HB 48, a bill that requires commercial insurances and the state employee health plan to pay pharmacists for both prescription drug claims and patient procedures or services within their scope of practice at a rate not less than that paid to other non-physician practitioners, was signed by Gov. Andy Beshear (D) last week and will be effective 90 days after sine die, which was March 30.
Also in Kentucky, NACDS has been informed that in a meeting this week DMS verbally shared that they have finalized the single PBM pharmacy reimbursement model as NADAC (including current FFS “lesser of” computation) + PDF of $10.64 — the current fee-for-service model. Notably, although SB 50 of the last session allowed Medicaid to implement tiering, the final proposal will reimburse all pharmacies equally. Commissioner Lisa Lee reported that MedImpact and the Managed Care Organizations are expected to and will be required to meet the July 1, 2021 implementation date. NACDS thanks the Kentucky Retail Federation and the Kentucky Pharmacists Association for their work on this issue during and after the passage of SB 50 of the last session. NACDS served on the Medicaid PTAC Committee which recommended this methodology to Medicaid.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.