Michael Silber, Author at In The States

California

The Department of Managed Health Care announced All Plan Letter 21-011 to provide an overview of new guidance from the federal Departments of Labor, Health and Human Services, and the Treasury that address the implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and other health coverage issues related to COVID-19. The letter discusses coverage of diagnostic testing, especially public health surveillance testing.

Also in California, The Board of Pharmacy posted its monthly news roundup. Among the items of interest are the March 2021 issue of “The Script” with articles about new pharmacy laws, new requirements for controlled substance prescription forms and for reporting to CURES, tips on how to avoid processing delays for pharmacy technician license applications, and a reminder that pharmacists-in-charge are required to complete a self-assessment of the pharmacy’s compliance with state and federal laws before July 1 of each odd-numbered year. Current forms and draft versions under review for possible adoption are available online under “Facility License Information/Renewal.” Effective April 1, 2021, the CURES fee will increase from $6 to $11 annually for two years in which most licensees will see a $22 CURES fee due to the biennial renewal cycle.

Also in California. The Board of Pharmacy posted “Guidance on Eligible Personnel for Vaccines Administered in Pharmacies.” Please visit the above link for more information.

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

Michael Silber2021-04-02T09:02:08-04:00April 2, 2021|California|

Colorado

Via an emergency regulation effective February 24, the Division of Insurance amends regulations under 3 CCR 702-4 to specify that carriers must provide coverage for persons undergoing treatment and receiving vaccines for COVID-19.

Also in Colorado, The Division of Insurance amends regulations under 3 CCR 702-4 related to coverage and cost-sharing requirements for the commercial insurance market coverage of COVID-19 claims. “Section 6 Access to Prescription Drugs During the COVID-19 Emergency” includes language to allow 90-day refills before the scheduled refill date and to prohibit carriers from applying a different cost-sharing amount for early refills. This emergency regulation 21-E-04 was effective March 19.

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

Michael Silber2021-04-02T09:00:45-04:00April 2, 2021|Colorado|

District of Columbia

Effective April 2021, HIV post-exposure (PEP) and Pre-exposure (PrEP) treatment for MCO beneficiaries will be carved out of managed care. Claims should be submitted through the Magellan POS system.

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

Michael Silber2021-04-02T08:59:53-04:00April 2, 2021|District of Columbia|

Iowa

The Department of Human Services, Iowa Medicaid Enterprise issued Informational Letter No. 2225-MC-FFS-CVD announcing the $40 administration rate per COVID-19 vaccine dose is effective April 1, 2021. This is $80 total for a two-dose series and $40 for a single-dose vaccine.

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

Michael Silber2023-10-10T09:03:02-04:00April 2, 2021|Iowa|

Kentucky

HB 48, a bill that requires commercial insurances and the state employee health plan to pay pharmacists for both prescription drug claims and patient procedures or services within their scope of practice at a rate not less than that paid to other non-physician practitioners, was signed by Gov. Andy Beshear (D) last week and will be effective 90 days after sine die, which was March 30.

Also in Kentucky, NACDS has been informed that in a meeting this week DMS verbally shared that they have finalized the single PBM pharmacy reimbursement model as NADAC (including current FFS “lesser of” computation) + PDF of $10.64 — the current fee-for-service model. Notably, although SB 50 of the last session allowed Medicaid to implement tiering, the final proposal will reimburse all pharmacies equally. Commissioner Lisa Lee reported that MedImpact and the Managed Care Organizations are expected to and will be required to meet the July 1, 2021 implementation date. NACDS thanks the Kentucky Retail Federation and the Kentucky Pharmacists Association for their work on this issue during and after the passage of SB 50 of the last session. NACDS served on the Medicaid PTAC Committee which recommended this methodology to Medicaid.

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

Michael Silber2023-10-10T09:03:10-04:00April 2, 2021|Kentucky|

Louisiana

Medicaid is launching a new Medicaid Provider Enrollment Portal in April to screen and enroll all Medicaid providers. The enrollment portal is being designed to meet a Centers for Medicare and Medicaid Services (CMS) requirement and must be used by all Medicaid providers. More information can be found here.

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

Michael Silber2023-10-10T09:03:21-04:00April 2, 2021|Louisiana|

Mississippi

SB.2119, has been signed by Governor Tate Reeves (R). Effective January 1, 2022, the measure amends the statute to authorize pharmacies to sell products that contain pseudoephedrine or ephedrine and requires pharmacies that do to use the NPLEX system before selling those products. This measure also requires pharmacies to maintain an electronic log of information for each transaction and to require that purchasers be at least 18 years old and to show identification. This measure requires these products to be stored behind the counter.

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

Michael Silber2021-04-02T08:55:29-04:00April 2, 2021|Mississippi|

Missouri

NACDS sponsored the Missouri Pharmacists Association’s Day at the Capitol. MPA’s priority bill, HB 834 by Rep. Dale Wright (R) that regulates PBMs, passed the House and is pending referral to a Senate Committee. More information can be found here.

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

Michael Silber2021-04-02T08:54:27-04:00April 2, 2021|Missouri|

Minnesota

COVID-19 vaccination reimbursement under Medicaid will be at the Medicare rate effective April 1, 2021. HF 1428/SF 1156 successfully passed both chambers and was signed by Gov. Jim Walz (D) on March 31.

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

Michael Silber2021-04-02T08:53:00-04:00April 2, 2021|Minnesota|

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