As a result of our past efforts finally recognizing Kansas pharmacists as Medicaid providers that can be reimbursed for services that are not directly related to the dispensing of medications, the Department of Health and Environment (KDHE) provided the new billing codes. KDHE established a new provider type for non-dispensing services, including immunizations, for pharmacies and pharmacists to enroll.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
HB 579, legislation filed by Rep. Wayne McMahen (R) allowing pharmacists to screen patients, initiate therapy, administer and dispense PEP (Post Exposure Prophylaxis) and PrEP (Pre exposure Prophylaxis) medications, and receive payments at the same rate as other healthcare providers, was reported favorably from the House Health and Welfare Committee on April 3.
Also in Louisiana, HB 193, legislation filed by Rep. Chris Turner (R) that authorizes the transfer of a prescription or prescription information for controlled substances between pharmacies in conformance with federal regulations, unanimously passed the House on April 2 and was referred to the Senate.
Also in Louisiana, the next regular meeting of the PBM Monitoring Advisory Council on which NACDS has a designated Council seat is scheduled for April 11 and will be held in the Poydras Hearing Room (Ground Floor) at the Louisiana Department of Insurance. The meeting agenda includes instructions on how to participate in a Zoom meeting.
Finally in Louisiana, the Department of Health (LDH) issued Informational Bulletin 19-3, revising the options to providers for pursuing resolution of issues with Medicaid managed care organizations (MCO) and the state’s fee-for-service claims processor, Gainwell Technologies. Unless explicitly notated, providers should first seek resolution with the MCO or Gainwell directly, prior to engaging LDH or other third parties.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy President Andy Bowman has announced that he will be leaving Board service before the end of his term, which opens a vacant position in the Board’s Southeastern District that will expire on April 30, 2026. To be eligible to run for this vacant Southeastern District seat, the candidate must be a pharmacist who holds an active North Carolina license to practice pharmacy and who resides (residential address, not work/practice address) in one of the counties comprising the Southeastern District. Interested pharmacists shall submit the following materials to the Board’s Executive Director, Jay Campbell, by 5:00 pm on April 26. For more information for the soon-to-be vacant Southeastern Board Member position, please visit the Board’s website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gov. Janet Mills (D) ordered State Offices to be closed on April 4 due to anticipated weather conditions. The Pharmacy board meeting is cancelled. Unless otherwise decided, all matters on the Board’s agenda will be placed on the agenda for the next scheduled meeting on May 2.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
MassHealth issued the following two updates on March 26:
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
On March 27, the State Department of Secondary Education published the following emergency orders in the New York Register (March 27, 2024, Vol XLVI, Issue 13).
Also in New York, the State Department of Health also issued a billing guidance on issuance of hormonal contraceptives. For NYRx billing, see below:
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Gov. Josh Shapiro (D) announced he will be issuing Guidance for Health Insurers to Improve Coverage for Over-the-Counter Contraception. Specifically, the Pennsylvania Insurance Department (PID) will issue guidance to insurers to provide coverage for over-the-counter contraception with or without a prescription. He further stated that PID will hold insurers accountable, requiring additional information from companies who chose not to cover OTC contraception.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Please see the April 2024 Provider Update from Medicaid. All previous provider updates may also be on this webpage.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Department of Health and Human Services (SCDHHS) is announcing a further extension of telehealth flexibilities issued during the COVID-19 federal public health emergency (PHE).
SCDHHS previously issued guidance via Medicaid bulletins announcing the status of telehealth flexibilities upon the expiration of the federal PHE (Medicaid bulletin MB# 23-018). Flexibilities were grouped as those that were made permanent, continued for one year after the expiration of the federal PHE or expired upon the end of the federal PHE May 11, 2023.
Flexibilities continued for one year after the expiration of the federal PHE are now extended by SCDHHS through December 31, 2024. This extension aligns with a similar policy announced by the Centers for Medicare and Medicaid Services that extended telehealth flexibilities issued during the COVID-19 federal PHE for Medicare providers through December 31, 2024.
As a reminder, these extended flexibilities, including telehealth flexibilities, were included in the applicable Medicaid provider manuals prior to the end of the federal PHE. Provider manuals can be found on the SCDHHS website.
South Carolina Healthy Connections Medicaid managed care organizations (MCOs) are responsible for the coverage and reimbursement of services described in this bulletin for members enrolled in an MCO.
Providers may direct any questions related to this bulletin to the Provider Service Center (PSC). PSC representatives can be reached at (888) 289-0709 from 7:30 am-5:00 pm Monday-Thursday and 8:30 am-5:00 pm Friday. Providers can also submit an online inquiry.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
