About Michael Angeloni

This author has not yet filled in any details.
So far Michael Angeloni has created 903 blog entries.

Alabama

As a reminder, the below paragraph was an ALERT disseminated to all pharmacy providers on October 26, 2006 and has been posted on the Agency website since that date. This policy continues to be in effect. Per Alabama Medicaid Administrative Code, Rule No. 560-X-16-.06 “Reimbursement for Covered Drugs and Services”, “usual and customary” is defined as the “charge to the general public regardless of program fees”.

In response to pharmacy retailers’ recent announcements of reduced prices for specific generic drugs, the Alabama Medicaid Agency will consider these reduced prices to be the “usual and customary” price for these retailers. Retrospective audits identifying claims that are inappropriately charging Alabama Medicaid any amount over the usual and customary amount will be recouped. Please refer to our Administrative Code Rule No. 560-X-16-.06, “Reimbursement for Covered Drugs”, as well as Provider Billing Manual Chapter 27, for more information on our reimbursement policy.

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

2019-08-08T09:41:36-04:00August 8, 2019|Alabama|

California

Last week, the Department of Health Care Services (DHCS) held a webinar to lay out DHCS’s plan to transition all Medi-Cal pharmacy services from managed care to fee-for-service by Friday, January 1, 2021. The slides outline the pharmacy carve-out policy and estimated fiscal savings for the state. More information can be found on DHCS’ homepage.

Also in California… During its recent meeting, the Board of Pharmacy took the following actions. Acting President Greg Lippe announced the resignation Victor Law, RPh, the Board’s president, and new officers will be elected at the next meeting on Friday, September 13. The board also voted to begin rulemaking to add new rules on compounding of nonsterile preparations, such as flavorings, and to proceed with rulemaking on community pharmacy staffing (B&P Section 4113.5 /SB 1442, Statutes of 2018).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2019-08-08T09:40:11-04:00August 8, 2019|California|

Kentucky

Though its original implementation was slated for December 2019, last week, the Board of Pharmacy voted not to adopt USP General Chapter <800>, standards for safe handling of hazardous drugs to minimize the risk of exposure to healthcare personnel, patients and the environment. NACDS supported efforts of our in-state partners to advocate against the state adopting these standards at this time.

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

2019-08-08T09:38:55-04:00August 8, 2019|Kentucky|

Louisiana

Legislation, requiring prescribers to indicate on the prescription it is medically necessary if the prescriber wants more than a seven-day supply of an opioid drug dispensed, took effect on August 1.

Also in Louisiana… The Department of Health has posted two Medicaid provider bulletins:

Also in Louisiana… Senate President John A. Alario, Jr. (R), who has served in the Legislature since 1972, announced that he will retire in January due to term limits.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2019-08-08T09:37:31-04:00August 8, 2019|Louisiana|

Maryland

Effective Saturday, August 10, the Medicaid Pharmacy Program announced brand Revatio® suspension is preferred over its generic equivalent (sildenafil). Claims for brand Revatio® suspension must be submitted with DAW 6 code and will be priced appropriately. A Department of Health Medwatch form will not be required. Claims with any other DAW code will reject.

Also in Maryland… Effective Saturday, August 10, the Medicaid Pharmacy Program announced all strengths of brand Lyrica® must be submitted with DAW 6 code and will be priced appropriately. A Department of Health Medwatch form will not be required. Claims with any other DAW code will be rejected.

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

2019-08-08T09:35:41-04:00August 8, 2019|Maryland|

Michigan

Gov. Gretchen Whitmer (D) announced the following appointments to the Board of Pharmacy:

  • Grace Sesi, a licensed pharmacist and CVS Health district leader in the Greater Detroit Area, was appointed to succeed Nichole Penny, whose term expired June 30.
  • Sandra C. Taylor, a licensed pharmacist and the director of pharmacy operations for Beaumont Healthcare System, was appointed to succeed Suit Hing “Mary” Moy-Sandusky, whose term expired June 30.
  • Maria Young, a licensed pharmacist and the owner of the University Pharmacy in Hamtramck, was appointed to succeed Patti Smeelink, whose term expired June 30.
  • Kelli Oldham, director of pharmacy and retail operations for Walgreens, was appointed to succeed Tyler Paesens, who has resigned, to represent the general public.

David Hills, a pastor with Stevensville United Methodist Church, was reappointed to represent the general public.

For more information, contact NACDS’ Joel Kurzman at 847-905-0555.

2019-08-08T09:33:19-04:00August 8, 2019|Michigan|

Minnesota

Continuing previous updates about the state’s compliance with CMS’ Covered Outpatient Final Drugs Rule effective July 1, the Department of Human Services will reprocess claims for dates of service from July 1-18 on Thursday, August 29 and they will appear on pharmacies’ remittance advices on Tuesday, September 17. Additional information can be found on the Minnesota Health Care Programs (MHCP) provider news and updates webpage.

For more information, contact NACDS’ Joel Kurzman at 847-905-0555.

2019-08-08T09:31:56-04:00August 8, 2019|Minnesota|

Mississippi

On August 1, Alliant Health Solutions began performing prior authorization reviews as the Division of Medicaid (DOM) transitions to a new Utilization Management/Quality Improvement Organization vendor. All prior authorization reviews in process before August 1 will be completed by eQHealth Solutions as part of the transition to Alliant. Alliant has scheduled a series of informational webinars with one date remaining in August on the 16th. To sign up for a webinar or to learn more about these changes, visit Alliant’s Mississippi Medicaid portal.

Also in Mississippi… On August 1, the DOM implemented a new opioid initiative, which affects pharmacy point-of-sale claims and applies to beneficiaries enrolled in Medicaid fee-for-service and all three MississippiCAN coordinated care plans. The initiative involves four changes that will directly impact Medicaid pharmacy/prescribing providers.

Also in Mississippi… On Friday, November 1, the DOM will implement new three-year contracts for the Children’s Health Insurance Program (CHIP). CHIP will continue to be administered by two vendors, but providers should be aware that there is one important change. Molina Healthcare will replace Magnolia Health as one of the two coordinated care organizations administering the program. UnitedHealthcare Community Plan will continue to serve as the other CHIP vendor.

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

2019-08-08T09:30:52-04:00August 8, 2019|Mississippi|

Oklahoma

NACDS is soliciting members’ comments this week on the implementation of the Bureau of Narcotics and Dangerous Drugs Control’s recent announcement regarding changes to the prescription drug monitoring program (PDMP) reporting requirements. As a result of the enactment of Oklahoma SB 848, prescribers are required to document any opioid prescription as being acute or chronic on the face of the prescription. As a result, the PDMP is looking to utilize this data by requiring pharmacies to report any opioid as being used for the treatment of acute or chronic pain. Along with this requirement, the PDMP is also requiring pharmacies to report a value of “99-Other” for any non-opioid controlled substance prescription.

NACDS’ analysis of this change is that most pharmacies will need to implement a block in their prescription fulfillment systems to ensure treatment type codes are being entered and reported accordingly for all opioid prescriptions in accordance with SB 848. This is creating a concern in that requiring a value of “99-Other” for all non-opioid controlled substances will create workflow issues in pharmacies which will cause a negative impact for patients.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2019-08-08T09:29:33-04:00August 8, 2019|Oklahoma|

© National Association of Chain Drug Stores
All Rights Reserved | Privacy & Disclaimer

Go to Top