Ohio

The Ohio Department of Medicaid's (ODM) next generation managed care program will go live July 1, 2022. At that time, they will introduce new programs, services, and managed care entities (MCEs). In preparation for the next generation program, ODM is encouraging providers to contact the next generation MCEs that they are interested in contracting with to begin the process to join their provider networks. Provider contracting contact information for the next generation MCEs can be found on the Resources for Providers webpage of the next generation Ohio Medicaid website. Contracting must be completed by February 15, 2022, to be included in the Next Generation Managed Care Provider Directory on day 1 of member transition enrollment. 

Also in Ohio, ODM has announced that the supplemental tiered dispensing fee quarterly payment to pharmacies that planned to be disbursed in the first two weeks of November has been delayed pending CMS approval. NACDS will keep members updated as new information becomes available. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 19, 2021|Ohio|

Oklahoma

The Board of Pharmacy received updated information from the Oklahoma Bureau of Narcotics and Dangerous Drugs (OBNDD) regarding how to submit DEA 106 forms.  Please send all DEA 106 forms for OBNDD via email to losstheftcds@obn.ok.gov.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

November 19, 2021|Oklahoma|

Minnesota

The Administrative Law Judge assigned to the PBM rulemaking process, Kimberly Middendorf, has concluded her review of the Department of Commerce’s proposed rule and SONAR, as well as all comments, responses, and rebuttals from members of the public, and on Friday issued a “Report of the Administrative Law JudgeJudge Middendorf’s report is available for review on the Commerce website (scroll down to Report of the Administrative Law Judge). 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 19, 2021|Minnesota|

Rhode Island

The Department of Health has extended (60 days) the Emergency Regulation requiring immunization against COVID-19 for all workers in licensed health care facilities and other practicing health care providers.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

November 19, 2021|Rhode Island|

South Carolina

The South Carolina Pharmacy Association is hosting their 19th Annual SE Women of Pharmacy Leadership Conference. You are invited to register for this event at the member rate using the discount code "STATE".  Click here for more information and register. Early Bird registration rates and hotel block are open from now until November 28, 2021. After this date, or after the block is filled, rooms are subject to prevailing rates and availability, and general registration rates will apply. 

Also in South Carolina, the Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments for one week in November 2021 to accommodate the 2021 Thanksgiving holiday. Thursday, Nov. 25, 2021, and Friday, Nov. 26, 2021, have been designated as South Carolina state holidays. Due to the holidays, claims must be submitted by 5 p.m. on Saturday, Nov. 20 to be included with the payment scheduled for Friday, Nov. 26. Payments will run on Monday, Nov. 22 and electronic remittance advice will be available on Tuesday, Nov. 23. Payments will be dated Friday, Nov. 26. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

November 19, 2021|South Carolina|

Washington

The State Department of Health (DOH) announced that as of early November, more than 10 million doses of COVID-19 vaccine have been administered since distribution began in mid-December 2020.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

November 19, 2021|Washington|

Alabama

Effective December 28, 2021, the Alabama Medicaid Agency will replace Claim Adjustment Reason Code (CARC) 45 with a new code to ensure compliance with the Committee on Operating Rules for Information Exchange (CAQH CORE) combinations reported on the X12 835 Electronic Remittance Advice (RA). The new CARC is as follows: 

CARC (96) – (non-covered charge(s)) with an appropriate Recipient Advice Remark Code (RARC) for the situation. 

UPDATE: These changes are currently available in our test environment for Provider and Vendor testing. Testing should be completed by December 24, 2021. The updated reporting will be implemented for claims appearing on the January 7, 2022 check write going forward.  

Also in Alabama, effective December 28, 2021, Alabama Medicaid will implement changes to the 271 Eligibility and Benefit Response transaction to ensure compliance with the Committee on Operating Rules for Information Exchange (CAQH CORE) for "Normalizing" the last name, which means removing all special characters, punctuation, upper case letters, suffixes, and prefixes to increase the chances of a match.  

UPDATE: These changes are currently available in our test environment for Provider and Vendor testing. Testing should be completed by December 24, 2021.  

Providers with questions concerning the upcoming change can submit them via the following email address: interChange_testing@DXC.com. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

November 12, 2021|Alabama|

California

The following documents were recently posted on the Medi-Cal Rx Web Portal:  

Also in California, Magellan informed NACDS and the California Retailers Association that many pharmacies have "requested" a PIN to register for the Medi-Cal Rx Provider Portal but less are activating their accounts.  As we get closer to the January 1, 2022, start date for Medi-Cal Rx, Magellan wants to make sure pharmacies are not only registered but have activated their accounts and are testing the provider portal.  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

November 12, 2021|California|

Delaware

The Delaware Division of Professional Regulation is proposing to amend the Uniform Controlled Substances Act regulations to make the provisions on expiration and partial filling of controlled substance prescriptions consistent with federal standards. The rule would make technical revisions. A hearing is scheduled for Dec. 1, 2021, in Dover.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

November 12, 2021|Delaware|

Kentucky

An RX Fraud Alert has been issued by the Office of Inspector General, Division of Audits & Investigation. The office has seen a huge uptick in prescriber identity theft and forged (C-V) Promethazine with codeine prescriptions across the Commonwealth. They encourage pharmacies to reach out to their Drug Enforcement and Professional Practices Branch with questions, concerns, or fraud reports at 502-564-7985.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 12, 2021|Kentucky|

Maryland

The State Health Information Exchange, CRISP (Chesapeake Regional Information System for our Patients) now allows pharmacists access to clinical data for patient treatment and clinical care coordination. It also allows pharmacists to see alerts in the Prescription Drug Monitoring Program (PDMP) like nonfatal overdoses and deceased patient notifications. To access this information, the pharmacy must complete the CRISP Participation Agreement and review additional policies and procedures. For information about the CRISP participation agreement and how to sign, click here. Pharmacies should also contact CRISP outreach at support@crisphealth.org.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 12, 2021|Maryland|

New Hampshire

The New Hampshire Board of Pharmacy is proposing to readopt amendment regulations under NHAR Ph 807 and 808 to revise the registered pharmacy technician duties to remove the restriction that a certified pharmacy technician may not perform data entry of prescription medication orders. The rule also would remove the requirement that pharmacy technicians fulfill Pharmacy Technician Certification Board or National Healthcare Association certification. A hearing is scheduled for Nov. 17, 2021, in Concord.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

November 12, 2021|New Hampshire|

New Jersey

The New Jersey Board of Pharmacy is proposing to adopt regulations under NJAC 13:39-1 to require pharmacy permit holders and registered pharmacists-in-charge to implement a continuous quality improvement program to prevent prescription errors.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

November 12, 2021|New Jersey|

Ohio

The Board is proposing an amendment to OAC 4729:5-5-06 to require the contact phone number of the dispensing pharmacy on the prescription label.  This rule only applies to labeling of drugs dispensed by an outpatient pharmacy.  Please send all comments to by close of business November 24th to RuleComments@pharmacy.ohio.gov.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 12, 2021|Ohio|

Oklahoma

Board of Pharmacy posted an "Inadequate Staffing" Form on its website.  According to the Board's notice, a pharmacist may complete this form "if conditions exist that could cause prescriptions to be filled in an unsafe manner with regard to staffing in the pharmacy".  Board staff will be reviewing the completed forms. 

 Also in Oklahoma, the Board of Pharmacy issued a correction to the OBNDD fax number in this recent communication. The Board of Pharmacy issued this alert: "Please be aware that there have been several Pharmacy Burglaries (Nighttime Break-Ins) recently. Please be alert to any suspicious activities. The DEA 106 Forms for theft/loss of CDS must be reported to the DEA, OBNDD and OSBP. OBNDD is requesting that the pharmacies fax the DEA 106 Forms for Burglaries to: Attention: Cynthia Perez, Criminal Intelligence Analyst, Oklahoma Bureau of Narcotics and Dangerous Drugs – Fax 405-524-7619. Make sure that you include the Police Report and provide Surveillance Video if available. Please make sure that your alarm systems are working properly and consider enhancing your security systems as well." 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

November 12, 2021|Oklahoma|

Arkansas

Governor Asa Hutchinson (R) and legislative leaders have finally reached an agreement on a tax cut package, so the Governor is now expected to make a formal statement soon announcing that he will convene a special session after Thanksgiving. NACDS has confirmed with several sources that the repeal of the Insulin Rebate law, Act 1104, will be an issue the legislature addresses. 

Also in Arkansas, the Governor has been assured by his Department of Human Services that the federal government will be granting a new waiver soon for the Medicaid expansion program first enacted in 2014.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

November 5, 2021|Arkansas|

California

The Department of Health Care Services published its Medi-Cal Rx Monthly Bulletin – November 1, 2021 issue. Below is the outline from this month's bulletin 

  1. Changes to the Contract Drugs List (CDL), Effective November 1, 2021 
  2. Changes to the Contract Drugs List (CDL) – Over the Counter Drugs, Effective November 1, 2021 
  3. Pharmacy Provider Notice 
  4. Prior Authorization Fax Form Available 
  5. Medi-Cal Rx Pharmacy Providers Electronic Fund Transfer Set Up and opt out 
  6. Medi-Cal Rx Transition and Resources Training – Register Now! 
  7. Medi-Cal Rx Transition Pharmacy Cutoff Instructions 

Also in California, as of January 1, 2022, all pharmacy benefits will transition away from CA-MMIS and the Medi-Cal managed care plans to Medi-Cal Rx. This transition will create a uniform process for pharmacy providers and prescribers and applies to everyone in Medi-Cal fee-for-service and managed care. All benefits that are billed on a pharmacy claim will be transitioned to Medi-Cal Rx and all Prior Authorizations (PA) will be reviewed by Medi-Cal Rx starting on January 1, 2022. Magellan Rx Management, the state's vendor, created these resources and information to assist pharmacy providers in their preparations for the implementation of Medi-Cal Rx.  

  • "Are you ready?" – Summary of information and resources for pharmacies and pharmacists. 
  • The Contract Drugs List (CDL) is found on the Medi-Cal Rx Web Portal and contains the searchable Medi-Cal Formulary. The CDL displays drugs covered by Medi-Cal without a prior authorization (PA). The searchable CDL allows prescribers to easily identify all covered drugs. Registering for the Medi-Cal Rx Web Portal allows for easy access to the Provider Portal, where the CDL can be found through the Forms & Information link. 

Also in California, the following documents were recently posted on the Medi-Cal Rx Web Portal: 

Also in California, the Department of Health Care Services (DHCS) is seeking eligible persons to expand the Medi-Cal Contract Drug Advisory Committee to a maximum of ten members, including three pharmacists. Interested persons may submit their statement of qualifications and CV/resume to DHCS by November 19. For details, see "Medi-Cal Contract Drug Advisory Committee (MCDAC)" on the DHCS website 

Also in California, NACDS submitted comments to the Board of Pharmacy outlining concerns with proposed rules that would impose onerous inventory reconciliation requirements on pharmacies throughout the state. Our comments urged the Board not to layer on additional requirements beyond what DEA requires, explaining that the Board's proposal would result in a cumbersome new process for pharmacies to accommodate.  

Also in California, the Board of Pharmacy published a Notice of Proposed Action that will require each permit holder to notify the board of any temporary closure of a facility as soon as the closure exceeds three consecutive calendar days. The closure status will be public information. Comments on the proposed text will be accepted by the board until December 13. 

Also in California, the Department of Consumer Affairs issued the following waiver extension:  

DCA Waiver DCA-21-200 Order Extending DCA-20-02, 20-57, 20-91, 21-165, and 21-187 Order Waiving License Reactivation or Restoration Requirements – Final Extension. A list of current waivers is available on the DCA website. 

Finally in California, the Department of Public Health developed a Q&A for booster doses now available for Pfizer, Moderna and Johnson & Johnson COVID-19 vaccines. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

November 5, 2021|California|

Delaware

SB 105 which allows pharmacists to administer or dispense hormonal contraceptives under a standing order from the Division of Public Health was signed into law.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

November 5, 2021|Delaware|

District of Columbia

The latest edition of the Board of Pharmacy’s newsletter is available here. It contains updated board contact information, the schedule of meetings, links to the new online licensing portal and a reminder about the Opioid Labeling Act which was effective in March of 2021.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

November 5, 2021|District of Columbia|

Illinois

The Illinois Department of Public Health (IDPH) has issued updated guidance to help people celebrate the holiday season more safely as the state continues to battle the COVID-19 pandemic.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

November 5, 2021|Illinois|

Iowa

The Iowa Department of Public Health (IDPH) posted the following: 

For the latest information and updates impacting Iowa's enrolled vaccine providers, please visit the IDPH COVID-19 Vaccine Providers webpage, and click on the most recent version of the " Vaccine Information Brief". If you have questions, contact the COVID-19 Vaccine Call Center at 1-800-831-6293 ext. 1 or COVID19Vaccine@idph.iowa.gov. 

Also in Iowa, the Board of Pharmacy published a Notice of Intended Action to amend Chapter 39, "Expanded Practice Standards" relating to collaborative pharmacy practice agreements between pharmacists and Iowa-licensed prescribers who have independent prescribing authority. The rule making identifies the minimum required elements of these agreements. Comments are due by 4:30 p.m. on November 23. 

Also in Iowa, the Department of Human Services announced registration is open for the November 2021, December 2021, and January 2022, virtual town halls for both providers and members. Please note the November and December meeting dates are different due to the holidays. Beginning in January 2022, the monthly virtual town halls will be held on the fourth Thursday of each month. For details, including registration, refer to INFORMATIONAL LETTER NO. 2283-MC-FFS-D. 

Finally in Iowa, if you are a provider, or part of a provider entity, that receives payments of $5,000,000 (million) or more from Iowa Medicaid in any federal fiscal year (October 1 to September 30), then INFORMATIONAL LETTER NO. 2275-MC-FFS-D, related to annual submission requirements regarding prevention and detection of Medicaid fraud and abuse, applies to you or your organization.  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

November 5, 2021|Iowa|
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