The Department of Health and Human Services (HHS), Iowa Medicaid posted INFORMATIONAL LETTER NO. 2630-MC-FFS 2024 Pharmacy Dispensing Fee Increase. Effective October 1, 2024, the Iowa Medicaid dispensing fee increased from $10.38 to $10.63 based on the 2022 Cost of Dispensing survey.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
MedImpact issued a communication to pharmacies this week as a reminder about each managed care organizations (MCO) lock-in policy, including a list of each MCO’s criteria.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Health issued Informational Bulletin 24-33. Open Enrollment for Medicaid members starts on October 15 and ends on December 2. During this period, members may change their health or dental plans without a qualifying reason.
The Prescription Drug Affordability Board met on October 7. The meeting’s main purpose was to finalize the draft for the questionnaire for public payors and to provide an update from the legislative planning workgroup, specifically concerning LD 1829. The Board is scheduled to meet next on November 25 at 10:30 am.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Prescription Drug Affordability Board (PDAB) and Stakeholder Council (PDASC) announced upcoming meeting schedules:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
On October 4, MassHealth released the results of its cost of dispensing study. It was announced that the proposed updated dispensing fee for chain pharmacies will be reduced by $1.51 per prescription from $10.02 to $8.51. This proposed change is scheduled to take effect on July 1, 2025. The dispensing fee for independent pharmacies will be increased by 19 cents to $10.21. The division also announced a policy change that will require managed care organizations (MCOs) to pay the MassHealth fee-for-service rate to independent pharmacies instead of the current managed care contract rate. MCOs will continue to pay chain pharmacies the negotiated contract rate. The raw data from the cost of dispensing survey is expected to be made available within the next two weeks. The proposed amendments will be submitted to CMS for its approval.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Board of Pharmacy posted a notice and agenda for a Rules Committee Workgroup on November 4. Instructions for attending the meeting are included in the notice.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Looking for ways to reduce healthcare costs for Missourians, six Senators have been named to the newly formed Senate Interim Committee on Driving Down the Cost of Healthcare. The committee will issue a report and recommendations by the end of the year
Also in Missouri, effective October 1, the MO HealthNet Pharmacy program discontinued coverage for at-home COVID-19 tests dispensed as a kit for at-home use. COVID-19 testing will continue to be covered for MO HealthNet participants when administered by a MO HealthNet enrolled provider.
Finally in Missouri, St. Louis Public Radio Morning Edition published online a PBM reform story about St. Louis-based Express Scripts being sued by the Federal Trade Commission (FTC). Pharmacists and patient advocates are advocating for lower drug prices.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy posted the agenda for the two-day hybrid meeting in Las Vegas scheduled for October 16 and 17. On October 17 there will be a public hearing on proposed rules regarding documentation a pharmacy must obtain from a person before dispensing a controlled substance prescription.
For more information, contact NACDS’ Mary Staples at 817-442-1155.