Michael Silber – Page 19

Texas

The Board of Pharmacy (TSBP) adopted and proposed several new rules at the May 7 Board meeting.

Also in Texas, the Pharmaceutical Initiative (TPI) met this week to discuss how to provide greater, more cost-effective access to prescription drugs and essential medical supplies for the health plans for state employees, retirees, Medicaid and CHIP. The three-member Board focused on developing a business plan and hiring an Executive Director.

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

Michael Silber2024-06-13T14:34:46-04:00June 13, 2024|Texas|

Vermont

On June 10, the Department of Vermont Health Access (DVHA) informed pharmacy providers of some important updates in the restoration of pharmacy services that were implemented in the Medicaid system, effective June 8.

Drug Pricing Updates:

NADAC (National Average Drug Acquisition Cost), AWP (Average Wholesale Price), FUL (Federal Upper Limit) and SMAC (State Maximum Allowable Drug Cost) drug pricing will be updated to reflect the most accurate and up-to-date pricing information.

New Drug Products and NDC (National Drug Code) Updates:

The Medicaid system will be updated to include the latest Medispan drug files which will add new drug products and NDCs that have been missing during the restoration process. This update will enhance Medicaid’s database with comprehensive information regarding the latest medications available.

SMAC Disputes:

Medicaid updated its contact information for SMAC disputes. Please note the updated email address below:

Email: smacdisputes@optum.com

Rejected Claim Issues:

Pharmacy Providers with claims still requiring assistance from the system outage (February 21, 2024 – March 18, 2024), please contact the Pharmacy Helpdesk at CHC/Optum for assistance.

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

Michael Silber2024-06-13T14:34:09-04:00June 13, 2024|Vermont|

Washington

The Health Care Authority (HCA) is hosting a webinar on June 25 at 11 :00 am Pacific time to educate providers on Apple Health (Medicaid) eligibility, benefits and expansion.

Also in Washington, Apple Health’s new point-of-sale system is live and processing claims. Providers are reminded to update to the new billing information for fee-for-service (FFS) clients:

New BIN = 024822
New PCN = DRWAPROD
New Group = CAID

Also In Washington, Apple Health’s new fax number is 833-991-0704.

Also in Washington, the Chief Science Officer signed an updated standing order that allows pharmacies to dispense the naloxone products to eligible persons and entities.

Also in Washington, HCA (Health Care Authority) published a revised Prescription Drug Program Billing Guide.

Finally in Washington, the Pharmacy Quality Assurance Commission (PQAC) is accepting applications to fill current and upcoming public member and pharmacist member vacancies. To qualify for a public member position, an individual must be a resident of Washington State and not affiliated with any aspect of pharmacy. To qualify for a pharmacist member position, an individual must be a resident of Washington State and, at the time of their appointment, have been a licensed pharmacist in Washington State for at least five consecutive years immediately preceding appointment.

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

Michael Silber2024-06-13T14:30:22-04:00June 13, 2024|Washington|

Alabama

Medicaid will begin to migrate the remaining recipients from the Alabama Medicaid Agency Eligibility System (AMAES) to the newer Centralized Alabama Recipient Eligibility System (CARES) in June 2024. Medicaid anticipates the process will be completed by July 1, 2024.

Medicaid recipients with a Medicaid ID number starting with 500 will get a new Medicaid ID number that starts with 530 (unless they already have a 530 Medicaid number). New Medicaid cards will be sent to recipients who do not already have a Medicaid card with the new 530 number.

Recipients in nursing facilities may receive a new Medicaid number but not a card. Medicaid is “linking” the old Medicaid ID number to the new Medicaid ID number. Recipients may continue to use the old Medicaid ID number during June 2024. Once numbers are linked, either number will work. Providers who need assistance may call the Medicaid Provider Assistance Center at 1-800-688-7989.

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

Michael Silber2024-06-06T16:10:05-04:00June 6, 2024|Alabama|

Arizona

The Board of Pharmacy will meet on June 19 and 20. Visit the Board’s website in advance to review the agenda.

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

Michael Silber2024-06-06T16:09:26-04:00June 6, 2024|Arizona|

California

The Department of Health Care Servies posted the following alerts, weekly report and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the “Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice”. Rates will be effective July 1, 2024, and were posted to the Mercer Medi-Cal Rx website no later than June 1.

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

Michael Silber2024-06-06T16:08:45-04:00June 6, 2024|California|

Colorado

HB24-209, practice act expansion, passed both houses and was sent to Gov. Jared Polis (D) to sign into law.

Also in Colorado, the Department of Health Care Policy and Financing (HCPF) submitted an 1115 Waiver Amendment requesting to the CMS an amendment to Colorado’s Expanding the Substance Use Disorder Continuum of Care Section 1115 demonstration waiver (1115 SUD (substance use disorder) waiver). For additional information and the entire amendment, contact hcpf_1115waiver@state.co.us.

Finally in Colorado, Gov. Jared Polis (D) signed HB24-1322, legislation providing Medicaid coverage for housing and nutrition services. HCPF (Department of Health Care Policy and Financing) now has the authority to pursue a Health-Related Social Needs (HRSN) 1115 demonstration waiver amendment to expand health-related social needs (HRSN) housing and nutrition services and support for certain eligible Health First Colorado (Medicaid program) members.

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

Michael Silber2024-06-06T16:08:09-04:00June 6, 2024|Colorado|

Connecticut

On June 4, the Department of Consumer Protection updated the proposed opioid warning label regulation upon some corrections from the Legislative Commissioner’s Office.

The Department of Consumer Protection has also given notice that it proposes to adopt a regulation concerning Emergency and Hormonal Contraceptives. Public comment period is 30 days from June 4.

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

Michael Silber2024-06-06T16:07:16-04:00June 6, 2024|Connecticut|

Florida

The University of Florida (UF) Health has been selected by the Centers for Disease Control and Prevention to lead a program that could reduce the health disparity gap in some Jacksonville communities by connecting patients with community pharmacists for help managing high blood pressure.

The Hypertension Pharmacists’ Program is scheduled to start this summer with the goal of expanding access to blood pressure care for the city’s medically underserved, predominantly Black communities.

The program aims to increase treatment for high blood pressure by embedding clinical pharmacists within a patient’s primary care team. The effort, facilitated by the UF Health Jacksonville Office of Community Engagement, is a collaboration among the UF Health Total Care Clinic – Jacksonville, the UF College of Pharmacy and Panama Pharmacy, and it will allow patients to see a specially trained pharmacist at a community pharmacy and seek individualized care and education.

Also in Florida, beginning July 1, 2024, hearing services for UnitedHealthcare of Florida, Inc. (United) will be provided by Audiology Distributors, LLC dba HearUSA. United is a Statewide Medicaid Managed Care plan operating in regions 3, 4, 6 and 11.

Providers that are out of network for hearing services as of July 1, will be eligible for a 60-day continuity of care period where claims will be payable to allow time for members to transition to a new provider, if necessary. All members were notified by mail of this transition. Members can still see their provider for up to sixty (60) days if they are currently receiving care from that provider. The continuity of care period will end on August 30.

If you are interested in becoming a participating provider with United for hearing services, please call HearUSA Member Services at 855-917-1967 or visit the HearUSA website.

For questions regarding this transition, contact United’s Customer Service Department at 1-877-842-3210.

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

Michael Silber2024-06-06T16:06:39-04:00June 6, 2024|Florida|

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