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So far Michael Silber has created 2052 blog entries.

Oregon

The Division of Financial Regulation recently announced  permanent rulemaking repealing 836-053-0025, the regulation of the insulin co-pay amount for health benefit plans for the state, as a result of SB 1508 (2024) effective January 1, 2025.

Also in Oregon, the Division of Financial Regulation recently announced permanent rulemaking amending 836-052-1000, establishing and updating the list of prosthetic and orthotic devices; prohibiting internal or separate limits or caps on prosthetic and orthotic devices, other than the lifetime policy maximum, when permitted by law; and defining when coverage for prosthetic and orthotic device is provided through a managed care organization effective January 1, 2025.

Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted an agenda and meeting materials for its December 18 meeting. You must register in advance to participate.

Finally in Oregon, the Oregon Prescription Drug Affordability Board has posted to the website the UPL report for the Oregon Legislature pursuant to ORS 646A.685.

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

2024-12-13T10:24:40-05:00December 13, 2024|Oregon|

South Carolina

The Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments to accommodate the December 2024 and January 2025 holidays. Due to observance of the Christmas holiday, December 19 at 5:00 pm is the deadline to submit claims for payment date December 27. Electronic remittance advice will be available December 24. Payments will be dated December 27, as usual. Due to observance of the New Year’s holiday, December 27 at 5:00 pm is the deadline to submit claims for payment date January 3. Electronic remittance advice will be available December 31. Payments will be dated January 3rd, as usual. The schedule will return to the normal payment cycle on January 3, 2025.

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

2024-12-13T10:24:10-05:00December 13, 2024|South Carolina|

Tennessee

TennCare released a document summarizing the temporary changes in counties impacted by Hurricane Helene, aligning with Gov. Bill Lee’s (R) Executive Order No. 105. These changes aim to provide relief to victims of severe weather and flooding and will remain in effect until December 25, 2024.

Also in Tennessee, all pharmacies participating with TennCare and OptumRx are encouraged to contact their provider liaison for any processing issues or questions.

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

2024-12-13T10:23:14-05:00December 13, 2024|Tennessee|

Alabama

Pharmacist registrations with Board of Pharmacy expire December 31, 2024. The Board of Pharmacy is accepting pharmacist license renewals online only. As a reminder, the Board transitioned to a new database last month. The new system and renewal process look different, and the changes will require individuals to create a new account to renew licenses. Pharmacies and facilities will not need to create a new account. Instead, each pharmacy will be linked to the supervising pharmacist, and each facility will be linked to the designated representative. For information, watch the tutorial videos on the ALBOP YouTube channel.

Also in Alabama, effective January 1, 2025, the Alabama Medicaid Agency’s Durable Medical Equipment (DME) Program will cover E2298, PWR SEAT ELEVATION SYS (Power Seat Elevation System), for adults 21 years of age and older. Prior authorization (PA) will be required. E2298 will continue to be covered for children under 21 years of age with a PA. The limit will be one (1) per two (2) calendar years for both adults and children. Policy questions concerning this provider notice should be directed to the DME Program at (334) 242-5050.

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

2024-11-14T10:50:57-05:00November 14, 2024|Alabama|

Arizona

This week, state legislators met to elect new caucus leadership as follows:

  • House Republicans:
    • House Speaker Steve Montenegro (R-Goodyear)
    • House Majority Leader Michael Carbone (R-Buckeye)
    • House Majority Whip Julie Willoughby (R-Chandler)
  • House Democrats:
    • Minority Leader Oscar De los Santos (D-Laveen)
    • Minority Assistant Leader Nancy Gutierrez (D-Tucson)
    • Minority Co-Whip Quantá Crews (D-Phoenix)
    • Minority Co-Whip Stacey Travers (D-Phoenix)
  • Senate Republicans:
    • President Warren Petersen (R-Gilbert)
    • Majority Leader Janae Shamp (R-Surprise)
    • Majority Whip Frank Carroll (R-Sun City West)
    • Majority Whip Frank Carroll (R-Sun City West)
  • Senate Democrats:
    • Minority Leader Priya Sundareshan (D-Tucson)
    • Assistant Minority Leader Flavio Bravo (D-Phoenix)
    • Minority Whip Rosanna Gabaldón (D-Green Valley)

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

2024-11-14T10:49:25-05:00November 14, 2024|Arizona|

Arkansas

NACDS sent a support letter to Arkansas Commissioner of Insurance Alan McClain on Rule 128, the Pharmacy Benefits Manager Compensation Requirements for Network Adequacy, Fair and Reasonable Pharmacy Reimbursements. Without meaningful actions, like Emergency Rule 128 which protects patients by prohibiting health plans and PBMs administering benefits on behalf of a health plan from recouping or recovering any increased costs to dispense from a patient at the point of sale through increased co-insurance, co-payment, or deductibles, more dollars will continue to flow to PBMs instead of reducing Arkansans’ prescription drug costs and safeguarding access to their trusted and convenient pharmacies. The enforcement of Rule 128 by Commissioner McClain will protect vital access to lifesaving prescription drugs and pharmacy services for Arkansans across the state.

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

2024-11-14T10:49:30-05:00November 14, 2024|Arkansas|

California

The Department of Health Care Services posted the following alerts, weekly notice, and monthly bulletin on the Medi-Cal Rx Web Portal:

Also in California, Proposition 36, The Homelessness, Drug Addiction and Theft Reduction Act, passed resulting in various changes to criminal and drug laws, including increasing penalties for some offenses, and providing treatment programs for people with drug addictions. Proposition 36 increases punishment for some theft and drug crimes in three ways: 1) turns some misdemeanors into felonies; 2) lengthens some felony sentences; and 3) requires some felonies be served in prison.

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

2024-11-14T10:46:04-05:00November 14, 2024|California|

Colorado

State House Democrats elected their slate of leaders for the 2025 session, including re-electing House Speaker Julie McCluskie (D), who is entering her fourth and final term. The full House must ratify Rep. McCluskie’s nomination when it convenes on January 8, 2025.

Also in Colorado, Senate Republicans elected new leaders this week. State Sen. Paul Lundeen (R) remains as Minority Leader.

Finally in Colorado, Phase III of the Medicaid program Accountable Care Collaborative (ACC) is scheduled to begin July 1, 2025. The Department of Health Care Policy and Financing (HCPF) developed the program with stakeholder input to improve quality of care, close health disparities, improve care access, improve the member as well as provider experience and manage costs, which is critical to protecting member coverage, benefits and provider reimbursements, especially in tight state budget years.

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

2024-11-14T10:45:11-05:00November 14, 2024|Colorado|
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