. The Speaker will serve as Chair. NACDS will closely monitor and engage in the Committee’s activities during the interim.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
As a result of House Joint Resolution 662, the Joint Commission on Health Care (JCHC) in late November and reviewed a report of policy options for pharmacists scope of practice as it relates to Collaborative Practice Agreements (CPAs), Standing Orders and Statewide Protocols. The commission unanimously adopted two options to recommend for legislation in the 2020 Regular Session. One would add independent practice nurse practitioners and physician assistants to the list of practitioners that could be a party to a CPA; the other is a request to the Boards of Pharmacy and Medicine to convene a workgroup to determine if statewide standing orders could be expanded to include other conditions, including CLIA-waived tests.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Health Services announced its third annual Opioid Forum will be held May 5-7, 2020, in the Wisconsin Dells. For more information, including presentations from previous years, please visit the Opioid Forum web page.
Also in Wisconsin… The Department of Health Services will carve out coverage of most prescription outpatient drugs from the Family Care Partnership benefit effective January 1, 2020. For more information, please see the ForwardHealth update.
Also in Wisconsin… Gov. Tony Everts (D) signed into law 2019 Wisconsin Act 24. The enacted legislation authorizes pharmacists to administer ACIP-recommended vaccines to individuals 6 years of age and older under their own independent authority and authorizes pharmacists to administer other vaccines pursuant to a prescription, vaccine protocol or standing order (including vaccines to children younger than 6 years of age pursuant to a prescription issued within 29 days of vaccine administration.)
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
On September 26, NACDS participated in a Medicaid meeting/conference call, during which the agency discussed potential pharmacy reimbursement modifications. In accordance with current market evidence, the agency proposed modifying the default reimbursement methodology from WAC + 0% to WAC – 4%, if no AAC exits for a drug product. Medicaid asked for all stakeholders to submit comments; those comments and responses, along with all other items discussed that day, may be found on the website. On November 15, the agency announced its plan to move forward with a State Plan Amendment (SPA) for the proposed change.
Also in Alabama… A reminder that gabapentin became a Schedule V medication on November 18. You may recall on May 15, the State Committee of Public Health voted to change gabapentin to a Schedule V medication, effective November 18, 2019. This was at the request of the Board of Medical Examiners. Pharmacies should have completed the necessary changes required when moving a legend medication to a scheduled medication. These changes may include software requirement changes, increases in physical space to store scheduled medications and changes in procedures for prescribing/dispensing a controlled substance. Questions can be directed to Nancy Bishop, State Pharmacy Director, Department of Public Health.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Department of Health Care Services (DHCS) posted a document titled “Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-For-Service Frequently Asked Questions,” to the DHCS’ Medi-Cal Rx: Transition webpage. The document provides additional guidance and clarification to Medi-Cal beneficiaries, providers, plan partners, tribal health programs and other interested parties, regarding the Friday, January 1, 2021, transition of Medi-Cal’s pharmacy benefit (collectively referred to as “Medi-Cal Rx”).
Also in California… Chain pharmacies interested in filing for the DHCS’ retroactive Medi-Cal rate recoupments and the alternative rate recoupment process must submit an application by this Friday, November 22. Applications will not be considered past that date. More information on the application process can be accessed online. For chain pharmacies not participating in the alternative payment rate process, please refer to the Pharmacy Retroactive Claim Adjustments FAQs on DHCS’ website – #5 explains the timeframe for recoupments for pharmacies, #7 explains how DHCS will handle the recoupments via different potential scenarios and #17 explains how pharmacies can estimate their outstanding balance due to DHCS.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health Care Policy and Financing, Medical Services Division is having a rulemaking hearing on Friday, January 10 on a proposed rule (10 CCR 2505-10, Section 8.800.18.C.1.a) regarding the Rx Review program which allows the program’s members to do a consultation with a pharmacist over the telephone if they live outside of a reasonable travel distance from the consulting pharmacist. Members may submit comments directly to Chris Sykes, Medical Services Board Coordinator.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
HB 389, Testing for and Treatment of Influenza and Streptococcus, was heard on November 13 in the House Health Quality Subcommittee. The bill passed favorably with a vote of 11-3, next stop is the House Health Care Appropriations Committee.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.