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So far Michael Silber has created 2529 blog entries.

Iowa

The Iowa Pharmacy Association (IPA) announced the selection of Matthew Pitlick, PharmD, BCPS, as its next Executive Vice President & CEO. Since its founding in 1880, Pitlick will serve as IPA’s ninth Chief Executive Officer. Matthew Pitlick is a graduate of Drake University College of Pharmacy and Health Sciences. Pitlick served as clinical faculty at the University of Health Sciences and Pharmacy in St. Louis, MO, for eight years before returning to his home state of Iowa. In 2018, Pitlick completed a one-year fellowship in Association Management with IPA. Dr. Pitlick will begin his service as incoming CEO on April 28, allowing for a brief overlap with Kate Gainer, PharmD, who will conclude her service as IPA’s CEO on June 6.

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

2025-04-03T14:30:47-04:00April 3, 2025|Iowa|

Kansas

The Department of Health and Environment (KDHE), Medicaid, is encouraging pharmacy providers to participate in a Myers and Stauffer pharmacy cost of dispensing survey. Responses are due April 23. The survey results will be used to evaluate the costs associated with dispensing medications in the Medicaid pharmacy program. To help prepare pharmacies to participate in the survey, Myers and Stauffer will be conducting an informational online seminar at 3:00 pm Central Time on April 8, presenting details about the survey process, discussing what information is being requested and answering questions regarding the survey form. Attendance at one of the online seminar sessions requires a reservation. Please call 800-374-6858 or email disp_survey@mslc.com for a reservation and further meeting details. For additional details and links to the survey, please visit the website.

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

2025-04-03T14:30:21-04:00April 3, 2025|Kansas|

Maine

On March 30, MaineCare provided notice regarding the financial status of the state and its need to temporarily withhold reimbursement. Relevant from the notice:  

For the payment cycle that will run on April 2, we will continue to take only the following actions, consistent with the approach for the previous three payment cycles:  

  • Pay Critical Access Hospital prospective interim payments (PIPs) at 70 percent the normal levels;  
  • Hold payment for all hospital claims greater than $50,000;  
  • Hold payment for multi-state chain, large health system and out-of-state retail pharmacies and durable medical equipment services; and  
  • Hold payment for out-of-state providers of hospital, ambulance, pharmacy (excluding pharmacies within 15 miles of the Maine border) and durable medical equipment services. 

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

2025-04-03T14:29:51-04:00April 3, 2025|Maine|

Maryland

The Prescription Drug Affordability Board’s (PDAB’s) Stakeholder Council will meet virtually April 28, 2025, at 2:00 pm. The agenda and other meeting materials will be available on the Stakeholder Council page of the PDAB’s website prior to the scheduled meeting. You must register in advance for the meeting link.

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

2025-04-03T14:29:09-04:00April 3, 2025|Maryland|

New York

On April 1, the state's Department of Health announced that beginning this summer, NYRx, the Medicaid Pharmacy Program, will accept electronic prior authorization (ePA) requests via CoverMyMeds® in addition to phone and fax requests. 

CoverMyMeds is a tool designed to simplify the prior authorization process by prompting prescribers to answer required clinical questions that can offer real-time approvals if clinical criteria are met. Prescribers can electronically submit prior authorization requests, upload supporting documents and track request status in real time. Additionally, pharmacy providers who utilize CoverMyMeds will have the opportunity to initiate medication ePA requests on behalf of the member for completion by the prescriber. CoverMyMeds will direct the case to the prescriber's queue and prompt them to complete and submit the ePA to NYRx. Further communications, including effective dates, resources, and educational events, will be coming soon. 

What Pharmacy Providers and Prescribers Need to Do 

  • Read the Quick Guide to CoverMyMeds Prior Authorization Requests to learn more about CoverMyMeds. 
  • Visit the CoverMyMeds Log In page to create an account, complete your profile and become familiar with the application. 

Also in New York, the NYRx Education & Outreach (E&O) team would like to invite interested parties to live training webinars, held weekly on Mondays, Wednesdays, and Fridays from 12:00 noon – 1:00 pm Eastern, excluding holidays. The live webinars focus on different areas of NYRx, the Medicaid Pharmacy Program. Registration is required to join. To attend an online seminar, starting April 2025, please click on the links provided below, or you may visit the NYRx Education & Outreach website to register. 

At each presentation's end, there will be time for a live question/answer session. Please share this information with others in your organization that may be interested or would find this online seminar helpful.  

NYRx Pharmacy Webinar: *NEW* A customized online seminar directed toward pharmacies, pharmacists and pharmacy staff who care for NYS Medicaid members. 

  • It is held weekly on Wednesday, from 12:00 noon – 1:00 pm Eastern. To register:  
  • April 9: click here  
  • April 16: click here  
  • April 23: click here  
  • April 30: click here  

Please send an email to NYRxEO@primetherapeutics.com for any questions or if you and your organization would like to schedule a webinar specific for your office staff or network. The NYRx E&O is happy to accommodate your schedule. Want to learn more about NYRx E&O? Visit our website: NYRx Education and Outreach website.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

2025-04-03T14:28:39-04:00April 3, 2025|New York|

Oregon

The Board of Pharmacy posted the April 9-11 Board Meeting agenda and meeting materials. Please note that on April 9, the board will meet in Executive Session immediately after recusal announcements and anticipates resuming Open Session around 4:30 pm. Also, note that on April 10, the board will meet in Executive Session after roll call and anticipates resuming Open Session between 1:00 pm-2:00 pm. Finally, the board will meet in Open Session on April 11. Please see the meeting agenda for additional information.  

Also in Oregon, State Plan Amendment (SPA) 24-0019 to increase professional dispensing fees for fee-for-service pharmacies, with fees ranging from $9.99 to $16.87 per prescription, depending on volume, and $20.86 for 340B covered entities is pending with the Centers for Medicare and Medicaid. As submitted by the Oregon Health Authority, this SPA proposes to update Oregon's professional dispensing fees (PDF) to $16.87 for pharmacies with a prescription volume of less than 40,000 claims per year, $11.93 for pharmacies with a prescription volume of 40,000 to 79,999 claims per year, and $9.99 for pharmacies with a prescription volume of 80,000 or more. 

The Prescription Drug Affordability Board posted its April 2025 issue of The Quarterly. Highlights of this issue include the following. Past issues are available online. 

  • PDAB would love to hear from Oregonians, Page 1 
  • PDAB selects subset list for affordability reviews, Page 2 
  • PDAB member profile: Dan Kennedy, Page 5 
  • News you can use, Page 6 
  • Senate Health Care Committee advances Senate Bill 289, Page 7 
  • 2025 board meeting calendar, Page 8 

Also in Oregon, the Prescription Drug Affordability Board posted it is agenda for the April 16 meeting. Register here in advance. 

Also in Oregon, the Oregon Health Authority Health Systems Division: Medical Assistance Programs adopted this temporary rule, OAR 410-122-0186, to amend Medicaid fee-for-service durable medical equipment, prosthetics, orthotics and supplies to comply with the recently approved state plan amendment (SPA), effective October 1, 2024. 

Finally in Oregon, the Division of Financial Regulation recently announced the following permanent rulemaking: ID 2-2025: Prescription Drug Price Transparency program updates 

Rules: 836-200-0500, 836-200-0505, 836-200-0510, 836-200-0515, 836-200-0520, 836-200-0525, 836-200-0530, 836-200-0531, 836-200-0532, 836-200-0535, 836-200-0540, 836-200-0545, 836-200-0550, 836-200-0555, 836-200-0560. 

Rules Summary: Adds a definition for "dosage;" combines the definitions for "inaccurate information" and "incomplete information;" adds clarification about what is not included in the definition of "new prescription drug;" removes dosage guidance from the definition of "one-month supply;" adds clarification to the definition of "reporting manufacturer; removes outdated timelines; sets timeline for reporting manufacturers to create an online account with the department; requires reporting manufacturers to provide the department with at least one contact person, with valid contact information, that is an employee who manages access to the account and receipt of trade secret determinations; updates the threshold for reporting new prescription drugs to reflect current specifications in Medicare Part D; provides a definition for the "date of introduction;" clarifies "good faith" language; clarifies requirements of manufacturer reporting including: drug strength, package size, and the date the drug was first approved; the description of the marketing used in the drug's introduction; and potential factors used to establish the price of the new drug; and more.  

Filed: March 26, 2025 

Effective: April 1, 2025 

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

2025-04-03T14:27:41-04:00April 3, 2025|Oregon|

Rhode Island

Medicaid posted its April 2025 Provider Update. Please note the “Pharmacy Spotlight” with information about the Medicaid Fee-for-Service program’s Stand Along Vaccine Counseling project in Spring 2025. This project allows pharmacies to be reimbursed for vaccine counseling services using the Service Billing (SI) and Service Reversals (S2) Transactions on the NCPDP transaction standard. See the update for additional details. All previous provider updates may be found online. 

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

2025-04-03T14:26:50-04:00April 3, 2025|Rhode Island|

South Carolina

NACDS attended in the SC Senate Labor, Commerce, and Industry Committee’s presentations on PBMs and the Future of Pharmacy. The session featured insights from several stakeholders, including the SC Pharmacy Association; Eunice Medina, Director of the SC Department of Health, and Human Services; the Cicero Institute; and the SC Alliance of Health Plans. 

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

2025-04-03T14:26:17-04:00April 3, 2025|South Carolina|

Tennessee

The Department of Health is confirming the state's first measles case in 2025 in a Middle Tennessee resident. The likely source of the infection is being investigated. Subsequently, the Department of Health confirmed three additional cases of measles in Middle Tennessee, which is also being investigated by public health officials. 

Also in Tennessee, the Department of Commerce & Insurance added a new PBM Compliance Pharmacist position to serve as a pharmacy consultant and professional resource to the PBM Compliance Section. The position will be responsible for enforcement of current statutes and rules related to PBMs as well as assisting with compliance audits of PBMs, assisting with PBM complaint analysis and investigation and analysis of PBM Annual Reports. 

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

2025-04-03T14:25:46-04:00April 3, 2025|Tennessee|
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