District of Columbia
The Department of Health Care Finance (DHCF) announced during this week’s quarterly pharmacy forum that they have applied for a waiver with the Centers for Medicare and Medicaid Services (CMS) to allow them to pay pharmacies for immunizations administered to Fee-For-Service beneficiaries. DHCF expects CMS to take action on the waiver in Jan. 2020. NACDS will keep members updated as the process continues.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
HB 389, Testing for and Treatment of Influenza and Streptococcus, was heard on November 13 in the House Health Quality Subcommittee. The bill passed favorably with a vote of 11-3, next stop is the House Health Care Appropriations Committee.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
SB 2104, that includes language to extend the Pharmacy Practice Act until Sunday, January 1, 2023, is headed to the desk of Gov. J.B. Pritzker (D). The bill contains many of the recommendations from the Collaborative Pharmaceutical Task Force.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Iowa Medicaid Enterprise has added a new provider type to allow pharmacists to enroll as Medicaid providers. Pursuant to statewide protocols, this will allow pharmacists to order and dispense naloxone and nicotine replacement therapy tobacco cessation products, as well as to order and administer vaccines to Medicaid members. For details, please see the Informational Letter No. 2048-MC-FFS dated November 18.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
The Department of Health Bureau of Health Services and Financing issued a Medicaid provider notice that effective December 15, the Fee-for-Service Pharmacy program and Managed Care organizations will implement a new POS diagnosis code requirement and quantity limits for certain nasal sprays.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
In November, the Mississippi Division of Medicaid (DOM) introduced a new Provider Satisfaction Survey, which is a brief, electronic survey distributed to the provider community on a quarterly basis. If members haven’t yet had a chance to fill it out, the survey will remain open for another 30 days. Each survey will cover a different topic, and we will share the results once each survey is closed and the answers are compiled. For the first survey, the Department wants to hear what topics/challenges are of most interest to providers. Mississippi Division of Medicaid Provider Satisfaction Survey. The survey will remain open through the end of December.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The MO HealthNet Pharmacy Help Desk (800-392-8030) has new phone menu sub-options effective November 21, including for early refill or opioid requests and rejections. For additional information, providers can email the Help Desk.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
Gov. Steve Sisolak (D) appointed three new members to the seven-member Board of Pharmacy – public member Richard Tomasso, hospital pharmacist Krystal Freitas, and pharmacist Helen Parks who will serve as president. There is still one vacant pharmacist seat.
Also in Nevada… NACDS submitted comments supporting a proposed rule allowing pharmacists to delegate access to run the Prescription Drug Monitoring Program (PDMP) reports to delegates including intern pharmacists, pharmaceutical technicians or pharmaceutical technicians in training. This rulemaking serves to eliminate some the administrative barriers that pharmacists encounter when running PDMP reports.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
In an effort to get Gov. Michelle Lujan Grisham’s (D) Administration to include reimbursement to pharmacists for clinical services in the 2020 one-month fiscal session, NACDS provided our in-state partner, the New Mexico Pharmacists Association, with recommendations for an upcoming meeting with David R. Scrase, MD, the Secretary of the Human Services Department.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Dakota
Effective January 1, 2020, Medicaid will process pharmacy claims for the Healthy Steps (CHIP) program as well as Medicaid Expansion. For more information, please contact Alexi Murphy, PharmD, at 701-328-4061.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Ohio
On November 1, the Bureau of Workers’ Compensation began reimbursing pharmacies for dispensing a drug disposal system to patients receiving an opioid prescription for the first time in the last 12 months. The Bureau’s October 2019 issue of the Provider eNews includes an overview of the program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
HEB pharmacist Doug Read was appointed to serve a three year term on the newly created Prescription Monitoring Program Advisory Committee charged with making recommendations to the Texas State Board of Pharmacy regarding operational improvements to the Prescription Monitoring Program, resolutions to identified data concerns, methods to improve data accuracy, integrity and security, and ways to reduce technical difficulties, as well as the addition of any new data sets or services to the information provided or the access to that information.
Also in Texas… House Speaker Dennis Bonnen (R) issued a press release announcing the creation of an 11-member House Select Committee on Statewide Healthcare Costs. The Speaker will serve as Chair. NACDS will closely monitor and engage in the Committee’s activities during the interim.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
As a result of House Joint Resolution 662, the Joint Commission on Health Care (JCHC) in late November and reviewed a report of policy options for pharmacists scope of practice as it relates to Collaborative Practice Agreements (CPAs), Standing Orders and Statewide Protocols. The commission unanimously adopted two options to recommend for legislation in the 2020 Regular Session. One would add independent practice nurse practitioners and physician assistants to the list of practitioners that could be a party to a CPA; the other is a request to the Boards of Pharmacy and Medicine to convene a workgroup to determine if statewide standing orders could be expanded to include other conditions, including CLIA-waived tests.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wisconsin
The Department of Health Services announced its third annual Opioid Forum will be held May 5-7, 2020, in the Wisconsin Dells. For more information, including presentations from previous years, please visit the Opioid Forum web page.
Also in Wisconsin… The Department of Health Services will carve out coverage of most prescription outpatient drugs from the Family Care Partnership benefit effective January 1, 2020. For more information, please see the ForwardHealth update.
Also in Wisconsin… Gov. Tony Everts (D) signed into law 2019 Wisconsin Act 24. The enacted legislation authorizes pharmacists to administer ACIP-recommended vaccines to individuals 6 years of age and older under their own independent authority and authorizes pharmacists to administer other vaccines pursuant to a prescription, vaccine protocol or standing order (including vaccines to children younger than 6 years of age pursuant to a prescription issued within 29 days of vaccine administration.)
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Alabama
On September 26, NACDS participated in a Medicaid meeting/conference call, during which the agency discussed potential pharmacy reimbursement modifications. In accordance with current market evidence, the agency proposed modifying the default reimbursement methodology from WAC + 0% to WAC – 4%, if no AAC exits for a drug product. Medicaid asked for all stakeholders to submit comments; those comments and responses, along with all other items discussed that day, may be found on the website. On November 15, the agency announced its plan to move forward with a State Plan Amendment (SPA) for the proposed change.
Also in Alabama… A reminder that gabapentin became a Schedule V medication on November 18. You may recall on May 15, the State Committee of Public Health voted to change gabapentin to a Schedule V medication, effective November 18, 2019. This was at the request of the Board of Medical Examiners. Pharmacies should have completed the necessary changes required when moving a legend medication to a scheduled medication. These changes may include software requirement changes, increases in physical space to store scheduled medications and changes in procedures for prescribing/dispensing a controlled substance. Questions can be directed to Nancy Bishop, State Pharmacy Director, Department of Public Health.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Services (DHCS) posted a document titled "Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-For-Service Frequently Asked Questions," to the DHCS' Medi-Cal Rx: Transition webpage. The document provides additional guidance and clarification to Medi-Cal beneficiaries, providers, plan partners, tribal health programs and other interested parties, regarding the Friday, January 1, 2021, transition of Medi-Cal's pharmacy benefit (collectively referred to as "Medi-Cal Rx").
Also in California… Chain pharmacies interested in filing for the DHCS' retroactive Medi-Cal rate recoupments and the alternative rate recoupment process must submit an application by this Friday, November 22. Applications will not be considered past that date. More information on the application process can be accessed online. For chain pharmacies not participating in the alternative payment rate process, please refer to the Pharmacy Retroactive Claim Adjustments FAQs on DHCS' website – #5 explains the timeframe for recoupments for pharmacies, #7 explains how DHCS will handle the recoupments via different potential scenarios and #17 explains how pharmacies can estimate their outstanding balance due to DHCS.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Department of Health Care Policy and Financing, Medical Services Division is having a rulemaking hearing on Friday, January 10 on a proposed rule (10 CCR 2505-10, Section 8.800.18.C.1.a) regarding the Rx Review program which allows the program’s members to do a consultation with a pharmacist over the telephone if they live outside of a reasonable travel distance from the consulting pharmacist. Members may submit comments directly to Chris Sykes, Medical Services Board Coordinator.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
HB 389, Testing for and Treatment of Influenza and Streptococcus, was heard on November 13 in the House Health Quality Subcommittee. The bill passed favorably with a vote of 11-3, next stop is the House Health Care Appropriations Committee.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
SB 2104, that includes language to extend The Pharmacy Practice Act until Sunday, January 1, 2023, is headed to the desk of Gov. J.B. Pritzker (D). The bill contains many of the recommendations from the Collaborative Pharmaceutical Task Force.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Iowa Medicaid Enterprise has added a new provider type to allow pharmacists to enroll as Medicaid providers. Pursuant to statewide protocols, this will allow pharmacists to order and dispense naloxone and nicotine replacement therapy tobacco cessation products, as well as to order and administer vaccines to Medicaid members. For details, please see the Informational Letter No. 2048-MC-FFS dated November 18.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Michigan
Gov. Gretchen Whitmer (D) signed into law HB 4412 (Act No. 123, Public Acts of 2019), effective Wednesday, July 1, 2020, prohibiting the sale of over-the-counter medicines containing the ingredient dextromethorphan to minors.
Also in Michigan…NACDS and the Michigan Retailers Association participated in a Board of Pharmacy Rules Committee Work Group meeting on November 15, where pharmacy technician draft language was discussed. NACDS also submitted written comments.
Also in Michigan… Gov. Gretchen Whitmer (D), the Department of Health and Human Services and other members of the Michigan Opioids Task Force, issued a press release to announce steps to combat the opioid epidemic. More information may be found on the Opioid Resources webpage.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Missouri
The MO HealthNet Pharmacy Help Desk (800-392-8030) has new phone menu sub-options effective November 21, including for early refill or opioid requests and rejections. For additional information, providers can email the Help Desk.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New Mexico
In an effort to get Gov. Michelle Lujan Grisham’s (D) Administration to include reimbursement to pharmacists for clinical services in the 2020 one-month fiscal session, NACDS provided our in-state partner, the New Mexico Pharmacists Association, with recommendations for an upcoming meeting with David R. Scrase, MD, the Secretary of the Human Services Department.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
On November 1, the Bureau of Workers’ Compensation began reimbursing pharmacies for dispensing a drug disposal system to patients receiving an opioid prescription for the first time in the last 12 months. The Bureau’s October 2019 issue of the Provider eNews includes an overview of the program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
The Department of Health and Human Services will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments for one week in November 2019 to accommodate the Thanksgiving holiday. Due to this holiday schedule, claims must be submitted by 5:00 p.m. on Saturday, November 23 to be included with the payment scheduled for Friday, November 29. Payments will run on Monday, November 25 and electronic remittance advices will be available on Tuesday, November 26. Payments will be dated Friday, November 29, as usual. Please refer any questions or concerns regarding this alert to the Provider Service Center at (888) 289-0709.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.