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California

This week the Assembly passed SB 966, PBM Reform legislation. The bill returns to the Senate for concurrence with the Assembly amendments. The legislature will adjourn no later than midnight on August 31.

Also in California, the Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal:

Also in California, effective for dates of service on or after September 1, 2024, the Department of Health Care Services has updated the List of Contracted Incontinence Creams and Washes.

Also in California, the Board of Pharmacy proposed the following rules:

Finally in California, the Board of Pharmacy’s Licensing Committee added an additional meeting on September 4, 2024, to continue its work on the Standard of Care Model. The agenda, meeting materials and written comments received were posted to the Board’s website.

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

2024-08-29T14:39:02-04:00August 29, 2024|California|

Colorado

NACDS is continuing to work with a coalition urging Gov. Jared Polis (D) to expedite implementation of SB24-168, a new law that expands diabetes care access for Medicaid enrollees.

Also in Colorado, Gov. Jarod Polis (D) convened a special session on August 26 to address property tax reform.

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

2024-08-29T14:38:32-04:00August 29, 2024|Colorado|

Indiana

The Health Coverage Programs (IHCP) issued a bulletin reminding providers requesting an administrative review, also known as a reconsideration, of a denied or partially approved fee-for-service (FFS) nonpharmacy prior authorization (PA), that they must submit a written request to the FFS prior authorization and utilization management (PA-UM) contractor within seven business days of receipt of the PA decision notification.

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

2024-08-29T14:38:08-04:00August 29, 2024|Indiana|

Nebraska

The Department of Health and Human Services cancelled the September 10 meeting of the Drug Utilization Review (DUR) Board.  The next DUR Board meeting will be November 12, 2024​.

Also in Nebraska, the Medicaid DUR Board is seeking nominations for pharmacists to serve on the board. Board members are required to serve a three-year term with a three-year renewal opportunity. Meetings are held at least quarterly and no more than six times a year (every two months). All interested applicants are required to submit an application via email.

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

2024-08-29T14:32:37-04:00August 29, 2024|Nebraska|

Nevada

The Retail Association of Nevada invited NACDS and their pharmacy members to attend a private fundraiser in Las Vegas for Gov. Joe Lombardo (R). Pharmacists and government affairs representatives Jaime Montuoro with Smith’s, Mark Soltes with Kroger, Lorri Walmsley and Jennifer Kurrie with Walgreens and the former executive director of the Idaho Board of Pharmacy Mark Johnston participated.

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

2024-08-29T14:32:01-04:00August 29, 2024|Nevada|

New Jersey

The New Jersey Legislature announced its fall schedule. The first meeting of the Senate Health Committee will be on October 7. NACDS, along with the New Jersey Pharmacists Association, has asked S1981 to be included on the agenda. The bill, a companion to A1899 which has passed the Assembly, would allow immunization of flu and COVID-19 for those ages 5 years and up and allow pharmacy technicians to administer vaccines.

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

2024-08-29T14:29:53-04:00August 29, 2024|New Jersey|

New York

On August 21, the State Department of Health held its monthly pharmacy call for NYRx transition, the Medicaid Pharmacy Benefit Program. Several relevant agenda items include the following:

  1. Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) order acceptance policy
  2. NYRx utilizes the NADAC file which contains historical information for rate/pricing changes. The following provides information on how to read the file:
    • The “Effective Date” is the effective date for each rate change. The effective date is designed to avoid overlapping date segments for a specific NDC.
    • The “As of Date” indicates the date a rate group first appeared on the NADAC.
    • The “Posting Date” is the date in which the NADAC is posted to eMedNY.
    • EMedNY cut-off time for file updates occurs every Friday (most NADAC prices show an “As of Date” every Wednesday).
    • Information in the pricing file will post to eMedNY every Tuesday.
  1. NYRx, the Medicaid Pharmacy Program, is making significant changes to the coverage of diabetic testing supplies. These changes align with Medicare coverage criteria.
  2. NYRx is conducting system enhancements to accommodate vaccine billing by NDC targeted for late October:
  • eMedNY systems will automatically apply the administration fee in a single transaction,
  • NYRx is committed to making this transition as smooth as possible.

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

2024-08-29T14:28:37-04:00August 29, 2024|New York|

Tennessee

TennCare announced the list of covered UPCs for its upcoming diaper program. Luvs, Pampers, Huggies and Cuties are the primary brands that will be covered. If your pharmacy plans to participate and wants to be featured on the TennCare website as a participating location, complete this survey.

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

2024-08-29T14:27:39-04:00August 29, 2024|Tennessee|

Texas

Speaker of the House of Representatives Dade Phelan (R) appointed Mike Toomey as his new chief of staff, replacing Enrique Marquez. Toomey is a former Texas House member, previously served as chief of staff to former Governors Bill Clements and Rick Perry and was most recently a partner at the Texas Lobby Group.

Also in Texas, PCMA presented at the Texas Pharmaceutical Initiative (TPI) Board’s August 20 meeting, claiming that 90% of the prescription dollar goes to pharmacies and pharmaceutical manufacturers, and that PCMA’s industry creates $155 billion in value each year. The TPI Board also received an update from McKinsey consultants on developing a business plan due to the legislature on October 1, 2024. The TPI was established last session by the Texas Legislature and aims to provide cost-effective access to prescription drugs and other medical supplies to individuals receiving health benefits paid for by the state through the Employee Retirement System of Texas (ERS), Teacher Retirement System (TRS), Health and Human Services Commission (HHSC) including Medicaid, The University of Texas System and Texas A&M University System. The next meeting is September 5.

Also in Texas, the Health and Human Services Commission (HHSC) Vendor Drug Program’s VDP Provider Portal allows pharmacies to retrieve weekly payment files, prescribers to submit prior authorizations, and more. VDP encourages pharmacies and prescribers to register for these valuable tools.

Also in Texas, the state’s economic forecast looks bright as Comptroller Glenn Hegar (R) estimates an $18 billion+ surplus, and about $24 billion in the Economic Stabilization (Rainy Day) Fund.

Finally in Texas, pharmacies can request expedited formulary coverage, an expedited preferred drug list change or notify HHSC about potential drug shortages impacting prescribing choice and pharmacy claim processing by using the Drug Shortage Notification and Expedited Formulary or Preferred Drug List Request (HHS Form 1315). Referrals should recommend an alternative with supply chain in mind so extra demand will not cause another shortage.

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

2024-08-29T14:26:44-04:00August 29, 2024|Texas|

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