In The States – Page 151 – Weekly news about states

Minnesota

The Minnesota Department of Human Services (DHS) held a pharmacy stakeholder meeting this week to discuss the upcoming 2022 fee-for-service pharmacy cost of dispensing survey that will be conducted by Myers and Stauffer. The surveys will be delivered on October 19 to pharmacies via mail (corporate headquarters for chains) and electronically to the email address they have on file. Surveys are to be completed by November 16. Myers and

Stauffer has set up a dedicated email for questions. The same email address may be used for pharmacies to provide an alternative email address for electronic survey delivery or to request an extension, if needed. For more detail on the survey process, see the meeting slide deck and draft survey instrument.

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

Erica Joyner2022-10-07T10:45:23-04:00October 7, 2022|Minnesota|

Missouri

The Board of Pharmacy is soliciting comments due October 15 on a proposal establishing requirements for authorized pharmacists dispensing HIV post-exposure prophylaxis as authorized by section 338.730, RSMo.

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

Erica Joyner2022-10-07T10:44:37-04:00October 7, 2022|Missouri|

Nebraska

Gov. Pete Ricketts (R) issued Executive Order 22-05, to expire on December 31, 2022. Executive Order 22-02, which is currently scheduled to expire on September 30, 2022, shall remain in effect through December 31, 2022, and the identical statutory waivers and conditions contained within Executive Orders 21-12 and 21-15 that were extended by Executive Order 22-02 shall remain in effect through December 31, 2022, except that Medication Aide renewals will no longer be deferred after March 31, 2022. The Department of Health and Human Services prepared FAQs related to Executive Order 22-05.

Also in Nebraska, the Department of Health and Human Services (DHHS) announced the next COVID Update call will take place on October 12 at noon (Central). To join the all, dial 1-408-418-9388 and enter access code: 2485 909 6350 or use the meeting link: https://sonvideo.webex.com/sonvideo/j.php?MTID=m18465ba5a677a644d13049ac859b21dc

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

Erica Joyner2022-10-07T10:43:27-04:00October 7, 2022|Nebraska|

Nevada

The Board of Pharmacy posted the agenda for the two-day hybrid virtual/in-person October 13 and 14 meeting.

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

Erica Joyner2022-10-07T10:42:17-04:00October 7, 2022|Nevada|

New York

New York: A grassroots alert supporting advocacy efforts in NYS (New York State) for the move of pharmacy benefits from Medicaid Managed Care to Fee for Service effective 4/1/23 (known as NYRx). Click here to access the alert

Please ask all your NY pharmacies and their staff members to act TODAY using this easy-to-use one click Alert to counter efforts by those opposed to NYRx who are actively trying to get NY lawmakers to repeal or delay it.

This policy is particularly important for Medicaid patients’ access to pharmacy care and for the community pharmacies that support them.

Also in New York, a request was sent out from the NY Department of Financial Services (DFS) last month. To clarify, please just send data to the Department directly, as directed below. Do not copy NACDS. However, if you do share that data with the state, I would ask that you let us know that you shared data with the Department so we will, at a minimum, be able to tell how many of our members responded with their own companies’ data. NACDS will be commenting and documents from other states highlighting the PBM issues.

The Department is inviting submissions of data or documented evidence from the public related to pricing models and pharmacy reimbursement practices by pharmacy benefit managers (“PBMs”) in New York State.

View the Request for Public Comments (PDF)

Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-06” included in the subject line. Failure to include “PBM2022-06” in the subject line may result in your comment not being considered. The deadline for responses is October 31, 2022.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

inthenews2022-10-07T14:27:50-04:00October 7, 2022|New York|

North Carolina

To ensure beneficiaries can seamlessly receive care on day one, the North Carolina Department of Health and Human Services (NCDHHS) will delay the implementation of the NC Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans until April 1, 2023.

Tailored Plans, originally scheduled to launch December 1, 2022, will provide the same services as Standard Plans in Medicaid Managed Care and will also provide additional specialized services for individuals with significant behavioral health conditions, Intellectual/Developmental Disabilities and traumatic brain injury.

The delayed start of Tailored Plans allows Local Management Entity/Managed Care Organizations, which will operate the Tailored Plans, more time to contract with additional providers to support member choice and to validate that data systems are working appropriately. The decision is supported by the leadership of the state’s six LME/MCOs.

While the start of Tailored Plans will be delayed, specific new services will still go live December 1, 2022.

More information regarding the beneficiary choice period and other key dates leading up to the April 1, 2023, launch will be shared by NCDHHS in the coming weeks. For more information about Tailored Plans, please visit NC Medicaid’s Tailored Plan website.

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

Erica Joyner2022-10-07T10:41:27-04:00October 7, 2022|North Carolina|

Ohio

As you are aware, Ohio Medicaid (ODM) implemented the Single PBM, Gainwell, at Midnight on October 1. NACDS has been working with members, ODM and Gainwell daily to provide solutions as they work through technical issues causing denials, many of which have since been resolved or temporarily patched over. To report any major system issues, please use the dedicated email that Gainwell/ODM is monitoring in real-time. If you need NACDS’ assistance to emphasize significant issues, please contact Jill McCormack.

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

Erica Joyner2022-10-07T10:40:24-04:00October 7, 2022|Ohio|

Pennsylvania

Gov. Tom Wolf (D) issued a news release this week announcing that the Naloxone Standing Order has been expanded to include the 2 Dose Formulation and encouraging patients to bring a copy of the standing order to pharmacies to request the drug. NACDS reminds members that the PA Naloxone Copay Assistance Program will reimburse pharmacies up to $75 for patient copays when the patient is hesitant to pick up the prescription due to cost. For practical operational reasons, the claim must be adjudicated on the current PACE Program system. However, a claim for ANY insured patient regardless of what type of insurance they have – commercial or public – qualifies. There are no criteria to proving financial hardship on the pharmacy because access is the point of the program.

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

Erica Joyner2022-10-07T10:38:19-04:00October 7, 2022|Pennsylvania|

Texas

The Drug Utilization Review Board posted the agenda for October 21 meeting. Refer to the Texas Drug Utilization Review Board Handbook for the instructions about submitting written materials to the board before the meeting and public testifying on the day of the meeting.

Also in Texas, the Health and Human Services Commission (HHSC) updated the July 2022 Medicaid Preferred Drug List on September 28 and provided the following updates:

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

Erica Joyner2022-10-07T10:37:24-04:00October 7, 2022|Texas|