The Department of Health and Human Services (DHHS) announced the next COVID Medicaid Provider call will take place on October 5 at noon (Central). Call details will be posted at this website one week before the call.
Also in Nebraska, the DHHS issued a News Release, titled “Nebraska Medicaid To Interview Bidders For New Managed Care Contracts.”
Finally in Nebraska, the DHHS posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
NACDS reminds members that Gainwell, the Ohio Medicaid Managed Care Single Pharmaceutical Benefits Manager (SPBM), will being offering pharmacies training on using the web portal on September 19. Registration instructions can be found on the Single PBM page. Select the selecting the provider resources tab, then clicking on “SPBM Web Portal Training.” Gainwell will be processing all Medicaid managed care claims beginning on October 1, 2022.
Also in Ohio, the Board of Pharmacy has issued draft regulations allowing registered and certified pharmacy technicians to vaccinate. The rule makes technician immunization authority consistent with Ohio’s current pharmacist immunization authority as it relates to age and vaccine type, per passage of House Bill 6 of 2021. NACDS intends to comment on this rule. Please send Jill McCormack your comments by October 3.
Finally in Ohio, Medicaid and Myers & Stauffer have announced an extension of the due date for the 2022 mandatory Cost of Dispensing Study to September 21 and have stated in a letter to pharmacies that this will be the final extension of the survey due date.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy posted the agenda for the Public Health & Pharmacy Formulary Advisory Committee to be held on September 21. Please note agenda items related to protocol development and proposed protocol revisions.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Legislation that would allow the state Auditor General to have access to PBM’s data from the Medicaid Managed Care program passed the House unanimously this week. House Bill 1630, sponsored by Rep. Jonathan Fritz (R), now goes to the Senate for consideration.
Also in Pennsylvania, the Board of Pharmacy has posted the agenda for their September 27th meeting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Effective for dates of service on or after Sept. 15, 2022, the South Carolina Department of Health, and Human Services (SCDHHS) will expand coverage for additional pneumococcal immunizations for Healthy Connections Medicaid members 19 years of age and older under the pharmacy and medical benefit.
SCDHHS will reimburse providers for the administration of the immunizations in accordance with the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) Adult Immunization Schedule for the following Healthcare Common Procedure Coding System (HCPCS) codes:
The new codes will be reflected on the Physicians Fee Schedule and updates to the Physicians Services provider manual will be available by Sept. 15, 2022.
Pharmacy reimbursement utilizes the standard basis of payment for the fee-for-service pharmacy benefit at the lowest of:
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Health and Human Services Commission’s (HHSC) Executive Commissioner Cecile Erwin Young announced that Dr. Jennifer Shuford will serve as interim commissioner of the Texas Department of State Health Services (DSHS), effective October 2022, replacing Dr. John Hellerstedt who is retiring from state service. Shuford currently serves as chief state epidemiologist at DSHS. She is also a member of the Texas Medical Association, where she serves as a consultant to TMA’s Committee on Infectious Diseases.
Also in Texas, the September draft specialty drug list has been posted. Comments are due by September 22, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health has issued an updated standing order for COVID vaccines reflecting current CDC (Centers for Disease Control) recommendations.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Health Care Authority (HCA) has made the following updates to its COVID-19 monoclonal antibody policy concerning HCPCS code Q0222:
See Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, under COVID-19, Policies, and billing guidance for more information regarding the policy and procedure codes involved.
HCA revised the COVID-19 Fee Schedule. See HCA’s Provider billing guides and fee schedules, under COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Dept. of Health Services recently announced the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.