Arkansas
Gov. Asa Hutchinson (R) appointed Mark White as the Secretary of the Department of Human Services, replacing Cindy Gillespie.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- Submission of Pricing Prior Authorization for Brand Medically Necessary Medications: Dispense as Written (DAW 1) (September 29)
- Enteral Nutrition: Powder Dispensed in Packets, Billing Units Reminder (September 27)
- CoverMyMeds: Provider Support (September 27)
- Enteral Nutrition Update: Changes to the List of Covered Enteral Nutrition Products, Retroactive to September 1, 2022 (September 23)
- Medi-Cal Rx Weekly Wrap-Up for September 16-22 (September 23)
Also in California, this week, Medi-Cal posted “Medi-Cal Provider “Coffee Break” Event.”
Finally in California, the Board of Pharmacy posted the agenda for the Enforcement and Compounding Meeting scheduled for October 4.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
As previously announced in a provider alert dated June 28, 2022 Provider Alert, the Agency for Health Care Administration (Agency) has been implementing Referring, Ordering, Prescribing, and Attending (ROPA) requirements as directed by the 21st Century Cures Act (Cures Act) and by the Centers for Medicare and Medicaid Services (CMS). Previous provider alerts on National Provider Identifier (NPI) requirements for ROPA providers can be found on the Agency’s website in the Provider Message Archive. Providers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b).
All Fee-For-Service claims submitted January 1, 2023, or after from a non-exempt provider type that does not have a ROPA provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed below, all other provider type claims must have a ROPA provider identified by NPI on the claim for reimbursement by Florida Medicaid.
In a provider alert dated June 28, 2022, the Agency previously set the effective date as October 1, 2022. To allow providers more time to prepare, we have extended the effective date to January 1, 2023. In addition, the Agency has continued to evaluate the effected provider types and has added several types to the exempted list.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
Gov. Eric Holcomb (R) administration that the state has $6.1 billion in reserve following the closeout of its fiscal year, having collected $353 million more in revenue than the current budget needs. Because of the new law passed during the special session, the first one billion dollars in excess goes to paying down debt in the teacher pension fund. The remaining surplus will be disbursed to taxpayers as part of the Governor’s inflation relief plan.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Board of Pharmacy Regulation Revisions Committee will be meeting on October 11 at their office in Baton Rouge to discuss these regulatory proposals.
Also in Louisiana, the Department of Insurance Office of the Commissioner promulgated Regulation 122 defining the roles and responsibilities solely within the purview of pharmacy benefit managers and pharmacy services administrative organizations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The agenda has been posted for the October 6th Board of Pharmacy meeting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
New Medicaid Paper Claims Billing Manual available online. In preparation for the Mississippi Division of Medicaid’s (DOM) transition to a new Fiscal Agent effective Oct. 3, a newly developed Paper Claims Billing Manual, produced by Gainwell Technologies, is available on the is available on the DOM website.
The Paper Claims Billing Manual is designed to offer guidance and assistance to providers submitting claims for reimbursement to DOM, including detailed information specific to the submission of paper claims.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The Board of Pharmacy next Lunch with the Chief Inspector online seminar is taking reservations for the October 13th compliance update.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services announced the selection of three health plans to provide health care services in Heritage Health, the state’s Medicaid managed care program. Molina Healthcare of Nebraska, Nebraska Total Care and UnitedHealth Care of the Midlands were selected; contracts will be effective January 1, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.