Michael Silber, Author at In The States

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So far Michael Silber has created 2507 blog entries.

Iowa

The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2685-MC-FFS-D – June 2025 Iowa Medicaid Pharmacy Program Changes effective June 1.

Also in Iowa, Gov. Kim Reynolds (R) announced the US Department of Agriculture Food and Nutrition Service approved a demonstration project for the state's own summer food pilot program. Healthy Kids Iowa is an alternative to the summer EBT program that serves Iowa children healthier foods at a lower cost by leveraging Iowa's already-existing, successful network of summer feeding programs and community providers. With the state's summer feeding demonstration project, each family will be able to select $40 worth of fresh and nutritious food for each eligible child per month. Families will be able to choose their monthly items, respecting their preferences and cultural and dietary needs. The Healthy Kids Iowa pilot program will run in June, July and August 2025.

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

Michael Silber2025-05-08T14:06:50-04:00May 8, 2025|Iowa|

Maine

On May 1, the Joint Committee on Appropriations and Financial Affairs held another budget work session, that was called on short notice. The Chairs never brought up the pharmacy tax, nor moved the budget. 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 next legislative work session for the Joint Committee on Appropriations and Financial Affairs was May 8. 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 Silber2025-05-08T14:05:57-04:00May 8, 2025|Maine|

Massachusetts

On April 29, the Joint Committee on Financial Services heard both H1091 and S800, Acts Relative to Pharmacists as Health Care Providers. These bills would authorize the Department of Public Health to allow pharmacists to order, test, screen and treat patients. H1091 and S800 would also require pharmacies to be reimbursed for services. NACDS submitted testimony and will continue to support the bill throughout the legislative session which ends July 31, 2026.

Also in Massachusetts, the Board of Pharmacy released three updates:

Policy 2025-01: Rapid Microbial Methods (Rapid Sterility Testing)

Outlines general considerations and requirements for compounding pharmacies contemplating the use of an alternative sterility testing method.

Policy 2022-02: Extended Absence or Departure of a Manager of Record or Designated Pharmacist-in-Charge

Addresses non-resident Designated PIC absences and departures.

Opioid REMS Program

Pharmacies can order take-back envelopes and access other information on this website.

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

Michael Silber2025-05-08T14:05:24-04:00May 8, 2025|Massachusetts|

Nebraska

The Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) is seeking individuals to serve on the Medicaid Advisory Committee (MAC). The MAC has a broad focus and includes a diverse range of stakeholders, including healthcare providers, community organizations, advocates and policy experts. The MAC advises the Medicaid agency on overall policy development and program improvements. For the MAC, the MLTC is seeking healthcare providers, community-based organizations, tribal representatives, public health professionals, social service providers, advocates and others with insight into the Medicaid system. To learn more or apply, explore the following online resources:

Learn more: https://dhhs.ne.gov/Pages/MAC.aspx

Apply now: https://dhhs.ne.gov/Documents/MLTC-39.pdf

Also in Nebraska, the Department of Health and Human Services (DHHS) recently sent out its first issuance of Summer Electronic Benefit Transfer (EBT) benefits. Throughout the 2025 Summer EBT period, households with eligible school-age children can receive assistance in buying groceries with the program's second year of operation. A one-time payment of $120 will be issued for each eligible child, intended to cover the three summer months at $40 a month. Eligible families will have 122 days, or four months, to use Summer EBT benefits. Summer EBT benefits can be used to purchase food at grocery stores, online food retailers, and farmer's markets that accept SNAP EBT.

Finally in Nebraska, Gov. Jim Pillen (R) signed LB 168, the 340B Contract Pharmacy Protection Act, legislation prohibiting any manufacturer from either directly or indirectly, denying, restricting, or prohibiting the acquisition of any 340B drug by or delivery of any 340B drug to any authorized 340B location. 

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

Michael Silber2025-05-08T14:04:45-04:00May 8, 2025|Nebraska|

North Dakota

Gov. Kelly Armstrong (R) signed several bills of interest into law including HB 1087, legislation replacing “certificate of authority” requirement for PBMs with a “licensure” requirement; HB 1584, legislation outlining requirements for licensure of PBMs; creating a PBM enforcement fund, strengthening enforcement of PBM laws and regulations and establishing penalties for PBMs found in violation of laws and regulations; and HB 1473, legislation prohibiting any manufacturer from either directly or indirectly, denying, restricting or prohibiting the acquisition of a drug by a contract pharmacy and from interfering with the ability of a covered entity or contract pharmacy to dispense a drug to an eligible patient of the covered entity. 

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

Michael Silber2025-05-08T14:04:04-04:00May 8, 2025|North Dakota|

New York

On May 5, NYRx issued a notice NYRx Helpful Hints for Pharmacies: Diabetic Testing Supplies.

Diabetic Test Strips and Lancets: NYRx coverage of preferred blood glucose test strips and lancets for members with diabetes aligns with Medicare Coverage of Diabetes Supplies.

Pharmacies must submit claims based on units per days' supply as follows:

Members who use insulin: Maximum 300 test strips and lancets per 90-day supply

Members who do not use insulin: Maximum 100 test strips and lancets per 90-day supply

Continuous Glucose Monitors and Disposable Insulin Pumps: Continuous Glucose Monitors and Disposable Insulin Pumps should be billed at the pharmacy point-of-sale for the proper quantity and days' supply as outlined on the product label.

What Pharmacies Need to Do: The pharmacy should become familiar with the NYRx Preferred Diabetic Supply Program. When submitting claims for preferred diabetic supplies do not request a PA (prior authorization) from the prescriber if the claim rejection states one of the following:

Maximum Quantity Exceeded

Early Fill Overuse

Recipient Ineligible on Service Date

Refill Number Exceeds Maximum

Therapeutic Duplication

Client Has Medicare Part D or Client Has Other Insurance

Coordination of Benefits Claim Processing

NYRx is always the payor of last resort and federal regulations require that all other available resources be used before NYRx considers payment.

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 ET, Monday through Friday, excluding holidays.

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

Michael Silber2025-05-08T14:03:15-04:00May 8, 2025|New York|

Oregon

The Board of Pharmacy announced the agency’s new director, Dr. Gary Runyon, PharmD, a graduate of the University of Tennessee College of Pharmacy. Gary brings over 22 years of diverse pharmacy experience to Oregon, where he relocated in late 2020. Gary joined the Board of Pharmacy as a Compliance Officer, then transitioned to the Pharmacist Consultant position before becoming Executive Director effective April 14.

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

Michael Silber2025-05-08T14:02:23-04:00May 8, 2025|Oregon|

South Carolina

NACDS submitted comments to the Senate Banking and Insurance Committee ahead of its hearing on SB 342, which includes several NACDS priorities related to reimbursement reform. As this marks the first session of a two-year legislative term, NACDS expects to continue advocating for this and related legislation throughout the summer and fall in preparation for the 2026 session.

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

Michael Silber2026-01-15T07:23:45-05:00May 8, 2025|South Carolina|

Virginia

Virginia Pharmacies had a remarkable win in Virginia, when Gov. Governor Glenn Youngkin (R) signed our Medicaid PBM reform bill, HB 2610, after initially vetoing it and replacing it with a study. NACDS and VACDS were present on the ground in Richmond throughout the process, working with members and partners to pull every lever to secure a final victory. T NACDS issued a press release to praise Gov. Youngkin’s signature, and the legislature’s willpower, that led to the enactment of Virginia’s “single PBM” bill.

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

Michael Silber2025-05-08T14:01:19-04:00May 8, 2025|Virginia|