The state’s Health Coverage Programs (IHCP) provided updates on prior authorization (PA) criteria and Preferred Drug List (PDL) as approved by the Drug Utilization Review (DUR) Board at its June meeting. The provisions apply only to Medicaid fee-for-service.
Also in Indiana, a Medicaid state plan amendment (SPA) allowing pharmacists to be enrolled as providers was submitted to the Centers for Medicare & Medicaid Services (CMS). The SPA allows pharmacists to be enrolled as providers and includes provisions that would reimburse for all services pharmacists provide within their scope. Unfortunately, the state rulemaking process could take 18 months to two years to implement once approved by CMS.
For more information, contact NACDS’ Mary Staples at 817-442-1155.