The Department of Health (LDH) Secretary Bruce Greenstein and the pharmacy Medicaid staff hosted a pharmacy stakeholders virtual meeting on June 10 to discuss LDH’s plans for transitioning from the costly sole source Prime PBM contract back to multiple Medicaid managed care contracts.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Medicaid Fee-for-Service released a bulletin updating its Brand vs Generic Preferred Drug List.
Also in Maryland, the Prescription Drug Affordability Board's (PDAB's) Stakeholder Council will meet virtually on June 23 at 2:00 pm. The agenda and other meeting materials will be available on the Stakeholder Council page prior to the scheduled meeting. Registration is required to receive the meeting link.
Finally in Maryland, the Prescription Drug Affordability Board also released an RFI to inform its cost review process for the drugs Skyrizi and Dupixet. Manufacturers, insurers, pharmacy benefit managers and wholesale distributors are eligible to respond.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The General Assembly will reconvene in a special session before July 1, due to missing the June 1 budget deadline. At that time, we expect them to consider pharmacy's priority issue, reforming the managed care pharmacy benefit under a state directed, transparent, pass-through single PBM. The new structure, similar to Ohio and Kentucky's, is included in both the Senate and House Health Omnibus bills (HF 2435/SF 2669). If adopted, pharmacy reimbursement would be set at Actual Acquisition Cost (AAC) + the current fee-for-service professional dispensing fee. NACDS played a key role in advocating for this structure and successfully secured support from the Administration and Department of Health and Human Services.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Effective, July 1, all OneTouch blood glucose test strips and meters manufactured by LifeScan will be removed from the Medicaid Preferred Diabetic Supplies List (DSL). Please refer to the updated DSL. The Division of Medicaid is providing this courtesy notice to allow providers time to adjust their inventory. Find more Late Breaking News online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy posted its June 13 meeting agenda. New agenda items may be added or removed up to forty-eight hours before the meeting. For the most accurate agenda, please consult the website. The Board may reorder the agenda at the beginning of the meeting
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
A confirmed measles case in Sheridan County has been reported to the Department of Health and Human Services. The patient is an appropriately vaccinated child with no out-of-state travel history. This is the first confirmed case reported this year.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Legislature adjourned its biennial session on June 2.
Also in Nevada, the legislature sent Gov. Joe Lombardo (R) SB 389, a bill that requires the Department of Health and Human Services (DHHS) to select and contract with a state PBM to manage Medicaid pharmacy and establish methodologies for the payment of and rates of reimbursement for prescription drugs. The bill also requires DHHS to approve PBM contracts.
Also in Nevada, SB 316, the PBM reform bill amended several times that would have ended below-cost reimbursements for non-ERISA plans, prevented steering patients to affiliated pharmacies and enhanced enforcement authority for the Insurance Commissioner, died on the Senate floor due to a Senator filibustering on an unrelated bill, just minutes before the biennial session adjourned sine die at midnight on June 2.
Finally in Nevada, NACDS signed a coalition letter urging Gov. Joe Lombardo (R) to veto AB 259, legislation that would establish maximum fair pricing thresholds. The Governor vetoed a similar bill in 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
On May 28, the Board of Pharmacy held its regular scheduled meeting. The agenda included regular business and a discussion of the National Association of Boards of Pharmacy (NABP) Report of the Task Force to Review Institutional Pharmacy and Compounding Rules. The next meeting will be held on June 25.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
NYRx, the State Medicaid Pharmacy Benefit Program, announced effective June 12, the following changes were made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program:
In conformance with State Education Law, a pharmacist shall dispense a less expensive, therapeutically equivalent drug containing the same active ingredients, dosage form and strength as the drug prescribed/ordered. This includes substituting the brand name drug when NYRx has determined it to be the less expensive alternative for the patient. Brand name drugs included in this program:
The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at NYRxEO@primetherapeutics.com from 8:00 am to 5:00 pm Eastern, Monday through Friday, excluding holidays.
The NYRx Education & Outreach team hosts virtual office hours every week for stakeholders to ask questions related to NYRx and care coordination. Visit the NYRx Education & Outreach website for more information.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
