Michael Silber, Author at In The States

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So far Michael Silber has created 2507 blog entries.

Idaho

Myers and Stauffer is the vendor contracted to conduct the annual prescription volume survey of pharmacy providers on behalf of the Department of Health & Welfare. In accordance with the Idaho Administrative Code 16.03.09.665.01j, the prescription volume data collected from pharmacies will be used to determine their dispensing fee tier for the following calendar year. Each year, surveys are distributed starting May 1 and will be due by May 31. Providers who fail to participate in the survey will be placed in the lowest dispensing fee tier of $11.51. Below are the current dispensing fee tiers based on Total Annual Prescription Volume:

Fewer than 40,000 claims: $15.11 dispensing fee

Between 40,000 and 69,999 claims: $12.35 dispensing fee

70,000 or greater claims: $11.51 dispensing fee

Please note that the requested information applies to total pharmacy volume and is not limited to prescription/sales information related to Department of Health & Welfare recipients unless otherwise indicated.

2025 Idaho Prescription Volume Survey

Providers should fill out the survey form for all pharmacy NPIs within their organization that are enrolled with Idaho Medicaid. For providers with 5 or more pharmacy NPIs, please upload via the “multiple store” submission option at the survey link above. For questions or help completing the survey, please contact Myers and Stauffer at pharmacy@mslc.com or toll free at 800-591-1183.

Also in Idaho, Myers and Stauffer is working with the Department of Insurance to conduct a survey of costs incurred by pharmacies to dispense prescription medications to Idaho residents. All pharmacies that dispense prescriptions to Idaho residents are requested to complete the pharmacy dispensing fee survey.

Myers and Stauffer mailed a packet with survey information to pharmacies on April 17. Providers can also access the survey documents and download an electronic version of the survey tool located on the Dispensing Fee Survey webpage.

It is very important that all pharmacies cooperate fully by filing an accurate cost survey.  Pharmacies are encouraged to return the requested information as soon as possible, but forms must be returned no later than May 29.

If you have any questions, please call toll free at 1-800-374-6858 or send an email to disp_survey@mslc.com.

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

Michael Silber2025-05-16T09:54:37-04:00May 16, 2025|Idaho|

Illinois

The Department of Healthcare and Family Services released an updated Preferred Drug List.

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

Michael Silber2025-05-16T09:53:45-04:00May 16, 2025|Illinois|

Indiana

Gov. Mike Braun (R) signed into law SB 140, PBM reform legislation establishing commercial reimbursement floors. The bill, effective January 1, 2026, requires reimbursement not less than the greater of the reimbursement level paid to PBM-owned or affiliated pharmacies, one of the following reimbursement methodologies depending on whether pharmacies hold permits to sell liquor. For pharmacies not holding permits to sell liquor, the reimbursement floor is NADAC, plus the professional dispensing fee from the Medicaid fee-for-service program. For pharmacies holding permits to sell liquor, the rate floor will be the actual acquisition cost (AAC) plus a “fair and reasonable” dispensing fee.

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

Michael Silber2025-05-16T09:53:14-04:00May 16, 2025|Indiana|

Kansas

The Department of Health and Environment issued two bulletins for paying pharmacists for services. The Stand-Alone Vaccine Counseling and Pharmacists bulletin authorizes pharmacists to provide and bill for vaccine counseling services for patients under the age of 21 years, retroactive to April 1, 2025. The Pharmacist as Provider, Emergency Opioid Antagonists and Medication Therapy Management adds payment for the extra counseling required when pharmacists dispense emergency opioid agonists (EOA) using the statewide protocol, commonly referred to as the naloxone protocol. This should be billed with the date of service dispensed and counseled, retroactive to January 1, 2025.

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

Michael Silber2025-05-16T09:52:07-04:00May 16, 2025|Kansas|

Maine

The Joint Committee on Appropriations and Financial Affairs met daily the week of May 12 for budget work sessions. The Chairs have yet to bring up the pharmacy tax. The bill remains pending before the joint committee. NACDS, working with the Maine Pharmacists Association and Retail Association of Maine, helped advocate against a potential "compromise" that would have exempted the independent pharmacies from the tax. While being fundamentally unfair, that compromise would have negated the federal match, eliminating the tax's utility. NACDS will continue to lobby the Governor's office and the legislature throughout the budget process. The bill must be moved by the Joint Appropriations Committee and approved by both chambers of the legislature. The fiscal year ends June 30.

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

Michael Silber2025-05-16T09:51:27-04:00May 16, 2025|Maine|

Minnesota

As the General Assembly enters its last week of the session, both the House and Senate have passed our priority PBM reform language in their respective health omnibus bills, HF 2435 and SF 2669. The bills are now on their way to conference committee to hammer out differences. (HF 2435/SF 2669). The provisions would reform the Medicaid pharmacy program under a single state-directed pharmacy benefit administrator. The bills require a rate floor of AAC + $11.55 and include prohibitions on questionable PBM business practices. Also included is a provision changing the cost of dispensing study frequency from every three years to biannually.

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

Michael Silber2025-05-16T09:51:01-04:00May 16, 2025|Minnesota|

New Hampshire

On May 21, the Board of Pharmacy will hold its regular monthly meeting. The agenda includes the following:

NABP Update

Administrative Rules and Legislative Topics

Hearings

Office of Professional Licensure and Certification (OPLC) Updates

Memo from Executive Director Deanna Jurius

50 State Drug Compounding Meeting June 4-5

Public Comments

Board of Pharmacy Research Organization Registration

NH Program Flyer

PH 300 Public Comment

Non Public Session

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

Michael Silber2025-05-16T09:50:32-04:00May 16, 2025|New Hampshire|

New Jersey

On May 15, the New Jersey Assembly Committee on Financial Institutions and Insurance held a hearing. During this hearing, the committee received testimony from invited guests concerning pharmacy benefit managers, their place within the broader health insurance system and their impact on prescription drug prices. The invited speakers included Dr. Pragya Kakani, Assistant Professor of Population Health Sciences, Well Cornell Medical College, and Anna Kaltenboeck, President, Verdant Research. They spoke about the PBM relationships with affiliated and unaffiliated pharmacies and the FTC reports. NACDS attended the hearing and will continue to support PBM reform efforts in New Jersey.

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

Michael Silber2025-05-16T09:49:23-04:00May 16, 2025|New Jersey|

North Carolina

The legislative session has reached the crossover deadline, the point by which bills must pass their chamber of origin to remain viable this session. Bills that did not meet this deadline are ineligible for carryover to 2026. However, the crossover rule does not apply to budget and appropriations bills, study bills, local bills or constitutional amendments.

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

Michael Silber2025-05-16T09:48:53-04:00May 16, 2025|North Carolina|