Washington
The legislature adjourned on Sunday, April 23, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Wyoming Attorney General (Commissioner of Drugs and Substances Control) issued a proposed rules to additional substances to Schedule I and Schedule IV in the Wyoming Controlled Substances Act of 1971. Comments may be emailed to melissa.rexius@wyo.gov; the comment period ends on June 1, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Alabama Medicaid Agency (Medicaid) is announcing the final extension of the COVID-19 public health emergency (PHE). The new expiration date is May 11, 2023, which correlates with the expiration date of the national emergency. A Provider ALERT will be forthcoming from Medicaid to communicate changes to services related to the COVID-19 PHE.
During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. Providers should include appropriate COVID-19 diagnosis code(s) on claims submitted to help with tracking of COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
Janet Mann is the new Medicaid Director with the Department of Human Services. Mann has over 20 years of experience in health care and finance, including working in Mississippi Medicaid.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy posted the agenda and meeting materials for the April 5 meeting of the Licensing Committee.
Also in California, the Department of Health Care Services posted the following updates:
- On March 29, DHCS received approval from CMS to waive the asset test at redeterminations for members enrolled in Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal. The waiver flexibility is effective for renewals retroactive to March 1 through December 31. Asset elimination takes effect on January 1, 2024. This waiver flexibility ensures continuity of coverage for seniors and persons with disabilities who meet all other Medi-Cal eligibility criteria, such as income, and will prevent potential disruptions in their Medi-Cal coverage once redeterminations resume in April 2023. DHCS issued Medi-Cal Eligibility Division Letter (MEDIL) 23-19 to provide counties with immediate guidance on operationalizing the waiver flexibility.
- This week, DHCS posted the Medi-Cal Continuous Coverage toolkit in 17 Medi-Cal threshold languages (in addition to the previously posted English and Spanish). Each toolkit includes materials that can be customized to help DHCS Coverage Ambassadors and partners assist Medi-Cal members with the redetermination process. The content encourages members to update their contact information to ensure they receive important information about keeping their Medi-Cal coverage. On April 6, from 1 to 2 p.m., DHCS will host a Continuous Coverage Unwinding and Communications Campaign webinar (advance WebEx registration required) to discuss the Medi-Cal renewal and redetermination process, communications campaign updates, and how DHCS Coverage Ambassadors and other partners can continue to help assist in this important effort.
- DHCS released a COVID-19 Uninsured Group (UIG) Program toolkit (in English and Spanish) to provide information to more than 500,000 UIG Program members about how to apply for ongoing coverage through Medi-Cal or Covered California before the program ends on May 31, 2023. Due to the COVID-19 Public Health Emergency ending, Covered California will open a special enrollment period for UIG Program members that have their coverage ending. The special enrollment period will end 60 days after May 31, 2023. The toolkit offers vital information for DHCS Coverage Ambassadors to share broadly with their networks about where UIG Program members can find the resources to apply for health coverage, including contact details for their local county offices and how to apply online. More information about DHCS’ strategy to unwind the UIG Program is available in the Medi-Cal COVID-19 Public Health Emergency and Continuous Coverage Unwinding Plan posted on the Keeping Medi-Cal Members Covered webpage.
- As of March 24, Phase III, Lift 1 of the Medi-Cal Rx Reinstatement plan has been successfully implemented. Providers are required to submit prior authorizations for new and renewing prescriptions in specific drug classes for members 22 years of age and older.
- On March 29, the California Health & Human Services Agency, Department of Managed Health Care, and DHCS held a webinar to walk through the Governor’s proposal to modernize California’s behavioral health system. The proposal builds on the Administrations’ previous investments and policy reforms to re-envision how the state treats mental health and substance use disorders. More information and the presentation are available on the Modernizing our Behavioral Health Initiative webpage.
Also in California, the Department of Health Care Services (DHCS) posted the following alert on the Medi-Cal Rx Web Portal: Mpox Vaccine No Longer a Family PACT Pharmacy Benefit (March 30).
Finally in California, Medi-Cal posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
HB 215, legislation adding enforcement language to Title 41-349 related to PBMs permitting the director [Department of Insurance] to act, issue penalties and make remedies for PBMs who violate the law in accordance with authorities in the Idaho Code, passed the House (61-9) and Senate (25-8-2). On March 29, it was sent to Gov. Brad Little (R) for consideration.
Also in Idaho, HB 291, legislation establishing the Fair Pharmacy Audits Act and creating standards and criteria for the audit of pharmacies by PBMs or other authorized entities, passed the House (61-7-2) and Senate (27-7-1). On March 29, it was sent to Gov. Brad Little (R) for consideration.
Finally in Idaho, the Board of Pharmacy posted its March 2023 Newsletter including the following items:
- 2023 Summary of Pending Statute and Administrative Rule Changes
- Idaho Telehealth Access Act COVID-19 Guidance Updated
- Announcement and Reminder: Prescription Drug Monitoring Program
- Idaho to License Virtual Wholesalers That Operate in and into Idaho
- Enforcement of Mandatory Checking of the PDMP to Begin April 1, 2023
- Board Executive Officer Awarded the Judy Smetzer Just Culture Champion Scholarship
- Board Sets 2023 Meeting Schedule
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
SB 678 has passed the House and Senate and is on its way to the Gov. Wes Moore’s (D) desk. It will require Medicaid, CHIP and commercial health plans to pay for services provided by pharmacists within their scope of practice.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
On March 2, the Department of Health and Human Services (MDHHS) began mailing beneficiary alert letters to notify beneficiaries that an eligibility renewal packet will be sent soon. Per federal legislation, Michigan will restart Medicaid eligibility renewals for both fee-for-service Medicaid and Medicaid Health Plan (MHP) beneficiaries effective April 1, 2023. MDHHS plans to continue to mail the beneficiary alert letters each month to additional groups of beneficiaries until February 2, 2024. Providers should continue to verify beneficiary eligibility prior to services. Visit the eligibility and enrollment webpage for step-by-step instructions. Eligibility redetermination or renewal dates can be viewed within the CHAMPS eligibility inquiry screen. For more information on how benefits are changing with the COVID-19 Public Health Emergency (PHE), visit Medicaid Benefit Changes.
Also in Michigan, MDHHS issued two bulletins:
- Medicaid Bulletin MMP 23-14 discusses Updates to the MDHHS Medicaid Provider Manual; Medicaid Eligibility Requirements; Federal Public Health Emergency and is issued on March 2, 2023.
- Medicaid Bulletin MMP 23-10 discusses Telemedicine Policy Post-COVID-19 Public Health Emergency and is issued on March 2, 2023.
All Medicaid bulletins can be accessed at www.michigan.gov/medicaidproviders click on “Policy, Letters & Forms”.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Department of Health, Health Economics Program (HEP), released the first set of data from the Minnesota Prescription Drug Price Transparency (RxPT) initiative. This release includes RxPT’s first legislative report and the new RxPT Data Dashboards and downloadable files. The report is the result of the Minnesota Prescription Drug Price Transparency Act of 2020. The Act tasked the Department of Health (MDH) with developing a system for collecting and reporting data from drug manufacturers on high and quickly increasing prescription drug prices. To address some these remaining challenges and provide more actionable data to policymakers, the Governor’s budget propo
For more information, contact NACDS’ Jill McCormack at 717-592-8977.