Rhode Island
Please see the December 2022 provider update found here on the Executive Officer of Health and Human Services (EOHHS) website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Gov. Bill Lee (R) named Dr. Ralph Alvardo, MD, FACP as the Commissioner for Tennessee Department of Health. Dr. Alvardo brings decades of diverse professional experience to Tennessee, which includes nearly 30 years as an attending physician, serving in the Kentucky State Senate since 2015 and leading the Senate Health and Welfare Committee as chairman since 2019.
Also in Tennessee, TennCare announces additional drugs to the CoverRx list, including Synthroid, Armour Thyroid and Nicotine Replacement Therapy (NRT). The TennCare CoverRx coverage was effective December 1.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS provided comments to the Health and Human Services Commission’s Vendor Drug on proposed policies related to the transition of the Medicaid pharmacy formulary, preferred drug list and prior authorization requirements to managed care organizations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
NACDS provided comments in advance of the Washington State House Health Care and Wellness Committee’s December 1 workshop meeting on “Pharmacy Benefit Manager Impacts on Prescription Drug Cost and Regulatory Developments.” In our letter, NACDS urged legislative action to curb harmful pharmacy benefit manager (PBM) practices including patient-steering, limiting pharmacies’ participation in provider networks and reimbursement practices that result in below-cost reimbursement to pharmacy providers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
All previously published expiration dates related to the COVID-19 public health emergency (PHE) are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of December 31, 2022, the conclusion of the COVID-19 national emergency or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. Medicaid is preparing now for the end of the COVID-19 PHE. Medicaid partners can assist in relaying a consistent and simple message to the Medicaid recipients by sharing key messages from the Agency in your newsletters, social media posts and other means of communication.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- 45-Day Countdown – Cal MediConnect Transition to Medicare Medi-Cal Plans (November 16)
- Update to Policy and Billing Guidance for Pharmacy Providers on COVID-19 Oral Antiviral, Paxlovid (November 11)
- Policy and Payment Allowance Update for Provider-Purchased Bebtelovimab for Treatment of COVID-19 (November 11)
- Medi-Cal Rx Weekly Wrap-Up for November 4-10 (November 11)
- NCPDP (National Council for Prescription Drug Programs) Reject Code 80 and Diagnosis Documentation of Code 1 Restriction (November 9)
- Changes to the Family PACT Pharmacy Formulary (November 7)
- Prior Authorization Required: Reject Code 75 Reminder (November 4)
- Medi-Cal Rx Weekly Wrap-Up for October 28-November 3 (November 4)
Also in California, Medi-Cal posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Gov. Jared Polis (D) named House Speaker Alec Garnett as his new chief of staff.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Indiana
The Indiana Health Coverage Programs will host an online seminar on December 1 to discuss provider notices published during November.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services, Iowa Medicaid published INFORMATIONAL LETTER NO. 2402-MC-FFS announcing the November Towns Halls will be held on Thursday, December 1, 2022, due to the Thanksgiving holiday. Visit the website for details, including registration information.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.