Gov. Mike Dunleavy (R) signed into law HB (House Bill) 145 which recognizes pharmacists as prescribers and mandates payment parity reimbursement for pharmacy services. The bill also broadens collaborative practice agreements, allows pharmacists to independently prescribe and dispense vaccines, and allows pharmacy technicians to administer vaccines and emergency medications. It will go into effect on September 28, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Notice of Final Rulemaking related to Pharmacist Delegation/Technicians was published in the “Arizona Administrative Register” with an effective date of July 2, 2022. See PDF pages 994-998.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New rules on therapeutic substitutions were adopted by the Board of Pharmacy, effective May 10, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health Care Services (DHCS) posted the July 2022 Durable Medical Equipment and Medical Supplies Bulletin 562 including the following updates:
In addition, the Part 1 – Program and Eligibility bulletin was posted to the Medi-Cal website.
Also in California, the DHCS posted the July 2022 Pharmacy Bulletin 1019 on the Medi-Cal website with content similar to the bulletin above with the addition of O&P Services Recategorized as Surgery Supplies.
Also in California, the DHCS posted "Paper RADs [Remittance Advice Details] AND No Pay Documents Will No Longer Be Mailed Due to Supply Chain Issues." Effective, July 18, 2022, RAD (Remittance Advice Details), EFT [Electronic Funds Transfer] and No Pay documents will only be available electronically. There is no impact on paper warrants or direct deposit payments. Additionally, the Medi-Cal Checkwrite Schedule will remain unchanged. Additionally, providers will be able to access them online PDF RADs and HIPAA 835 files as published. Providers who have not yet transitioned to the PDF RADs are encouraged to do so.
Also in California, the Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal.
Finally in California, the Board of Pharmacy posted its meeting agenda and meeting materials for the July 27-28 Full Board Meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The state Medicaid Health Coverage Programs' (IHCP) Drug Utilization Review (DUR) Board issued several updates in the IHCP Bulletin for pharmacies.
Also in Indiana, effective August 1, the IHCP will cover COIVD-19 Vaccine Counseling as part of Early and Periodic Screening, Diagnostic and Testing (EPSDT) benefit. Coverage applies to all IHCP programs for beneficiaries under the age of 21 who are eligible for EPSDT.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Walgreens pharmacist Troy Menard, a member of the Louisiana Board of Pharmacy, was chosen by his peers and honored by NACDS at the Louisiana Pharmacist Association Annual Convention's award ceremony as the "2022 Chain Pharmacist of the Year."
Also in Louisiana, effective July 1st, the Medicaid Fee for Service Pharmacy Program and Managed Care Organizations will be reduced 30-cents from $37.08 to $36.78 to align with the Medicare rate and Louisiana Medicaid Professional Services. No dispensing fee shall be reimbursed, only an administration fee. At home, administration of the COVID-19 vaccine for any dose will be increased 38-cents from $32.60 to $32.98 for a total reimbursement of $69.76 ($32.98 + $36.78) or billed charges, whichever is the lesser amount.
Also in Louisiana, the Department of Health (LDH) Bureau of Health Services Financing sent a reminder memo that Medicaid will begin denying claims on December 31, 2022, for providers that have not completed the enrollment process through the Medicaid Provider Enrollment Portal by September 30.
Also In Louisiana, Gov. John Bel Edwards signed into law HB 673/Act 723 that establishes a new Pharmacy Benefit Manager Advisory Council. Both NACDS and our in-state partner, the Louisiana Alliance for Retail Pharmacies (LARP) have designated seats on the Council. The purpose of the Council is to provide monitoring of pharmacy benefit managers in Louisiana to advise the legislature, commissioner of insurance, and Board of Pharmacy on the most effective and efficient manner of regulation of pharmacy benefit managers to ensure the protection of the public.
Also in Louisiana, on July 13th both the Prescription Benefits Manager Monitoring Advisory Council (PBM-MAC) and the Pharmacy Benefit Manager Council (PMPAC) held in-person meetings in Baton Rouge. NACDS has designated seats on both Councils.
Finally in Louisiana, on July 1, Medicaid implemented a new preferred drug list (PDL). There were no new therapeutic classes added to the PDL at the spring 2022 Pharmaceutical & Therapeutics (P&T) Committee meeting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
As the Mississippi Division of Medicaid's (DOM) transitions to a new Medicaid Management Information System (MMIS), the Department has announced a series of workshop webinars will be available in August and September to train providers in how to use the new system, MESA: Medicaid Enterprise System Assistance. Details about those webinars and instructions on how to register for them can be found on Gainwell Technology's new Learning Management System (LMS), which is now available online.
Only current Medicaid-enrolled providers will be able to access the LMS and register for training (the webinars are not intended for CHIP-only providers). To verify your status as a Medicaid provider, you are asked to:
Providers can also learn more about MESA and find the latest updates and FAQs on the system implementation on DOM's website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
On July 14, the MO HealthNet Pharmacy Program transitioned the Preferred Drug Searchable Database to a new vendor. If the new database is unavailable, providers may use the Pharmacy Clinical Edits and Preferred Drug Lists webpage.
Also in Missouri, MO HealthNet Division (MHD) will begin desk audits of providers to ensure proper billing units are used for drugs billed to MO HealthNet. Providers are responsible for proper billing of claims as outlined in Section 15 of the Pharmacy Provider Manual. Providers must have adequate documentation and these records must be made available to MO HealthNet upon request.
Also in Missouri, announced provider rate increases contingent on CMS approving the State Plan amendment (SPA). Until then, current rates remain in effect.
Finally in Missouri, Gov. Mike Parsons (R) signed into law two opioid bills effective August 28, 2022. HB 2162 expands the definition of opioid antagonists that can be dispensed under a prescriber's protocol or standing order to include addiction mitigation medications, and MO HB 2331 allows a pharmacist to dispense and opioid antagonist under a protocol or standing order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Medical Assistance Division (MAD) of the New Mexico Human Services Department (HSD) is requiring all prescribers including pharmacists with prescriptive authority for Centennial Care members to enroll as a Medicaid Provider by November 12, 2022, to continue to receive payment for prescriptions. Failure to enroll as a Medicaid Provider will result in denial, rejection, or recoupment of payment for prescriptions when written for Centennial Care members.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
