On June 27, Gov. Gavin Newsom (D) signed SB (Senate Bill) 154 (Chapter 43) which includes language allocating $114.4 million to forgive the retroactive reduction of claims reimbursement for independent pharmacies in 2022-23. Another $28.4 million will be allocated in 2023-24. This was due to an error in the implementation of the actual acquisition cost reimbursement methodology for dates of service from April 1, 2017, to February 22, 2019, inclusive. On June 30, Gov. Newsom signed AB (Assembly Bill) 178 (Chapter 45) that directs the Department of Health Care Services to forego the recoupment of overpayments from independent pharmacies and defined “independent pharmacy” as a pharmacy owned by a person or entity who owns not more than 74 pharmacies in California. Also, on June 30, the Governor signed SB 184 (Chapter 47), the health trailer bill, that expands telehealth and exempts continuous glucose monitors and medication therapy management services from a 10 percent provider cut based on 2011 legislation.
Also in California, the Department of Consumer Affairs issued this waiver extension on July 11: DCA Waiver DCA-22-217 Order Waiving Restrictions on Pharmacists Independently Initiating and Furnishing Paxlovid to Individual Patients. The full waiver and a list of current waivers is available on the DCA website.
Also in California, the Board of Pharmacy recently communicated the following:
- Complaints about Pharmacy Performance Quotas
- July 18 at 9:00 a.m. – Licensing Committee Meeting Agenda and Meeting Materials
- July 18 at 1:00 p.m. – Legislation and Regulation Committee Meeting Agenda and Meeting Materials
- July 19 at 9:00 a.m. – Enforcement and Compounding Committee Meeting Agenda and Meeting Materials
- July 19 at 1:00 p.m. – Communication and Public Education Committee Meeting Agenda and Meeting Materials
Also in California, the Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal. Please note this week’s announcement about the postponement of implementation of NCPDP (National Council for Prescription Drug Programs) reject code 80 and the reminder about the July 31 deadline for all participating Medi-Cal Rx pharmacy providers and billers to submit a Medi-Cal Rx Telecommunications Provider and Biller Application/Agreement Form to continue submitting electronic claims without interruption.
- Prescriber Advantages of Using CoverMyMeds® for Medi-Cal Rx Prior Authorization Requests (July 13)
- Update: Postponement of Implementation of NCPDP Reject Code 80 (July 12)
- Changes to Medical Supplies Reimbursement Methodology, Effective July 1, 2022 (July 8)
- Medi-Cal Rx Weekly Wrap-up for July 1-7 (July 8)
- Second Booster Dose for Targeted Populations (July 7)
- Medi-Cal Rx Training Catalog (July 5)
- Medi-Cal Rx Weekly Wrap-up for June 24-30 (July 1)
- Medi-Cal Rx Monthly Bulletin for July (July 1)
- Changes to the Contract Drugs List (CDL) (July 1)
- Changes to the Contract Drugs List (CDL) – Authorized Drug Manufacturer Labeler Codes (July 1)
- Updates to the Medi-Cal Rx Provider Manual (July 1)
- 30-Day Reminder: Electronic Claims Agreement – Submission Deadline Extended to July 31, 2022 (June 30)
- Medi-Cal Rx Office Hour – Reinstatement of Reject Codes 80 and 88 (June 29)
- Reminder: Fiscal Year Two-week Fee-for-Service Hold for Specific Provider Payments (June 29)
- Now Available: Medi-Cal Rx Telecommunications Provider and Biller Application/Agreement Form – Supplemental Form (June 27)
- Enteral Nutrition Updates Additions, Effective July 1, 2022 (June 24)
- Medi-Cal Rx Weekly Wrap-up for June 17-23 (June 24)
- Medi-Cal Rx Point-of-Sale Messaging Update (June 22)
- Appendix A: Reject Code 88 DUR: Service Codes Scenarios (June 22)
- NDPDP Reject Code 88 DUR Reference Guide (June 22)
- NCPDP Reject Code 80 Reference Guide (June 22)
- 30-Day Countdown – Reinstatement of Reject Codes 80 and 88 (June 22)
- Medi-Cal Rx Weekly Wrap-up for June 10-16 (June 17)
Finally in California, the Department of Health Care Services posted the “August 2022 Medi-Cal Provider Training Webinars”.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.