The Department of Health and Human Services, Iowa Medicaid posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Department of Human Services announced that due to the COVID-19 pandemic and the noticeable increase in vaccinations administered by pharmacy providers in recent years, they will be increasing the current pharmacy vaccine administration fee ($3.30) effective October 16, 2023. The new administration fee will be $27.49 for the first dose in the series. Each subsequent dose will receive an administration fee of $9.80 (if applicable). The effective date of this change is October 16, 2023. Members should expect to receive more information and billing instructions from MedImpact. NACDS reminds members that Medicaid no longer requires pharmacies to enroll in the Vaccine for Children Program (VFC) to be reimbursed for vaccines.
Also in Kentucky, the Board of Pharmacy published a final rule permitting pharmacies to provide COVID treatment to patients. NACDS encourages members to review the rule because it also makes substantive changes to the process for providing test and treat services under ALL Board-approved protocols.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Effective October 1, 2023, Medicaid will reimburse continuous glucose monitors and other diabetic supplies as a pharmacy benefit.
Also in Louisiana, the Department of Health (LDH) and its vendor Magellan Medicaid Administration (MMA) finally held an online seminar on July 17 detailing their plans to migrate to a Single MCO PBM on October 1, 2023. Pharmacy stakeholders were briefed on their plans to open a portal with on-line training videos and a testing window beginning on August 1. All pharmacies need to have a signed contract with MMA. New ID cards will be mailed by mid-September, but the Member’s ID number will remain the same, so no crosswalk is needed.
Also in Louisiana, by line-item vetoing certain sections in HB 1, the state’s budget bill, Gov. John Bel Edwards (D) restored the $100 million reduction in funding to Louisiana Department of Health (LDH). Had the Governor not acted, the cuts would have caused loss of funding and federal matching funds, totaling between $400 million and $700 million.
Also in Louisiana, Gov. John Bel Edwards (D) vetoed two school vaccine bills, HB 182 and HB 399, that the Governor feared could undermine public confidence in vaccines. The Legislature has an Override Veto Session scheduled to convene on July 18.
Also in Louisiana, the Department of Health posted several provider notices of interest to pharmacies:
Finally in Louisiana, the Board of Pharmacy published two rules in the Louisiana Register with immediate effective dates.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Prescription Drug Affordability Board (PDAB) released the agenda for the July 24 meeting which will be held remotely at 2:00 p.m. Please register for the meeting in advance. The Board continues to welcome public comment and input on all its work. Please submit comments to comments.pdab@maryland.gov, and they will be provided to the Board prior to the upcoming Board Meeting. Please visit the Board’s website for more information about the upcoming and previous board meetings, presentation materials, and to learn more about the PDAB’s work.
Also in Maryland, The Department of Health (MDH (Maryland Department of Health)) is currently accepting applications and nominations for physicians and pharmacists to serve on the Medicaid Drug Use Review (DUR) Board in 2024. The DUR Board is comprised of up to twelve (12) licensed and actively practicing physicians and pharmacists in Maryland. Members are appointed by the Secretary of MDH and serve one term of three (3) years from the date of their appointment with the option to serve an additional three (3) year term. All interested applicants are required to submit a formal application by August 1, 2023.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
This week, Gov. Gretchen Whitmer (D) signed SB 219 effective July 19. The bill codifies PREP (Public Readiness and Emergency Preparedness) Act authority, allowing pharmacies to provide all ACIP (Advisory Committee on Immunization Practices) vaccines to patients aged 3 years and older. It also authorizes pharmacists to order and administer CLIA-waived tests for COVID, Flu and RSV and provide drugs that treat those conditions under CDC protocols. Many thanks to members, the Michigan Retailers Association, and the Michigan Pharmacists Association for their work with the Legislature on this critical patient access to care law.
Also in Michigan, the Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA) sent a communication reminding pharmacy that the new Central Fill and Shared Pharmacy Services rules were effective as of May 19, 2023. The email asks that Licensee review the rules and statute for a complete understanding of all applicable requirements. Questions about the revised rules may be sent to BPLHELP@michigan.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Health’s weekly COVID Vaccine Provider Update reminds immunizers that the COVID-19 Vaccine Provider Agreement is still in effect until the new vaccine formulations are available.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
On July 6, Gov. Mike Parson (R) signed into law three bills enacting the largest pharmacy scope of practice expansion (HB 115 / SB 157 / SB 45 & 90). The bills allow pharmacists to independently administer all vaccines approved by the FDA as of January 1, 2023. The law also expands the services pharmacists can provide through physician protocols, and it creates framework for statewide standing orders for the testing and treatment of COVID, Flu and Strep.
Also in Missouri, effective July 30, MO HealthNet will no longer allow automatic refills or automatic shipments of medications, devices, or supplies. MO HealthNet does not pay for any
prescription without an explicit request from a participant or the participant’s responsible party, such as a caregiver, for each refilling event. Participants and providers cannot waive the explicit refill request requirement and enroll in an automatic refill program.
Also in Missouri, MO HealthNet also reported that due to the increase in the Missouri Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Professional Dispensing Fee for Medicaid-reimbursed prescriptions was increased effective July 1, 2023.
Also in Missouri, the Department of Commerce and Insurance’s (DCI) Department of Health and Senior Services issued a revised naloxone HCL standing order that now lists the nasal spray generically, allowing pharmacists to dispense the brand name or generic product.
Also in Missouri, starting July 17, MO HealthNet announced that the Pharmacy Help desk’s NEW hours for drug prior authorizations will be Monday through Friday, 8:00 a.m. to 7:00 p.m. Central; weekend hours will remain the same 8:00 a.m. to 6:00 p.m.
Finally in Missouri, the MO HealthNet Division recently moved all provider forms regarding MO HealthNet benefits to a new Provider Forms page.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Based on the annual survey conducted by the Department of Public Health, this year’s survey results provide data to support a proposed minimum dispensing fee of $5.11. Also, the maximum dispensing fee, for each volume range, is proposed to increase to incorporate the legislatively approved provider rate increase.
The Department of Public Health and Human Services issued a Notice of Public Hearing on Proposed Amendment to ARM 37.85.105, updating effective dates of Medicaid fee schedules effective July 1, 2023. The public hearing via remote conferencing will be held on July 27 at 9:00 a.m. Below are the proposed changes to pharmacy reimbursement.
(f)The outpatient drugs reimbursement dispensing fees range, as provided in ARM 37.86.1105(3)(b) is effective July 1, 2022 July 1, 2023:
(i) for pharmacies with prescription volume between 0 and 39,999, the minimum is $4.32 $5.11 and the maximum is $15.73 $16.36;
(ii) for pharmacies with prescription volume between 40,000 and 69,999, the minimum is $4.32 $5.11 and the maximum is $13.62 $14.16; or
(iii) for pharmacies with prescription volume greater than or equal to 70,000, the minimum is $4.32 $5.11 and the maximum is $11.52 $11.98.
(g) remains the same.
(h) The outpatient drugs reimbursement vaccine administration fee, as provided in ARM 37.86.1105(6), will be $21.32 for the first vaccine and $15.65 $18.65 for each additional administered vaccine, effective July 1, 2022 July 1, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Department of Health and Human Services (DHHS) posted the following:
https://sonvideo.webex.com/sonvideo/j.php?MTID=mc307e2dda218d1060adfed7f454cfc16 or 408-418-9388 (access code: 2480 661 3098)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.