Michael Silber, Author at In The States

Kentucky

Gov. Andy Beshear (D) declared a state of emergency due to the severe storms that swept through the Commonwealth on February 14. In response, Medicaid has activated NCPDP procedures for pharmacies to override certain denials for members impacted by the storms. Gov. Beshear also activated the state’s emergency operations center and implemented the state’s price gouging laws to protect Kentuckians from overpriced goods and services as they recover from the storm.

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

Michael Silber2025-02-20T13:43:21-05:00February 20, 2025|Kentucky|

Louisiana

The state Surgeon General Ralph Abraham sent a directive to state health workers on February 13, 2025, ending long-standing mass vaccination clinics and banning staff from promoting seasonal vaccines. Abraham also issued a letter to the public criticizing the state’s COVID response and public health institutions.

Also in Louisiana, NACDS submitted a letter supporting the proposed rules implementing House Bill 579 which we passed in 2024, enabling pharmacists to offer HIV prevention services.

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

Michael Silber2025-02-20T13:42:44-05:00February 20, 2025|Louisiana|

Missouri

MO HealthNet (Medicaid) is conducting a survey regarding the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act’s prescription drug monitoring program mandate. The SUPPORT Act required that states mandate that covered providers consult a qualified prescription drug monitoring program (PDMP) before prescribing controlled substances to covered individuals. States must report annual data about the use of PDMPs by covered providers before prescribing controlled substances to the Department of Health and Human Services (HHS).

Also in Missouri, effective January 9, 2025, the MO HealthNet Division (MHD) carved-out certain drugs from the 340B Drug Pricing Program reimbursement. It was necessary to allow the state to collect supplemental and value-based agreement rebates on certain therapies. The state cannot collect federal, supplemental, or value-based agreement rebates when a covered entity utilizes 340B stock.

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

Michael Silber2025-02-20T13:41:58-05:00February 20, 2025|Missouri|

Nebraska

The Department of Health and Human Services added the following items under the Vaccines for Children (VFC) Provider Resources dropdown.

Daily Freezer Temperature Log
Daily Refrigerator Temperature Log
Daily Ultracold Freezer Temperature Log
Quick Reminders
Transport During Emergencies
Vaccine Restitution Form
VFC Borrowing Report
Vaccine Storage Troubleshooting Report
Clinic Line Listing Template
Clinic Line Listing Blank

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

Michael Silber2025-02-20T13:40:33-05:00February 20, 2025|Nebraska|

New York

The New York Department of Health held its monthly pharmacy industry call for NYRx, the state Medicaid pharmacy benefit program on February 19, 2025. The agenda included (1) DME supplies, processing of incontinence supplies, as this is the highest category of waste, fraud and abuse in the program today; (2) enhancements to the internal system for prior authorizations which allow the state to override and amend as needed; and (3) unenrolled providers are rejected by EMEDNY, if there are any concerns, make sure your pharmacy is enrolled when activating. The next monthly meeting will be March 19, 2025, at 1pm.

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

Michael Silber2025-02-20T13:39:51-05:00February 20, 2025|New York|

North Carolina

The Department of Insurance has published rules regulating Pharmacy Benefit Managers were published this week. The reason for this proposed action is to implement statutes for the licensure of pharmacy benefits managers (PBMs) and directed the Department to adopt rules for licensure (see G.S. 5856A-2). Entities to be licensed as PBMs have previously been licensed or registered as third-party administrators (TPAs). Borrowing from the licensure requirements for TPAs, the proposed rules further set out the requirements for licensure as a PBM. Additionally, where G.S. 58-56A-2 gives the Commissioner the authority to charge an initial application fee of $2,000 and a renewal application fee of $1,500, those fees will be established by the proposed rule 11 NCAC 24 .0102. The date of the public hearing will be April 1, 2025, at 10:00 a.m., NC Department of Insurance, Hearing Room 211, 3200 Beechleaf Ct., Raleigh, NC 27604.

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

Michael Silber2025-02-20T13:38:55-05:00February 20, 2025|North Carolina|

North Dakota

Register Now for the Informative Training Session: Supporting the American Indian Population in North Dakota. This one-hour recorded on-demand training is designed to equip you with the knowledge and skills necessary to develop new practices and approaches that will enhance health outcomes and improve the quality of life for the American Indian population in North Dakota. By participating in this training, you will gain valuable insights into the unique health challenges faced by this community and learn effective strategies to address these challenges.

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

Michael Silber2025-02-20T13:38:04-05:00February 20, 2025|North Dakota|

Oklahoma

On February 20, the Senate Business and Insurance Committee scheduled a hearing for two PBM bills of interest to pharmacies, SB 789 addressing below cost reimbursements by establishing a reimbursement rate floor of no less than 106% of the NADAC plus a professional dispensing fee of $15.00, and SB 993 establishing requirements and limits for audits. NACDS submitted a support letter on SB 789.

Also in Oklahoma, Sen. Adam Pugh (R) filed SB 806 creating the Food is Medicine Act, directing Oklahoma Health Care Authority (OHCA) Medicaid to implement a financial incentive for contracted entities who improve health outcomes of covered members through nutrition services. OHCA is directed to seek federal approval from CMS to implement the Nourish My Health program. The state Department of Education will provide technical assistance with applying for grants and administering programs that expand student access to fresh, healthy food.

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

Michael Silber2025-02-20T13:37:09-05:00February 20, 2025|Oklahoma|

Ohio

The Board of Pharmacy announced that they have developed and posted a new tool in the form of a dashboard that provides data on pharmacy trends and access in the state. The dashboard includes data on closures, openings and “pharmacy deserts” across communities.

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

Michael Silber2025-02-20T13:35:56-05:00February 20, 2025|Ohio|

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