Michael Silber, Author at In The States

Kentucky

MedImpact issued a bulletin outlining the following COVID-related coverage and policy changes, effective Oct.1 2024, pursuant to the expiration of the American Rescue Plan (ARP):

COVID-19 OTC tests will be limited to four per member per rolling 90 days. Patients requiring more tests will be required to submit a prior authorization request for review. Kentucky’s Statewide Physician Protocol for Point of Care COVID-19 Testing will be updated to reflect the changes to allowed quantity limits.
The COVID-19 vaccine administration fee will remain the same. Pharmacies administering COVID-19 vaccines will continue to be reimbursed at $40.
Pharmacies may continue to bill CPT code 99401 for standalone vaccine counseling.
COVID-19 treatments classified as EUA (Emergency Use Authorization) may be subject to additional prior authorization review for coverage.

Also in Kentucky, Medicaid issued a Statewide Physician Protocol for Point of Care COVID-19 Testing. The protocol, meant for pharmacies who do not have a medical director, applies only to testing for Medicaid patients.

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

Michael Silber2024-09-19T10:50:03-04:00September 19, 2024|Kentucky|

Louisiana

The Department of Health (LDH) issued a memo clarifying they are continuing to reimburse pharmacies for at-home OTC COVID-19 diagnostic tests to Medicaid patients through December 31, 2024.

Also in Louisiana, on September 9, 2024, Governor Jeff Landry declared a state of emergency for Tropical Storm Francine. LDH issued a memo detailing the procedures for emergency prescriptions claims for Medicaid beneficiaries

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

Michael Silber2024-09-19T10:49:19-04:00September 19, 2024|Louisiana|

Maine

The Board of Pharmacy held a pharmacy rule-making subcommittee meeting on September 16, 2024, regarding updating the board rules. The subcommittee goals are

Protect the public
Update/Modernize current rules
Streamline to eliminate repetition, separate rules from statutes
Create an easy-to-use reference for all stakeholders
Ensure our rules align with current Federal law and allow for modern pharmacy practice

They reviewed chapters four and five of rules, which cover registration and continuing education. The next meeting will be October 21, 2024.

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

Michael Silber2024-09-19T10:48:51-04:00September 19, 2024|Maine|

Michigan

Sen. Santana has introduced SB 993, a “trailer” bill that require insurers to reimburse pharmacies for the vaccination and test and treat services authorized under P.A. 97 of 2023. The bill was referred to the Senate Health Policy Committee and could see action as early as this fall.

Also in Michigan, the Department of Health, and Human Services (MDHHS) has issued a final bulletin ending three temporary COVID-19 Medicaid Pharmacy provisions due to the COVID-19 PHE.

HASA 22-02 – Authorization of U.S. Food & Drug Administration (FDA) Emergency Use Authorization (EUA) pharmacist prescriptive authority of oral antivirals for the treatment of COVID-19;
MMP 22-29 – Coverage of FDA EUA COVID-19 monoclonal antibody injections by pharmacy providers; and
L 22-04 – Stand-alone vaccine counseling services billed as a Medication Therapy Management service.

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

Michael Silber2024-09-19T10:48:17-04:00September 19, 2024|Michigan|

Minnesota

DHS has published a provider update with details about the November 4^th transition to the new claims processing system. On October 16 they will host what they anticipate will be the last provider virtual meeting prior to implementation and have posted the call in information. Lastly, they have also released the payer specification document for claims processing and billing.

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

Michael Silber2024-09-19T10:47:37-04:00September 19, 2024|Minnesota|

New Hampshire

The New Hampshire Board of Pharmacy will be holding a hearing on September 25, 2025, at 9:30 am to review the repeal of three rules. The three rules being repealed are (1) in regard to unused prescription drugs, (2) the New Hampshire Controlled Drug Prescription Health and Safety Program, and (3) Continuous Quality Improvement. In lieu of attending, written comments can be submitted to OPLC-Rules@oplc.nh.gov.

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

Michael Silber2024-09-19T10:47:02-04:00September 19, 2024|New Hampshire|

New York

On September 5, Governor Hochul signed into law the Retail Workers Safety Act, which requires employers to implement policies and training programs to prevent workplace violence. It requires a retail store with 500 or more employees to install panic buttons in all New York locations. The Department of Labor would be required to create a model workplace violence prevention training program, policy, and guidance document to be utilized by employers. The law is effective March 4, 2025, however the section requiring panic buttons would take effect January 1, 2027.

On September 13, 2024, the New York Pharmacy Conference held its regular meeting. The meeting included updates from Donate Life New York State, the Comprehensive Contraceptive Coverage Act, and Expansion of Collaborative Drug Therapy Management to offsite practices, and a legislative update from Assemblyman John McDonald. The next meeting of the conference will be held on Friday December 13, 2024, at 10 AM.

On September 18, 2024, the New York Department of Health held their monthly pharmacy industry call regarding NYRx, the Medicaid Fee-For-Service Program. This month’s call included updates on Blood Glucose Test Strip Coverage Policy and Covid Tests Coverage Policy Update.

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

Michael Silber2024-09-19T10:46:14-04:00September 19, 2024|New York|

Ohio

The Board of Pharmacy published the following final rules:

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

Michael Silber2024-09-19T10:45:39-04:00September 19, 2024|Ohio|

Oregon

The Prescription Drug Affordability Board (PDAB) moved its next meeting from September 18 to October 2 due to unforeseen scheduling issues and lack of a quorum. The agenda has been updated to reflect this change. Please note the “Medicare MFP modeling presentation and SB 192 upper payment limit discussion” by PDAB staff and Myers and Stauffer on the agenda. You must register in advance of the meeting to participate.

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

Michael Silber2024-09-19T10:44:57-04:00September 19, 2024|Oregon|

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