The Prescription Drug Affordability Board met on October 7. The meeting’s main purpose was to finalize the draft for the questionnaire for public payors and to provide an update from the legislative planning workgroup, specifically concerning LD 1829. The Board is scheduled to meet next on November 25 at 10:30 am.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Prescription Drug Affordability Board (PDAB) and Stakeholder Council (PDASC) announced upcoming meeting schedules:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
On October 4, MassHealth released the results of its cost of dispensing study. It was announced that the proposed updated dispensing fee for chain pharmacies will be reduced by $1.51 per prescription from $10.02 to $8.51. This proposed change is scheduled to take effect on July 1, 2025. The dispensing fee for independent pharmacies will be increased by 19 cents to $10.21. The division also announced a policy change that will require managed care organizations (MCOs) to pay the MassHealth fee-for-service rate to independent pharmacies instead of the current managed care contract rate. MCOs will continue to pay chain pharmacies the negotiated contract rate. The raw data from the cost of dispensing survey is expected to be made available within the next two weeks. The proposed amendments will be submitted to CMS for its approval.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Board of Pharmacy posted a notice and agenda for a Rules Committee Workgroup on November 4. Instructions for attending the meeting are included in the notice.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Looking for ways to reduce healthcare costs for Missourians, six Senators have been named to the newly formed Senate Interim Committee on Driving Down the Cost of Healthcare. The committee will issue a report and recommendations by the end of the year
Also in Missouri, effective October 1, the MO HealthNet Pharmacy program discontinued coverage for at-home COVID-19 tests dispensed as a kit for at-home use. COVID-19 testing will continue to be covered for MO HealthNet participants when administered by a MO HealthNet enrolled provider.
Finally in Missouri, St. Louis Public Radio Morning Edition published online a PBM reform story about St. Louis-based Express Scripts being sued by the Federal Trade Commission (FTC). Pharmacists and patient advocates are advocating for lower drug prices.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy posted the agenda for the two-day hybrid meeting in Las Vegas scheduled for October 16 and 17. On October 17 there will be a public hearing on proposed rules regarding documentation a pharmacy must obtain from a person before dispensing a controlled substance prescription.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
On October 9, the Board of Pharmacy held its regular scheduled meeting. The agenda included the report of the 2024 Pharmacy Workplace Survey.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Office of Emergency Medical Services seeks pharmacists to assist with medical response in Western North Carolina due to Hurricane Helene. A minimum deployment of three consecutive days is preferred. If interested, sign up here and note your availability in the comments section. For questions, email OEMSSupportCell@dhhs.nc.gov.
Also in North Carolina, with Western North Carolina seeing conditions of catastrophic proportions due to Hurricane Helene, there are still many areas without power or cell service and individuals are stranded on islands due to massive road closures. If your company plans to move people, resources or equipment into western North Carolina, you must coordinate plans and movements through NCEM at BEOC@ncdps.gov and copy elizabethr@ncrma.org
Finally, the Department of Health and Human Services (DHHS) is committed to ensuring continued access to care for Medicaid beneficiaries, as well as reimbursement to qualified providers for services rendered, in good faith, throughout the period of impacts from Hurricane Helene, retroactively from September 25 through October 15 (unless otherwise communicated by DHHS).
Health care professionals who will be rendering services to Medicaid beneficiaries due to Hurricane Helene can complete and apply through the NCTracks Provider Portal. Please refer to the disaster provider enrollment job aid Disaster Relief Provider Enrollment Application Job Aid (PRV703) located under Quick Links on the NCTracks Provider Enrollment home page for necessary instructions to complete the temporary disaster provider enrollment application. Be sure to review the job aid before starting to complete the application, as several preliminary steps are necessary.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gainwell delivered a communication this week to notify pharmacies that the 2025 Payment Error Rate Measurement (PERM) program is now in progress. The Department of Medicaid (ODM) is mandated to participate in PERM by the Centers for Medicare and Medicaid (CMS). The program will assess payment accuracy rate for the Medicaid and CHIP programs. If chosen in a random sample, your pharmacy will soon receive a Medical Records Request from the CMS review contractor, Empower AI. This cycle measurement will review Medicaid and CHIP payments made in Reporting Year (RY) 2025: July 1, 2023, through June 30, 2024. ODM may recover payments made to providers who fail to cooperate by the established deadlines. Providers must retain recipient records for six years from the date of payment, under the terms of the Provider Agreement, even if they no longer do business with ODM. For more information about PERM, please visit the Provider link on the CMS PERM website. A video explaining the process is also available. For questions, please contact the ODM Medicaid Audit Coordination Team.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.