New York
On October 9, the Board of Pharmacy held its regular scheduled meeting. The agenda included the report of the 2024 Pharmacy Workplace Survey.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
The Office of Emergency Medical Services seeks pharmacists to assist with medical response in Western North Carolina due to Hurricane Helene. A minimum deployment of three consecutive days is preferred. If interested, sign up here and note your availability in the comments section. For questions, email OEMSSupportCell@dhhs.nc.gov.
Also in North Carolina, with Western North Carolina seeing conditions of catastrophic proportions due to Hurricane Helene, there are still many areas without power or cell service and individuals are stranded on islands due to massive road closures. If your company plans to move people, resources or equipment into western North Carolina, you must coordinate plans and movements through NCEM at BEOC@ncdps.gov and copy elizabethr@ncrma.org
Finally, the Department of Health and Human Services (DHHS) is committed to ensuring continued access to care for Medicaid beneficiaries, as well as reimbursement to qualified providers for services rendered, in good faith, throughout the period of impacts from Hurricane Helene, retroactively from September 25 through October 15 (unless otherwise communicated by DHHS).
- The Centers for Medicare & Medicaid Services (CMS) granted approval effective October 1 for DHHS to implement a temporary, expedited enrollment process for health care professionals to become a Medicaid provider due to a natural disaster. This process is not for providers who regularly see Medicaid beneficiaries.
Health care professionals who will be rendering services to Medicaid beneficiaries due to Hurricane Helene can complete and apply through the NCTracks Provider Portal. Please refer to the disaster provider enrollment job aid Disaster Relief Provider Enrollment Application Job Aid (PRV703) located under Quick Links on the NCTracks Provider Enrollment home page for necessary instructions to complete the temporary disaster provider enrollment application. Be sure to review the job aid before starting to complete the application, as several preliminary steps are necessary.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Gainwell delivered a communication this week to notify pharmacies that the 2025 Payment Error Rate Measurement (PERM) program is now in progress. The Department of Medicaid (ODM) is mandated to participate in PERM by the Centers for Medicare and Medicaid (CMS). The program will assess payment accuracy rate for the Medicaid and CHIP programs. If chosen in a random sample, your pharmacy will soon receive a Medical Records Request from the CMS review contractor, Empower AI. This cycle measurement will review Medicaid and CHIP payments made in Reporting Year (RY) 2025: July 1, 2023, through June 30, 2024. ODM may recover payments made to providers who fail to cooperate by the established deadlines. Providers must retain recipient records for six years from the date of payment, under the terms of the Provider Agreement, even if they no longer do business with ODM. For more information about PERM, please visit the Provider link on the CMS PERM website. A video explaining the process is also available. For questions, please contact the ODM Medicaid Audit Coordination Team.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted a draft agenda for its October 16 meeting. Please note the discussion of “Policy recommendations for the Oregon Legislature” and SB 192 upper payment limit study. You must register in advance of the meeting to participate.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
Please see the October 2024 Provider Update from Medicaid. All previous provider updates may also be found online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
The Board of Pharmacy has issued guidance on the state of emergency regarding out-of-state pharmacies and emergency refills.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Gov. Bill Lee (R) issued an executive order allowing pharmacist to dispense a 30-day supply of medication (excluding controlled substances) without prior authorization for victims of Hurricane Helene. This order remains in effect until November 10. The Tennessee Pharmacy Association has compiled a list of resources and ways to support the impacted communities as relief efforts continue. Recent Department of Commerce and Insurance (TDCI) Bulletin 24-03 also provides for one early or replacement prescription refill per medication; see last bullet on page 2.
Also in Tennessee, the Tennessee Pharmacy Association requests your participation in the TennCare Diaper Program Survey. The feedback will provide data that will be shared directly with TennCare pharmacy leadership addressing reimbursement rates, administrative fees, successes and difficulties that pharmacy professionals have experienced since the diaper program launch.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Texas Pharmaceutical Initiative (TPI) Board established by HB 4990 (2023) submitted its business plan recommendations to Gov. Greg Abbott (R), the Legislature and the Legislative Budget Board on September 30. TPI’s goal is to provide greater, and more cost-effective access to prescription drugs and essential medical supplies to employees, dependents and retirees of public higher education systems; members of the Employees Retirement System of Texas (ERS); members of the Teacher Retirement System of Texas (TRS); individuals under the Texas Department of Criminal Justice or Texas Juvenile Justice Department; and individuals served by health and human services programs, including Medicaid and the Child Health Insurance Program.
Also in Texas, last month, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP announced that HHSC suspended its efforts to conduct pharmacy cost of dispensing and ingredient cost studies. The reason given was that “As in recent past legislative sessions, the 89th Legislature may choose to contemplate pharmacy reimbursement matters which could significantly influence how HHSC approaches and obtains necessary appropriations for pharmacy reimbursement in both fee-for-service and managed care settings.”
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts and weekly notice on the Medi-Cal Rx Web Portal:
- Pemgarda™ (pemivibart) Now a Medi-Cal Rx Benefit
- User Administration Console (UAC) URL Update
- Medi-Cal Rx Weekly Wrap-up for September 13-19
Also in California, NACDS submitted a letter to the Board of Pharmacy expressing concerns with proposed rules updating the Board’s quality assurance program regulatory requirements. The primary concern is that these amendments could potentially put pharmacies that are members of Patient Safety Organizations (PSOs) at odds with the requirements set forth in the Patient Safety and Quality Improvement Act of 2005 (PSQIA) and recommended the Board further analyze these amendments. Additionally, we requested a one-year delayed implementation of this regulation to allow pharmacies sufficient time to update their policies and systems to comply.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.