The Department of Health Care Services posted the following on the Medi-Cal Rx Web Portal:
Also in California, effective immediately, the Department of Health Care Services (DHCS) rescinded the standing order originally issued in January 2022 that allowed pharmacists to order and dispense OTC COVID-19 antigen test kits to eligible Medi-Cal beneficiaries.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
State Auditor Rob Sand announced the results of a recent audit about how PBMs manage prescription drug payments. The audit reviewed data from 2019-2021. The findings outlined in this report include concerns about compliance, financial integrity and oversight within Medicaid and the Children's Health Insurance Program.
Also in Iowa, Gov. Kim Reynolds (R) signed HF 2585, legislation directing the Board of Pharmacy to adopt rules to ensure that on or before January 1, 2027, if a person who is blind, has a visual impairment or other print disability requests access to prescription drug labels, bag tags and medical guides, a pharmacy provides access to prescription drug labels, bag tags and medical guides, or refer the person to a pharmacy that provides access to prescription drug labels, bag tags and medical guides. Additionally, on or before April 1 each year, the board shall publish a list on the board's website that contains the pharmacies that provide accessibility measures.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Maryland Health Care Commission (MHCC) released version 2.0 of the Noncontrolled Prescription Drugs Dispenser Data Submission Manual (dispenser manual). This version includes non-substantive updates that clarify certain processes for reporting noncontrolled prescription drug (non-CDS) dispensing information to the State-Designated Health Information Exchange (CRISP). As a reminder, Maryland law (Health General Article §19-145) requires licensed dispensers to submit non-CDS dispensing information to CRISP. Annually, MHCC develops and approves the dispenser manual with technical guidance on the format and frequency for non-CDS reporting.
The MHCC is also seeking input on the following updates to version 2.0 of the dispenser manual:
For more information on non-CDS reporting, please visit MHCC's dedicated webpage. Questions can be directed to mhcc.noncds@maryland.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Health and Human Services posted its presentation from the June Medicaid Pharmacy Liaison Committee meeting. Note that the deck contains timely information concerning how pharmacies can enroll to be reimbursed for clinical services.
Also in Michigan, the agenda for the June 17 Board of Pharmacy meeting has been released.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 1735 was passed by the General Court on June 4 and will be sent to Gov. Kelly Ayotte (R) for enactment. The legislation includes several key provisions impacting pharmacy care, including establishing a statutory standard of care provision within the Pharmacy Practice Act, delinking vaccine administration authority from ACIP and creating a remote processing allowance for pharmacy technicians.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
With a favorable final vote in the Assembly of 133-0, the Patient Access to Pharmacy Act (S5939C/A5882C) passed both chambers of the Legislature this session and will be sent to Gov. Kathy Hochul (D) for enactment. The legislation will establish a reimbursement “floor” across all pharmacy network contracts in state-regulated commercial health plans based on the Medicaid fee-for-service rate, which is currently set at NADAC + $10.18. Additionally, the bill creates a payment appeals process for pharmacies dispensing higher cost medications that require special handling, increased delivery costs and other special services to ensure pharmacies receive an adequate dispensing fee to cover their costs in the specialty market. Advancing this legislation in partnership with the Community Pharmacy Association of New York has been a critical component of NACDS’ advocacy on pharmacy reimbursement this session.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
By a 31-2 vote, just before adjourning for summer, the Senate passed SB 230, that would permit pharmacists to test and treat for flu, strep and COVID under a Board of Pharmacy statewide protocol. The bill also requires insurance carriers and Medicaid to reimburse pharmacies for providing the services. We expect the House to take up the bill during the lame duck session in the fall.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Please see TennCare's recent updates to the Preferred Drug List (PDL), including changes to prior authorization (PA) criteria and quality limits, effective June 1. These updates may affect medication coverage, utilization management and prescribing processes across several therapeutic areas for patients with TennCare coverage.
Also in Tennessee, TennCare is currently conducting a cost-of-dispensing survey. The state, in collaboration with Mercer, opened the survey on June 1 and it will remain open through June 30.
An informational webinar was held on May 28 to review the survey process. If you anticipate needing an extension, please contact Mercer as soon as possible to discuss your options. Please note that the state is expected to continue applying a reduced dispensing fee of $5.00 for pharmacies that do not complete the survey.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gov. Phil Scot (R) signed NACDS priority legislation H.588 on June 8 to expand pharmacist test and treat authority across four conditions – Flu, Strep, COVID and HIV. The legislation received significant support from NACDS and its membership operating in the state and was widely endorsed by numerous in-state health groups and the Vermont Department of Health Access (DVHA). DVHA made recent references to the value of pharmacist test and treat services in its rollout of Rural Health Transformation Program (RHTP) grants.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
