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So far Michael Silber has created 1944 blog entries.

Maine

The state legislature held two work sessions on LD 1829, An Act to Reduce Prescription Drug Costs by Requiring Reference-based Pricing. The measure attempts to prohibit the dispensing, delivery or administration of a prescription drug at a cost that exceeds the maximum fair price during the price applicability period. The bill also attempts to prohibit insurers from purchasing or seeking reimbursement for referenced drugs at a cost higher than the maximum fair price. Lastly, LD 1829 attempts to prohibit retail pharmacies from purchasing or seeking reimbursement for referenced drugs dispensed to a consumer whose health care is provided by an insurer at a cost exceeding the maximum fair price. The bill is still pending before the Committee on Health Coverage, Insurance and Financial Services. NACDS joined other industry groups in a letter of concern with opposition to several aspects of the bill. 

Also in Maine, on February 1, the Board of Pharmacy held its regularly scheduled meeting.  

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

2024-02-02T10:20:13-05:00February 2, 2024|Maine|

Massachusetts

On February 1, the Massachusetts Board of Pharmacy held its regularly scheduled meeting. Two actions were taken by the board: 

  1. A proposed change to 247 CMR 3.00 will create two different licensing categories for pharmacy technicians. This proposed change is designed to attract more individuals to serve as pharmacy technicians. Once approved, the new regulations will create a Pharmacy Technician 1 (PT1) and a Pharmacy Technician 2 (PT2). The new PT1 applies to persons 16 years of age or older, is of good moral character, and has a high school education or are enrolled in a program that awards that degree or certificate. The PT1 can be licensed by the Board if they meet those qualifications. The PT1 will not be required to participate in a training program, complete a minimum hours on-the-job-training or pass a certification exam. The requirements for PT2 mirror the current regulations the licensing of pharmacy technicians. This proposed regulation must be reviewed and approved by the Governor’s office. After the Governor’s approval, a public hearing will be held to receive public comments. 
  2. A new policy on non-sterile compounding that provides some exemptions to the current USP (United States Pharmacopeia) mandate was also acted upon.  

Also in Massachusetts, MassHealth provided an update to the pharmacy benefit concerning obesity drugs. To maximize the state’s ability to collect drug rebates on the following drugs, the Executive Office of Health and Human Services, which oversees MassHealth, is directing Managed Care Entities to not pay for the following drugs if the provider uses 340B stock: Saxenda® (liraglutide), Victoza® (liraglutide), Ozempic® (semaglutide), Rybelsus® (semaglutide), Wegovy® (semaglutide), Mounjaro® (tirzepatide) and Zepbound® (tirzepatide) 

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

2024-02-02T10:19:37-05:00February 2, 2024|Massachusetts|

Michigan

The Department of Health and Human Services announced that effective December 22, 2023, Blue Cross Blue Shield of Michigan (BCBSM) is no longer a clearinghouse for Medicaid. Beginning February 2024, BCBS will no longer receive the 835/Electronic Remittance Advice (ERA). Providers who currently have BCBS associated and authorized as a billing agent in their CHAMPS provider enrollment information will need to update or modify their enrollment. To continue to receive the 835, providers will need to update their authorized billing agent in CHAMPS. For questions or assistance please

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

2024-02-02T10:18:51-05:00February 2, 2024|Michigan|

Missouri

MO HealthNet (MHD) issued Bulletin 46-38 announcing that due to the decrease in the Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Medicaid-reimbursed prescriptions was decreased effective January 1, 2024. In-state pharmacy providers receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Missouri Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.65. Out-of-state pharmacy providers continue to receive a professional dispensing fee of $8.85. Long-term care pharmacy providers supplying covered drugs to participants in long-term care facilities continue to receive an additional $0.50 dispensing fee. 

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

2024-02-02T10:18:16-05:00February 2, 2024|Missouri|

New York

NYRx, the New York Medicaid Prescription Drug Program, made the following changes to the preferred drug list. Effective February 7, the following changes will be made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program: 

  1. Alphagan P® 0.1%, Forteo® and Votrient® will be ADDED to the program.
  2. Flovent® HFA and Pennsaid® pump will be REMOVED from the program. Note: Pennsaid® pump has been discontinued by the manufacturer.
  3. Diclofenac 2% topical solution will remain in non-preferred status on the NYRx Preferred Drug List. Prescribers should transition their patients to an alternative preferred product or obtain a prior authorization for the diclofenac 2% solution. 

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: 

  1. Do not require “Dispense as Written” (DAW) or “Brand Medically Necessary” on the prescription.
  2. Have a generic copayment.
  3. Are paid at the Brand Name Drug reimbursement rate or usual and customary price, whichever is lower (SMAC/FUL are not applied).
  4. Do not require a new prescription if the drug is removed from this program. 

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

2024-02-02T10:17:03-05:00February 2, 2024|New York|

North Carolina

The Board of Pharmacy will be holding a Pharmacy Compounding Summit on March 6-8 at the Friday Conference Center in Chapel Hill. The agenda and details are available online.

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

2024-02-02T10:15:58-05:00February 2, 2024|North Carolina|

Ohio

The Board of Pharmacy published a bulletin regarding Registered Technician license renewals. The renewal period opened on January 31.

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

2024-02-02T10:15:21-05:00February 2, 2024|Ohio|

Pennsylvania

The Board of Pharmacy has posted the agenda for the February 6 meeting.

Also in Pennsylvania, a PACE Provider bulletin announcing benefit and corresponding billing code changes to the Pharmacy Naloxone Copay Assistance Program was published. The bulletin announces a new limit of $50 per prescription and a new policy that requires coordination of benefits for insured patients. 

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

2024-02-02T10:14:40-05:00February 2, 2024|Pennsylvania|

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