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So far Michael Silber has created 2118 blog entries.

Ohio

The Department of Medicaid (ODM) announced the timeline for upcoming “catch up” payments of the managed care “supplemental” dispensing fee to pharmacies along with a revised FAQ with further detail on the amount of the payments and formula for determining which payment tier your company will receive. Members will recall that these payments, which pharmacies have been receiving over the last few years, were delayed in the first quarter of 2022 while awaiting CMS approval. 

Also In Ohio, on March 11 ODM is hosting an online seminar for pharmacies to give further details about the upcoming contracting process with their new SPBM (Single Pharmacy Benefit Manager), Gainwell Technology. Click here to register. 

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

2022-03-04T09:43:03-05:00March 4, 2022|Ohio|

South Carolina

Governor Henry McMaster issued Executive Order 2022-10 to suspend certain commercial vehicle regulations and provide transportation waivers to address the continued supply chain disruptions. The Governor’s executive order waives or suspends enforcement of certain state and federal regulations pertaining to registration, permitting and size. The read the full Executive Order click here 

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

2022-03-04T09:41:39-05:00March 4, 2022|South Carolina|

Tennessee

Please see the updates to PDL, Clinical Criteria, and Interim Criteria below and the attached documents for March 2022. These changes went into effect on March 1st 

  • Added to preferred: dimethyl fumarate, Dexilant, SPS, 
  • Added to non-preferred: Tecfidera, Tecfidera starter pack, dexlansoprazole, Dhivy, ciprofloxacin/dexamethasone, Epclusa pellet, Mavyret pellet
  • Added to interim: Rezurock, Vuity, Voxzogo,  
  • BaG additions: Dexilant 
  • BaG removals: Tecfidera, Tecfidera starter pack 
  • Hepatic C Direct Acting Antivirals prior authorization criteria and PA forms: removal of restrictions surrounding prior history of substance or alcohol abuse, where applicable, removed questions related to pregnancy, concomitant ribavirin use, and renal function dosage adjustments.  

Additionally, these documents can be found on the TennCare website: www.optumrx.com/tenncare  

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

2022-03-04T09:40:52-05:00March 4, 2022|Tennessee|

Virginia

The Pharmacy Channel Team at the Department of Health have published a recent version of the Vaccine Standing Order, which reflects recent CDC updates on COVID-19 vaccination guidance with additional information to help vaccinators determine the optimal interval between the first and second dose of an mRNA vaccine series, based on the individual patient.

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

2022-03-04T09:37:44-05:00March 4, 2022|Virginia|

Washington

The 60-day legislative session ends on March 10th. 

Also in Washington, the Health Care Authority (HCA) will submit to Centers for Medicare & Medicaid Services by July 15, 2022, a request to renew the Section 1115 Medicaid demonstration waiver, called the Medicaid Transformation Project (MTP), which will allow the state to create and continue to develop projects, activities, and services that improve Washington’s health care system using federal Medicaid funding. The new proposals include: 

  • Continuous Medicaid enrollment for children 
  • Extending coverage for postpartum services 
  • Re-entry services for individuals who are exiting jail, prison, or other correctional facility 
  • Enhancements to long-term services and support (LTSS) 

Finally in Washington, the Health Care Authority (HCA) aimed at increasing health care cost transparency and controlling health care cost growth include: 

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

2022-03-04T09:36:19-05:00March 4, 2022|Washington|

Wisconsin

Wisconsin Medicaid, ForwardHealth, has released an update on coverage of at-home COVID tests for Medicaid patients. As a reminder, Pharmacies must submit a claim for these tests as a prescription. There is a standing order in place from the Department of Health Services (DHS) Chief Medical Officer Dr. Ryan Westerguard. The pharmacists may order the tests and patients may receive 8 tests per 30-day period.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

2022-03-04T09:39:14-05:00March 4, 2022|Wisconsin|

Alaska

New rules relating to the Prescription Drug Monitoring Program (PDMP) go into effect on March 17, 2022. The regulations clarify the registration process to align with the account creation steps at alaska.pmpaware.net, replaces “registration” with “designation,” and establishes a new requirement for pharmacists and pharmacies to notify the board within 10 days of a change in dispensing/distributing status of controlled substances. The forms will be available in the coming weeks at pharmacy.alaska.gov.

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

2022-02-25T11:48:17-05:00February 25, 2022|Alaska|

California

The Department of Health Care Services posted the following alerts to the Medi-Cal Rx Web Portal: 

 Also in California, COVID-19 related news highlighted below: 

 Finally in California, the Department of Health Care Services is proposing a budget trailer bill language to require Medi-Cal pharmacy providers to maintain records for ten years, consistent with federal law.  The current requirement in the state is three years. DHCS prepared this fact sheet about the proposal.     

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

2022-02-25T11:47:36-05:00February 25, 2022|California|
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