Maine
On September 5, the Board of Pharmacy held its regular meeting. The agenda included licensure by endorsement and a central fill data collection pilot project.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Maryland
The Prescription Drug Affordability Board (PDAB) has rescheduled its September 23 Board meeting for September 10. Registration is required to participate. The Board welcomes public comment and input on all its work. Additional information about providing public comment can be found on the Board Meetings page of the PDAB’s website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
The Board of Pharmacy issued notice that licensing of non-resident pharmacies will become available in the coming months. At least one pharmacist at each non-resident pharmacy must hold a Massachusetts pharmacist license. (This pharmacist does not have to be the store’s pharmacist-in-charge.) In preparation for non-resident pharmacy licensing, it is strongly recommended to begin the licensing process for the pharmacists as the process can take 30-60 days. Applications and instructions can be found online. Please see the FAQ document for other information regarding non-resident pharmacy licensing.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Michigan
The Department of Health and Human Services issued a final bulletin related to the end of COVID flexibilities for OTC (Over-the-Counter) COVID tests and pharmacies as labs.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
Effective September 6, 2024, brand name Adderall XR® will no longer be preferred on the MO HealthNet Preferred Drug List (PDL). Dextroamphetamine/Amphetamine ER capsules (generic Adderall XR®) is currently a preferred agent on the PDL and will continue to remain a preferred agent. Please reference the List of Preferred & Non-Preferred Products, as well as the ADHD, Amphetamines Long Acting PDL edit for more information. Maximum Allowable Cost (MAC) rates will apply to brand and generic products. Providers who dispense the brand product without a prior authorization (based on medical necessity) will receive MAC reimbursement.
Also in Missouri, on August 29, the Medicaid Audit & Compliance (MMAC) launched the new secure Provider Communications Portal, which is an efficient method for providers and MMAC to communicate and exchange information and records.
Finally in Missouri, effective August 29, MO HealthNet expanded coverage of Continuous Glucose Monitors (CGMs) to participants currently diagnosed with Gestational Diabetes allowing this vulnerable population to obtain a CGM without prior authorization. Claims for a CGM will auto-approve if the participant has had a gestational diabetes diagnosis billed to MO HealthNet recently or if the pharmacy submits the appropriate gestational diabetes diagnosis code with the claim. Any MO HealthNet participant who currently utilizes insulin can also obtain a CGM without prior authorization.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Board of Pharmacy posted the agenda (revised August 29, 2024) for its September 9 meeting.
Also in Nebraska, new income guidelines increased the number of families who could qualify for the Women, Infants and Children (WIC) supplemental nutrition assistance program. The WIC program is a federally funded program and is an equal opportunity provider. The maximum income allowed for participation in WIC increased. Some families not eligible for the program in the past may now be eligible. Nebraska WIC serves every county in the state with 13 main agencies and over 100 sites.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
Medicaid is committed to supporting increased adoption and utilization of the Board of Pharmacy statewide protocols authorized by legislation. As part of this commitment, effective August 1, 2024, immunizing pharmacists began to receive reimbursement for clinical services provided when utilizing the statewide Nicotine Replacement Therapy (NRT) Protocol. This bulletin applies to Medicaid Managed Care and Medicaid Direct. The claim should be submitted using a medical claim and payment will be issued to the pharmacy.
Also in North Carolina, effective September 1, 2024, Medicaid began covering condoms and spermicides as over-the-counter products, through the pharmacy benefit. This coverage applies to both Medicaid Direct and Managed Medicaid Plans. Coverage supports reproductive health care for Medicaid beneficiaries, including prevention of unintended pregnancy and sexually transmitted diseases. Medicaid beneficiaries will be able to obtain condoms and spermicides from pharmacies enrolled in Medicaid with a prescription from a Medicaid-enrolled provider, with no cost sharing responsibility.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Board of Pharmacy issued draft rules to implement SB 144, the new pharmacy immunization expansion law that passed in July. We have reviewed the rule and found no issues or concerns and intend to file a letter of support. However, if members have any concerns or comments, please share them with Jill McCormack by September 13.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted the draft agenda for its next meeting on September 18. Please note the “Medicare MFP modeling presentation and SB 192 upper payment limit discussion” by PDAB staff and Myers and Stauffer on the draft agenda. You must register in advance of the meeting to participate.
Also in Oregon, NACDS, as a participant in the PBM Working Group, submitted a letter to Rep. Rob Nosse (D), Chair, House Behavioral Health and Health Care Committee, to provide comments and pharmacy reimbursement concepts in advance of the next working group meeting scheduled to be held on September 18.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.