Arizona
HB 2841, the general appropriations act (2022-2023), includes funding for the Organized Retail Theft (ORT) Task Force; see page 9 for details.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal.
- Medi-Cal Rx Policy for Requesting Alternative Medication in Case of Supply Shortage (April 15)
- Medi-Cal Rx Policy for Requesting Alternative Medical Supplies or Enteral Nutrition Products Due to Supply Shortages (April 15)
- Medi-Cal Rx List of Resources (April 11)
- Prior Authorization Status Notifications (April 11)
- Medical Supplies Update on Pen Needles (April 11)
- Medi-Cal Rx Coordination of Benefits (COB) Reminder (April 8)
- Dexcom Therapeutic Continuous Glucose Monitoring (CGM) – Issue Resolved (April 7)
- Medicare Remit Easy Print Software for EDI 835 Files (April 5)
- Medi-Cal Rx 101 Trainings for April 2022 (April 4)
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- Friday, April 22 – 2:00 p.m.-3:00 p.m. PST
- Friday, April 29 – 2:00 p.m.-3:00 p.m. PST
- Enteral Nutrition Update: Temporary Interchange of Equivalent Contracted Enteral Nutrition Products Due to Recent Formula Recall (April 4)
- Monoclonal Antibodies for the Outpatient Treatment of COVID-19 as a Pharmacy Benefits (April 1)
- Changes to Pneumococcal 15 & 20 Vaccines (April 1)
- Medi-Cal Rx Monthly Bulletin (April 1)
- Changes to the Contract Drugs List (April 1)
- Changes to the Contract Drugs List (CDL) – Over-the-Counter Drugs (April 1)
- Changes to Contract Drugs List (CDL) – Authorized Drug Manufacturer Labeler Codes (April 1)
- Updates to the Medi-Cal Rx Provider Manual (April 1)
- How to Find Covered Drugs (March 28)
- Deadline Reminder: Electronic Claims Agreement (March 25)
- By April 30, 2022, all participating Medi-Cal Rx pharmacy providers and billers need to submit a Medi-Cal Rx Telecommunications Provider and Biller Application Agreement (DHCS Form 6500) to continue submitting electronic claims without interruption. Refer to the Medi-Cal Rx Electronic Claims Agreement alert, originally posted on December 31, 2021.
Also in California, the Board of Pharmacy posted the following to the website:
- Legislation and Regulation Committee Meeting Agenda – April 26
- Communication and Public Education Committee Meeting Agenda and Meeting Materials – April 26
- Full Board Meeting CORRECTED Agenda – April 26-27
Also in California, AB 852, related to e-prescribing software requirements and prescriber exceptions to e-prescribing requirements, was amended on April 18.
Finally in California, AB 1651 was amended on April 18, creating the Workplace Technology Accountability Act. Among its various provisions, this legislation would give workers new rights with respect to their data, regulates data employers collect, regulates how employers can monitor workers, regulates the ways in which employers use algorithms to monitor workers and creates a new enforcement regime through the Department of Fair Employment and Housing. The bill is sponsored by the California Labor Federation, SEIU California, the United Food and Commercial Workers-Western and the States Council.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Gov. Ron DeSantis (R) signed into law on April 6, two bills, HB 1209,, effective July 1, 2022, which allows registered pharmacy technicians, with appropriate training, to administer vaccines to adults, and SB 544, also effective July 1, 2022, which allows a pharmacist to dispense an emergency opioid antagonist, an auto injection delivery system or intranasal application, pursuant to a pharmacist’s order or to a non-patient-specific standing order.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
On April 9, the Illinois Senate adopted Senate Resolution 792, which calls upon the Auditor General to conduct a performance audit of Healthcare and Family Services (HFS) administration of pharmacy benefit managers.
Also in Illinois, Healthcare and Family Services (HFS) issued the following Provider Notice. HFS and state’s Department of Public Health asked that we issue a reminder that even though the HRSA uninsured program has ended there is still a process through HFS.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
HB 424, by Rep. Chris Taylor (R) related to immunization administration authority, was amended and reported out of the House Health and Welfare Committee last week. The bill is scheduled on the House Calendar on Monday, April 25. The bill would allow pharmacists to continue their authority granted under the federal Public Readiness and Emergency Preparedness Act (PREP Act) authority to immunize patients seven years of age and older without a prescription. NACDS is urging members to take action immediately utilizing the NACDS RxIMPACT Alert.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services posted the agenda for the next Medicaid DUR Board Meeting scheduled to be held on May 10.
Also in Nebraska, the Department of Health and Human Services issued Request for Proposal (RFP) Number 112209 O3 facilitating the selection of a qualified bidder to provide a full-risk, capitated Medicaid Managed Care program for physical health, behavioral health, pharmacy and dental services for at least the next five years. Nearly all Medicaid beneficiaries currently receive health care services through Heritage Health, the state’s integrated managed care program.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the March 2022 Medicaid Update.
You may also go straight to an article or topic that pertains to you by selecting it from the current issue’s table of contents below.
Policy and Billing
- Early and Periodic Screening, Diagnostic, and Treatment Program Childhood Vaccine Counseling Coverage Benefit (Cover)
- New York State Medicaid Professional Pathology Policy
- Attention: New York State Medicaid Fee-For-Service Providers Administering Drugs
- Pharmacy and Medical Billing Guidance for SPRAVATO® (esketamine)
- Discontinued Coverage for TerSera Therapeutics LLC Drugs
- COVID-19 Testing, Therapeutics, Vaccine Administration, and Vaccine Counseling Policy Reminders
All Providers
- Medicaid Consumer Fact Sheets Now Available
- Official Launch of eMedNY Provider Enrollment Portal
- New York State Medicaid Launches Emergency Triage, Treat, and Transport Program
- NY State of Health: Affordable Care Act 12th Anniversary; Congress Encouragement to Extend American Rescue Plan Tax Credits; Medicaid Resumes Eligibility Reviews, Disenrolled Members Should Be Directed to the Marketplace
- New York State Department of Health Medicaid Accelerated eXchange (MAX) Workshop Series: Register for Round Two and Upcoming Informational Webinar
- Medicaid Breast Cancer Surgery Centers
Pharmacy
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Ohio
The Department of Medicaid (ODM) held its second stakeholder webinar regarding the implementation of the Single Pharmacy Benefits Manager (SPBM) under the Next Generation of Managed Care program on April 15. The subject matter was the new Specialty Drug Program. Copies of the PowerPoint slides and other information regarding the program can be found on ODM’s SPBM webpage. The slides state the next webinar will be held in early May and will cover SPBM pricing.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
Long-awaited Board of Pharmacy regulations allowing pharmacy interns to immunize have been released in final form by the Independent Regulatory Review Commission (IRRC), where they are scheduled for a vote on May 19. After IRRC passage, the regulations will go to the Attorney General and be published in the Pennsylvania Bulletin. The regulations will be final 30 days after the official publication date. The rulemaking is pursuant to the Pharmacy Act amendments made by Act 8 of 2015, the same law that allowed pharmacists to administer influenza vaccines to children aged 9 years and older.
Also in Pennsylvania, the PACE program issued a bulletin regarding Program audit procedures. It includes clarification regarding who is responsible for providing information related to the requested documents.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.