The New York State Department of Health has proposed to amend regulations to limit the Medicaid fee for service prescriptions to a maximum of 11 refills within a 12-month issuance. Comments are due by March 6, 2022.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The January 18th Board meeting will be conducted via Microsoft Teams. You will be able to join the meeting either by downloading the Microsoft Teams app or you may open the link in a web browser. Simply click on this link at the start of the meeting. If you prefer to attend the meeting by phone, call (336) 604-5350. The conference ID is 907 040 796#. You may view the agenda here.
Also in North Carolina, NC Medicaid is increasing the reimbursement for COVID vaccine administration from $40 to $65. The effective date of the rate change will be retroactive to April 1, 2021. All claims previously submitted with dates of service from April 1, 2021, through the NCTracks implementation date of the rate change will be systematically reprocessed. No action will be required by providers to receive the retroactive rate increase.
Finally in North Carolina, the Board of Pharmacy issued the following guidance regarding the role of pharmacists in oral therapeutics to treat COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Blue Cross Blue Shield of North Dakota is providing coverage to the Medicaid expansion population effective January 1, 2022. See the Medicaid Expansion Provider Manual for information to submit claims for pharmacist administered vaccines.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Board of Pharmacy ‘s January 19, 2022, Board Meeting will be shown via YouTube. The meeting will begin at 9:00 am. View the agenda here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy published its January 2022 Newsletter, including information about the new Prescription Drug Monitoring Program NarxCare Report called “Tile View”, an update on the drug take-back program, and other information of interest to pharmacies and pharmacists.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Virginia Department of Health (VDH) has issued an updated COVID-19 standing order to include the latest CDC recommendations.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The State Health Care Authority (HCA) issued a statement that while they are not able to implement at this time, HCA is working to create a process to meet these legislative mandates in a law passed last year, Substitute Senate Bill 5195. The law requires HCA to reimburse hospitals, behavioral health agencies, or pharmacies who dispense opioid overdose reversal medication to uninsured individuals by January 1, 2022. The plan will include a process to back-dated opioid reversal medication claims to January 1, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The 2022 list of 100 most used generic prescribed drugs has just been released. Each Wisconsin pharmacy must provide notice to the public on how it may access the Pharmacy Examining Board list.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Effective January 1, 2022, the Alabama Medicaid Agency will have contracts with eight companies that offer Medicare Advantage coverage in Alabama: Aetna Better Health, Inc., Arcadian Health Plan, Inc. (Humana), Centene Venture Company Alabama Health Plan, Inc. (Ascension Complete), HealthSpring Life & Health Insurance Company, Inc. (CIGNA), Simpra Advantage, Inc., UnitedHealthcare of the Midlands, Inc., VIVA Health, Inc., and WellCare of Alabama, Inc.
Providers are encouraged to check Medicaid’s Eligibility Verification File, under the Managed Care Section, to determine if capitation payments have been made for recipients during a particular month. If a capitation payment has not been made, providers should refer to Chapter 5 of the Provider Billing Manual, Sections 5.6.1 – 5.6.2, for claims filing instructions. Questions may be directed to Shari Rudd at (334) 353-3403 or shari.rudd@medicaid.alabama.gov.
Also in Alabama, the Board of Pharmacy is reporting that only 35% of licensed technicians have renewed their licenses. Please be aware that the submission of a renewal by the December 31 deadline does not mean that individuals are clear to work on January 1. The renewals must be processed, not just submitted. We recommend that you renew your license NOW, with plenty of lead time to handle any issues that may come up.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.