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So far Michael Silber has created 1944 blog entries.

Vermont

Due to the current state of emergency in the state and to ensure that Medicaid beneficiaries have access to the medications they need, the Department of Vermont Health Access (DVHA) is temporarily re-activating SCC 13 as an allowable NCPDP submission clarification code in the adjudication of pharmacy claims. Changes to point-of-sale will be effective from July 13, 2023, to July 25, 2023. This code is utilized by the dispensing pharmacist when processing an early refill for the patient and indicates that an override is needed based on an emergency/disaster situation recognized by the payer. The use of SCC 13 will override a Reject 79 (Refill too soon). It will not override either Reject 75 (prior authorization required) or Reject 76 (Plan limits exceeded). DVHA will monitor claims using this submission clarification code to ensure it is used only when medically necessary. Improper use of SCC13 will subject the claim to recoupment. For questions, please contact the Change Healthcare Pharmacy Help Desk at 1-844-679-5362. Vermont providers can also send inquiries via email to PBA_VTHelpdesk@changehealthcare.com.  

On July 20, Gov. Phil Scott (R) signed the 3rd addendum to his emergency declaration. This addendum added the following relevant to pharmacies: “The Secretary of State is hereby directed to waive such rules and requirements as may be necessary to allow a pharmacist to extend a previous prescription for up to a 30-day supply for a maintenance medication for which the patient has no refills remaining or for which the authorization for refills has recently expired if it is not feasible to obtain a new prescription or refill authorization from the prescriber. “Maintenance medication” means a prescription drug taken on a regular basis over an extended period to treat a chronic or long-term condition. The term does not include a regulated drug, as defined in 18 V.S.A. § 4201.” Additionally, a pharmacist who extends a prescription for a maintenance medication pursuant to this authority shall take all reasonable measures to notify the prescriber of the prescription extension promptly. 

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

2023-07-21T10:40:51-04:00July 21, 2023|Vermont|

Virginia

The Board of Pharmacy announced that due to the expiration of the federal public health emergency (PHE) and pursuant to the third enactment clause of HB 1323, routine childhood vaccines may be administered under the Board of Pharmacy (BOP) Vaccine Statewide Protocol for Persons Ages Three (3) through Seventeen (17). HB 1323 of 2022 made pharmacists’ authority to provide vaccines under the PREP Act permanent in the Commonwealth. 

Also in Virginia, the Department of Health sent a communication to licensees to clarify that the CDC’s COVID-19 Vaccination Program Provider Agreement is still in effect and requires that all organizations and providers participating in the CDC COVID-19 Vaccination Program continue to abide by its terms until the transition to commercialization is complete. 

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

2023-07-21T10:40:06-04:00July 21, 2023|Virginia|

Alabama

Effective October 1, 2022, the Medicaid Agency removed the requirement of absence of alcohol and illicit drug use by recipients for the prior approval of antiviral drugs used in the treatment of hepatitis C. A copy of the patient’s drug and alcohol screening lab report is no longer required. All other criteria remain, including the patient consent form with the patient’s and physician’s signature, which must be submitted with requests. 

The updated Prior Authorization (PA) request form and criteria booklet should be utilized by the prescriber or the dispensing pharmacy when requesting a PA. Updated forms and criteria can be found here.  

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

2023-06-23T10:43:39-04:00June 23, 2023|Alabama|

Indiana

The Family and Social Services Administration’s (FSSA) Office of Medicaid Policy and Planning’s Medicaid Director Allison Taylor is retiring later this summer. FSSA Secretary Dr. Dan Rusyniak announced that Cora Steinmetz, Gov. Holcomb’s senior operations director for health-related state agencies, will be the next director of Indiana Medicaid. Steinmetz and Taylor will work closely during the weeks ahead to ensure a smooth transition.  

Also in Indiana, the Health Coverage Programs (IHCP) updated its member eligibility and benefit coverage manual.  

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

2023-06-23T10:42:36-04:00June 23, 2023|Indiana|

Michigan

The House Health Policy Committee reported a substitute version of SB 219 (H-2). The bill allows pharmacists to order and administer immunizations to patients aged three years and older; order and administer tests for COVID, flu or respiratory illness and furnish medications to treat COVID and flu. The bill is scheduled for a vote by the full House and must be returned to the Senate for concurrence.

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

2023-06-23T10:42:00-04:00June 23, 2023|Michigan|

Minnesota

As result of the passage of 2023 Session Law Chapter 70 (Article 2, Sections 8-21, 43), pharmacies and wholesalers will be required to report on Drugs of Significant Public Interest beginning in 2024. The Minnesota Department of Health (MDH) is in the initial stages of developing the reporting initiative. As work progresses, they will provide updates on implementation, opportunities for public comment and resources to support reporting entities newly engaging in this reporting initiative. NACDS will pass on all information to members. If you are interested in directly receiving announcements on prescription drug price transparency from MDH, you may subscribe to Prescription Drug Price Transparency updates.

Also in Minnesota, the MIIC (Minnesota Immunization Information Connection) forecaster has been updated to ensure all people ages five years and older are recommended to receive one dose of COVID-19 vaccine and people under five years to receive two or three doses, depending on the product and appropriate intervals. The forecaster cannot recommend a specific COVID-19 vaccine schedule based on the date of an administered dose or recommend bivalent (updated) doses only. The forecaster’s updates will now validate the first dose received by clients ages five years and older and the first two or three doses received by clients under the age of fvie. Doses will be validated regardless of when they were received. All other doses will be recorded in a client’s immunization record but not evaluated. Unevaluated doses will display in MIIC but will not contain information in the series column. 

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

2023-06-23T10:41:28-04:00June 23, 2023|Minnesota|

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