Michael Silber – Page 170

Virginia

The Board of Pharmacy has published final emergency regulations authorizing pharmacists to initiate treatment with certain drugs, devices, controlled paraphernalia, and other OTC supplies and equipment for adult patients became effective December 22, 2021. Pharmacists may now utilize the new statewide protocols to initiate treatment for vaccines, TB, HIV PeP and PrEP, and over-the counter medications when they decrease a patient’s out-of-pocket expenses. The regulations are a result of legislation that members, allies and NACDS worked on in the 2021 legislative session.

Also in Virginia: The Department of Health has published a Revised COVID-19 Vaccine Standing Order has been updated and posted here. Also refer to the revised Summary of Legal Authorities for Pharmacists to Administer COVID-19 Vaccine. The updates to the Standing Order include:

Allowing any COVID-19 vaccine booster to be administered at an interval of 5 months, rather than 6 months, after completion of the Pfizer-BioNTech primary series (any COVID-19 vaccine booster remains recommended 6 months after a Moderna vaccine primary series and 2 months after Johnson & Johnson vaccine)

Children 12-17 years old are recommended to receive a Pfizer booster vaccine 5 months following their primary series
Children 5-11 years old who are immunocompromised are recommended to receive a 3rd Pfizer dose as part of their primary series 28 days after 2nd dose

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2022-01-07T17:13:45-05:00January 7, 2022|Virginia|

Alabama

Changes described in the ALERT dated November 5, 2021, regarding the replacement of Claim Adjustment Reason Code (CARC) Code 45 with CARC Code (96) will not be implemented. Gainwell verified CARC Code 45 still conforms to the Payment & Remittance Uniform Use of CARCs and RARCs (835) Rule. As a result, Alabama Medicaid will continue using CARC Code 45 to indicate pricing adjustments to payments due to fee schedules/allowed amounts.

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

Michael Silber2021-12-17T11:59:48-05:00December 17, 2021|Alabama|

California

The Department of Health Care Services continues to post and publish information to prepare pharmacy providers for the implementation of Medi-Cal Rx effective January 1, 2022.  See “Medi-Cal Rx begins January 1st, are you ready?”. Note: use this link Office Hour Luncheon Session ,which is only available Monday-Friday, 12 p.m. to 1 p.m. PST (excluding holidays).  Please note the prior authorization process and other essential information. Lastly, the Medi-Cal Rx customer service number is 1-800-977-2273 and is available 24 hours a day, 365 days a year after January 1, 2022. The Customer Service Center published a list of Main Menu Prompt Options.

Also in California, the Medi-Cal Rx Web Portal has been updated with the following. Note: Medi-Cal Rx will be implemented effective January 1, 2022. 

Also in California, the Department of Health Care Services (DHCS) published its Stakeholder Communication Update – December 2021. Highlights include the following. See update for details and additional information.

Continuous glucose monitors, as a pharmacy-billed medical supply benefit through Medi-Cal Rx, will be covered effective January 1, 2022. See Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-for-Service Frequently Asked Questions (Version 10.0 – December 3, 2021).
Medi-Cal Rx: For questions or comments related to Medi-Cal Rx, email RxCarveOut@dhcs.ca.gov
CMS has approved SPA 21-0028, adding MTM as a payable Medi-Cal Fee-for-Service pharmacy service provided in conjunction with certain complex chronic medical conditions. participate in the program, Medi-Cal-enrolled pharmacies will be required to enter a contract with DHCS.

Also in California, the Department of Consumer Affairs issued a news release reminding providers of mandatory e-prescribing requirements effective January 1, 2022, pursuant to AB 2789 (Chapter 438, 2018).

Finally in California, the Department of Justice (DOJ) recently announced that Bamboo Health will be the new vendor for prescription data collection services for the Controlled Substance Utilization Review and Evaluation System (CURES). Additional details and information will be provided in the coming weeks regarding the transition process in early 2022 from the current vendor, Atlantic Associates Inc. (AAI), to the new vendor, Bamboo Health.

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

Michael Silber2021-12-17T11:59:11-05:00December 17, 2021|California|

Georgia

The Georgia Medicaid Fee-For-Service pharmacy system has now been updated to accept a pharmacist’s NPI as the prescriber ID on flu vaccine claims using a Submission Clarification Code = 42. The below communication will be sent in an upcoming pharmacy banner.

PHARMACIST ORDERED FLU VACCINES

The U.S. Department of Health and Human Services (HHS) issued an eighth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act), expanding the authority for pharmacists to order influenza vaccines. For flu vaccine claims with fill dates on or after 08/04/2021, pharmacies may utilize a Submission Clarification Code (SCC) of 42 in NCPDP Field: 420-DK in response to a rejection regarding prescriber NPI when the prescribing NPI is the pharmacist of record and is compliant with state and federal guidlines.

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

Michael Silber2021-12-17T11:57:43-05:00December 17, 2021|Georgia|

Iowa

The Board of Pharmacy published a Notice of Intended Action to amend the following. The deadline for comments is January 4, 202,2 at 4:30 p.m. Central.

Chapter 10, “Controlled Substances” (ARC 6082C)
Chapter 13, “Telepharmacy Practice” (ARC 6083C)

Also, the Board adopted and filed Chapter 3 “Pharmacy Technicians” (ARC 6071C) which is currently in effect as an emergency rule.

Lastly, the Board published the following adopted and filed rules effective January 19, 2022:

Chapter 3, “Pharmacy Technicians” (ARC 6071C)
Chapter 8, “Universal Practice Standards” (ARC 6073C)
Chapter 10, “Controlled Substances” (ARC 6074C)
Chapter 3, “Pharmacy Technicians,” Chapter 8, “Universal Practice Standards,” Chapter 20, “Compounding Practices,” and Chapter 39, “Expanded Practice Standards” (ARC 6076C)
Chapter 21, “Electronic Data and Automated Systems in Pharmacy Practice” (ARC 6077C)

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

Michael Silber2021-12-17T11:56:30-05:00December 17, 2021|Iowa|

Kentucky

MedImpact has published a bulletin with override codes for early refills for patients impacted by tornadoes in Kentucky.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2021-12-17T11:55:44-05:00December 17, 2021|Kentucky|

Louisiana

The Department of Health (LDH) issued a revised Bulletin 19-3 outlining provider’s options have to resolve issues with Medicaid Managed Care Organizations. (MCOs)

Also in Louisiana, despite objections from some lawmakers and the Attorney General, Gov. John Bel Edwards (D) announced that he is adding COVID-19 vaccinations to the list of required shots for students to attend schools and universities, effective for the 2022-23 school year.

Finally in Louisiana, NACDS submitted written comments to the Louisiana Board of Pharmacy in support of proposed rules that make permanent certain authorities for pharmacy technicians and interns authorized under the PREP Act. Specifically, the proposed rules would codify authority for pharmacy technicians and interns to administer vaccines, in addition to making other changes to the existing rules that simplify existing administrative requirements for vaccines provided by pharmacy providers. The Board will hold a public hearing on December 28, 2021.

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

Michael Silber2021-12-17T11:55:10-05:00December 17, 2021|Louisiana|

Minnesota

The Minnesota Department of Health (MDH) will host a public, virtual meeting on Wednesday, December 29, 2021, at 2 p.m. CST to demonstrate the functionality of the registration system and provide an update on the technical build for the Prescription Drug Price Transparency Act (the “Act”) (Minnesota Statutes 62J.84; amended by Minnesota Laws, 2021, Regular Session, Chapter 30 – HF 2128 – Article 3, Sec. 5 – 9). To join, use the Webex Meeting Link, Meeting Number (access code): 2494 346 4226, Meeting Password: tXaTGFdT722. MDH will post–meeting materials on the Prescription Drug Price Transparency Meetings page. Additional information is available online at www.health.state.mn.us/data/rxtransparency, where interested individuals and stakeholders may also subscribe to periodic updates.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2021-12-17T11:54:01-05:00December 17, 2021|Minnesota|

Missouri

The RX Cares for Missouri Program, administered by the Missouri Board of Pharmacy, is seeking grant funding proposals for the purpose of developing or providing programs or education to promote medication safety or prevent prescription drug abuse, misuse, and diversion.

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

Michael Silber2021-12-17T11:53:05-05:00December 17, 2021|Missouri|

About Michael Silber