Michael Silber – Page 120

North Carolina

Please find here a notice from North Carolina Medicaid to permanently transition to a specific dispensing fee for North Carolina Medicaid based on the Cost-of-Dispensing Study performed every five years. This fee is currently $10.24. Also, included in this notice is North Carolina Medicaid’s decision to allow for more than one dispensing fee per month.

Also in North Carolina, see the Medicaid Special Pharmacy Newsletter providing Revised Procedures for Prior Authorization of palivizumab (Synagis®) for Respiratory Syncytial Virus Season 2022/2023 – Coverage starts Oct. 1, 2022.

Finally, effective with date of service Aug. 31, 2022, the NC Medicaid and NC Health Choice programs cover Pfizer-BioNTech COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5) – 12 years of age and older (N/A) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 91312 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, bivalent spike protein, preservative free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use.

Effective with date of service Aug. 31, 2022, the NC Medicaid and NC Health Choice programs cover Moderna COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5) – Booster Dose (N/A) for use in the Physician Administered Drug Program (PADP) when billed with HCPCS code 91313 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, bivalent, preservative free, 50 mcg/0.5 mL dosage, for intramuscular use. More information.

Providers are encouraged to review this information. All bulletin articles, including those related to COVID-19, are available on DHB’s Medicaid Bulletin webpage.

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

Michael Silber2022-09-30T12:36:35-04:00September 30, 2022|North Carolina|

Oklahoma

Gov. Kevin Stitt (R) appointed pharmacists Randy Curry D.Ph., and Shonda Lassiter, D.Ph, to the Board of Pharmacy.

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

Michael Silber2022-09-30T12:35:48-04:00September 30, 2022|Oklahoma|

Oregon

The Board of Pharmacy posted the agenda and meeting materials for its October 12-14 meeting.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2022-09-30T12:35:13-04:00September 30, 2022|Oregon|

Rhode Island

Please find the October 2022 provider update here.

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

Michael Silber2022-09-30T12:34:32-04:00September 30, 2022|Rhode Island|

Texas

The Board of Pharmacy has moved to the George H. W. Bush State Office Building. Their new mailing address is Texas State Board of Pharmacy, 1801 Congress Avenue, Suite 13.100, Austin, TX 78701. All telephone numbers, emails and faxes remain the same.

In advance of the October 3 Texas House Select Committee on Health Care Reform, NACDS submitted a statement recommending allowing pharmacists to permanently order and administer CDC/ACIP -recommended vaccines for ages 3 and older; permitting certified pharmacy technicians to also administer vaccinations to the same age group; and initiate corresponding treatment pursuant to the result of CLIA-waived tests.

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

Michael Silber2022-09-30T12:33:36-04:00September 30, 2022|Texas|

Washington

The Pharmacy Quality Assurance Commission (PQAC) is conducting an accessible labeling capability assessment survey to assess current pharmacy practices around providing accessible labeling options to patients, including whether such options are already made available, and what technological, financial, or resource-based obstacles prevent such options from being offered. PQAC filed a rulemaking inquiry (CR-101) to consider new and amended rules related to prescription label accessibility standards on issues pertaining to both visual/print disability access and the translation of prescription drug information for individuals for whom English is not a primary language.

Also in Washington, the Health Care Authority (HCA) is publishing quarterly updates to many of the Apple Health billing guides effective October 1, 2022.

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

Michael Silber2022-09-30T12:33:04-04:00September 30, 2022|Washington|

Wyoming

The Joint Corporations, Elections and Political Subdivisions Committee will meet October 13-14 to finalize interim work and prepare for the 2023 General Session.  The agenda includes PBMs at 3:30 p.m. on October 13. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2022-09-30T12:32:25-04:00September 30, 2022|Wyoming|

Arkansas

On September 19, the Insurance Department (AID) issued Rule 118, a final rule regulating Pharmacy Benefit Managers.

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

Michael Silber2022-09-23T13:33:00-04:00September 23, 2022|Arkansas|

California

The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.  

Diabetic Supplies Updates: Changes to the Lists of Covered Diabetic Test Strips and Lancets and Covered Self-Monitoring Blood Glucose Systems (Glucometers), Control Solutions, and Lancing Devices, Effective November 20, 2022 (September 20) 
Medical Supplies and Enteral Nutrition Coverage Reminder (September 19)
Now Active – Physician Administered Drug Policy Updates (September 16)
Now Active – Reinstatement of Limited Prior Authorization Requirements for 11 Drug Classes (September 16)
Medi-Cal Rx Weekly Wrap-Up for September 9-15 (September 16)
Informational Claim Message: Prescriber Enrollment (September 15) 
Medi-Cal Enrollment for Ordering, Referring, Prescribing Providers (September 15)

Also in California, Medi-Cal posted the following:  

Billing Update for Bebtelovimab Use for COVID-19 Treatment (September 20)
National Correct Coding Initiative Quarterly Update for October 2022 (September 16)
Addition of Novavax COVID-19 Vaccine (September 16)
Medi-Cal Update – Durable Medical Equipment and Medical Supplies – September 2022 – Bulletin 564 (September 16)
Medi-Cal Update – Pharmacy – September 2022 – Bulletin 1023 (September 16)
New Laboratory Test for Orthopoxvirus is a Medi-Cal Benefit (September 16)

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2022-09-23T13:31:54-04:00September 23, 2022|California|

About Michael Silber