Alaska
The Board of Pharmacy approved a training resource from the Asthma and Allergy Foundation of America – Alaska Chapter for the prescribing and dispensing of epinephrine.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
The Board of Pharmacy issued a notice and agenda for a virtual task force/stakeholder meeting on December 20 at 10:00 am.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- Update: Deferral Response Method via Medi-Cal Rx Provider Portal (December 8)
- Medi-Cal Rx Weekly Wrap-up for December 1-7 (December 8)
- Reinstatement Spotlight (December 8)
- Activation of Reject Code 16 – Medi-Cal Rx Program Integrity Update (December 5)
Also in California, the Department of Health Care Services posted the following:
- Family Mosaic Project is No Longer a Medi-Cal Managed Care Plan in San Francisco County, effective for dates of service on or after January 1, 2024
- Billing Update for COVID-19 Oral Medication Paxlovid
- Forthcoming Contracted Incontinence Supplies Program Updates
- Novavax COVID-19 Vaccine Authorization
Also in California, the Board of Pharmacy proposed modifications to the following. To view all documents associated with these proposed regulatory actions and other pending regulations, visit the board’s “Pending Regulations” webpage.
- Designation of Pharmacist-in-Charge
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- 45-Day Comment Period: November 17, 2023-January 2, 2024
- Temporary License for Military Spouses
- Modified Text
- 15-Day Comment Period: December 13, 2023-December 28, 2023
- Notice to Consumers
- Notice of Modified Text
- Modified Text
- 15-Day Comment Period: December 13, 2023-December 28, 2023
Also in California, Gov. Gavin Newsom (D) appointed Sarah Brooks, as Chief Deputy Director of Health Care Programs at the Department of Health Care Services. Given the capacity to manage program growth and increased complexity of the programs, moving forward, the Chief Deputy Director for Health Care Programs and State Medicaid Director will be two separate roles. The Chief Deputy Director for Health Care Programs will focus on internal program implementation and operations in California’s health care programs, whereas the State Medicaid Director will focus on Medi-Cal policy development and relationships with its external partners, including the federal Centers for Medicare & Medicaid Services (CMS). Recruitment efforts are ongoing for a State Medicaid Director.
Finally in California, Gov. Gavin Newsom (D) announced the launch of a new tool to continue the state’s efforts to fight the ongoing opioid crisis – a comprehensive website with resources for Californians: Opioids.CA.GOV. This website serves as a reliable source of information on prevention, data, treatment and support. Also, Californians can access information related to the state’s use of opioid settlement funds and efforts to hold drug-traffickers accountable.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2537-MC-FFS-D: HHS New Website Launch and Content Changes
- INFORMATIONAL LETTER NO. 2535-MC-FFS-D: January 2024 Iowa Medicaid Pharmacy Program Changes
- INFORMATIONAL LETTER NO. 2531-MC-FFS: Member Cost Sharing Limits
- INFORMATIONAL LETTER NO. 2528-MC-FFS-D: SUPPORT Act Section 5042(e)(I)(A) Reporting Requirements Survey for Federal Fiscal Year (FFY) 2023
- INFORMATIONAL LETTER NO. 2522-MC-FFS: New Vaccine for Children (VFC) Program Codes
- INFORMATIONAL LETTER NO. 2521-MC-FFS: New Respiratory Syncytial Virus (RSV) Vaccine Codes
- INFORMATIONAL LETTER NO. 2511-MC-FFS: Date Span Billing for Durable Medical Equipment (DME) Rental and Medical Supplies; this replaces INFORMATIONAL LETTER NO. 2395
- INFORMATIONAL LETTER NO. 2509-MC-FFS: Over-the-Counter COVID Test
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health issued an informational bulletin on tobacco cessation counseling.
Also in Louisiana, the Department of Health (LDH) updated the available options to providers for pursuing resolution of issues with Medicaid managed care organizations (MCO) and the state’s fee-for-service (FFS) 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.
Finally in Louisiana, the Board of Pharmacy is soliciting comments and holding a Public Hearing on December 28 on three proposed rule changes:
- Regulatory Project 2023-09 ~ Product Integrity – (temperature control for mail order)
- Regulatory Project 2023-10 ~ Prescription Monitoring Program (PMP)
- Regulatory Project 2023-11 ~ Pharmacists Application
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Board of Pharmacy held its monthly meeting on December 7. The agenda covered the following policies and updates:
- Access to HIV Prevention Medications, including PEP and PrEP Protocols
- Access to Birth Control by Making Certain Contraception Accessible from a Pharmacist
- Authorize Vaccine Administration by Pharmacy Technicians and Reduce Vaccine Administration Training Requirements for Pharmacists
- Licensure by Endorsement
- Board Rule Chapter Amend Limits on Medication in Vending Machines
- Pharmacists Dispense an Emergency Supply of Chronic Maintenance Drugs
- Telehealth Rulemaking Status – Update
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Maryland
Medicaid published an advisory regarding upcoming denials of prescription claims due to the prescribing provider not completing revalidation. The advisory also contains email and phone contacts for patients and provider issues.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
MassHealth has issued a new draft of the Pharmacy Manual at 130 CMR 406. The new regulations make the following changes:
- Adds compounded drugs, and medically necessary cosmetic drugs for the treatment of alopecia or gender identity that are listed on the MassHealth Drug list, to the list of Covered Drugs and Medical Supplies at 406.412.
- Deletes the language in the current regulations at 406.413 that prohibits MassHealth from paying for any drug used for the treatment of obesity. The prohibition has been eliminated and MassHealth will now pay for drugs to treat obesity that are included on the MassHealth Drug List.
- Adds the new section 406.446 relative to Pharmacy Drug Review and Counseling that requires pharmacies that are servicing MassHealth patients to offer prospective drug review and counseling that are consistent with the current MA law that requires pharmacists to make an offer to counsel. Only a patient’s refusal of counseling must be documented.
These changes will become effective on January 1, 2024.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Michigan
Gov. Gretchen Whitmer (D) signed HB 4276. The bill requires PBMs to reimburse pharmacies with no more than seven retail outlets at NADAC plus a professional dispensing fee comparable to the state Medicaid Dispensing Fee. It also prohibits the Department of Health and Human Services (department) from entering into a contract with a Medicaid managed care organization if its pharmacy benefit manager (PBM) does not do the following: reimburse for a legally valid claim at a rate not less than the rate in effect at the time the original claim adjudication was submitted at the point of sale; agree to move to a transparent pass-through pricing model, in which the PBM discloses the administrative fee as a percentage of the professional dispensing costs to the department; agree to not create new pharmacy administration fees and to not increase current fees more than the rate of inflation; and, agree to not terminate an existing contract with a pharmacy with no more than seven retail outlets for the sole reason of the additional professional dispensing fee authorized.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.