Missouri

The Department of Health and Senior Services (DHSS) issued a standing order on March 15th signed by the state Epidemiologist, Dr. George Turabelidze, enabling individuals to receive coverage for purchased tests for SARS-CoV-2. This policy authorizes Missouri pharmacies to charge an individual’s insurance carrier, whether it is private insurance, Medicaid, or Medicare coverage, for COVID-19 testing. Additional state testing resources are available at health.mo.gov/communitytest.  

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

2022-03-18T10:38:18-04:00March 18, 2022|Missouri|

Nebraska

The Department of Health and Human Services posted the fee schedule for COVID-19 Monoclonal Antibodies effective March 11.  

Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on April 6 at noon (Central). This webpage also includes links to notes and audio recordings of previous calls.   

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

2022-03-18T10:35:55-04:00March 18, 2022|Nebraska|

Oregon

The Board of Pharmacy issued its March 2022 newsletter that includes the following articles: 

  • “No. 671 New Rules for Telework” 
  • “No. 672 New Temporary Rules: Accurate Hours of Operation, Temporary/Emergency/Permanent Pharmacy Closures, and PT and COPT Licensure”
  • “No. 673 Rulemaking Updates” 
  • “No. 674 Compliance Updates” 
  • “No. 675 Technicians Must Work Under the Supervision, Direction, and Control of a Pharmacist at All Times” 
  • “No. 676 Licensing” 
  • “No. 677 Board Member News: A New Board Member and Current Opportunities” 

Also in Oregon, as the state enters a new phase of the pandemic, the Oregon Health Authority announced its five-point plan, “Oregon RISE: Resilience in Support of Equity.” 

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

2022-03-18T10:35:01-04:00March 18, 2022|Oregon|

Rhode Island

The Department of Health issued a Public Health Alert due to increased opioid overdose activity in Hopkinton, Richmond, East Greenwich, West Greenwich, and Exeter (Region 9). Read the full Alert here.

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

2022-03-18T10:33:49-04:00March 18, 2022|Rhode Island|

South Carolina

The Department of Health and Human Services (SCDHHS (South Carolina Department of Health and Human Services)) will reimburse for Food and Drug Administration-approved coronavirus disease 2019 (COVID-19) over the counter (OTC) tests for home use. SCDHHS will reimburse SCDHHS-enrolled pharmacy providers for these tests as authorized within sections 9811 and 9821 of the American Rescue Plan Act, and further delineated within the August 30, 2021, letter from the Centers for Medicare and Medicaid Services (SHO# 21-003).  

OTC tests will be covered without prior authorization or cost share with a quantity limit of eight tests per 30-day period. Prescriptions for tests are not required. A one-time override will be allowed per 30-day period (up to a maximum of 10 tests per 30-day period). The per test (unit) rate of reimbursement will not exceed $12 ($24 for a box of two tests). To be eligible for reimbursement, claims must be submitted as a pharmacy claim. For billing purposes, pharmacies will use one of the five SCDHHS-recognized OTC test kits in the table below.  

 

SCDHHS will reimburse for dates of service on or after Jan. 1, 2022. The Medicaid program cannot pay a member directly for a test they have purchased on their own; therefore, SCDHHS will only reimburse providers for OTC COVID-19 tests. SCDHHS will also update guidance regarding coverage of additional COVID-19 OTC tests as required.  

Questions regarding fee-for-service claims processing should be directed to Magellan Medicaid Administration’s Call Center at (866) 254-1669. The call center is available 24 hours/day. 

For questions regarding pharmacy benefits related to the managed care organizations (MCOs) serving South Carolina Healthy Connections Medicaid members, please contact the MCO (Managed Care Organizations) directly. 

Also in South Carolina, PSyn (a Health Insurance Consulting Firm), Inc has been contracted by DHEC’s Division of Diabetes and Heart Disease Management to gain insight from pharmacists regarding your knowledge and interests in primary care clinics. We would appreciate it if you would take some time to complete this survey to help PSyn, Inc and DHEC develop their research.  

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

2022-03-18T10:33:09-04:00March 18, 2022|South Carolina|

Texas

The Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) published information on pharmacy coverage of COVID-19 test kits.  

Also in Texas, Beginning May 31st, HHSC will stop using the Texas Medicaid Standing Order for Mosquito Repellent. Pharmacies must obtain a prescription from a Medicaid-enrolled prescribing provider to dispense mosquito repellent beginning June 1, 2022, for Medicaid, Children’s Health Insurance Program (CHIP), and Healthy Texas Women (HTW). HHSC has extended the effective date of the current standing order until May 31, 2022, to ensure providers have adequate notice regarding upcoming changes to the mosquito repellent benefit. Pharmacy staff may obtain a copy of the extended standing order by submitting a request via email to vdp-formulary@hhsc.state.tx.us.  

Pharmacies or pharmacists not operating under the standing order will require a prescription from a valid healthcare provider before dispensing mosquito repellent to people enrolled in Medicaid. Pharmacies may use the standing order if a new prescription or a refill is required until May 31, 2022. Afterward, the terms of the standing order will no longer be valid. For refill requests, pharmacies should not contact or fax Dr. Van Ramshorst, the physician signing the standing order. Refer to the mosquito repellent section of the Pharmacy Provider Procedure Manual for more information about the benefit. 

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

2022-03-18T10:30:07-04:00March 18, 2022|Texas|

Washington

Effective March 12th, Gov. Jay Inslee (D) issued Proclamation 20-25 rescinding face covering requirements in most places except healthcare settings including pharmacies, long-term care facilities, correctional facilities, and jails.

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

2022-03-18T10:29:31-04:00March 18, 2022|Washington|

Alabama

Effective April 1, 2022, the Alabama Medicaid Agency will: 

  1. Require Vascepa to be billed with a Dispense as Written (DAW) Code of 9. DAW Code of 9 indicates the following: Substitution Allowed by Prescriber but Plan Requests Brand. This value is used when the prescriber has indicated, in a manner specified by prevailing law, that generic substitution is permitted, but the Plan requests the brand product to be dispensed.
  2. Require Prior Authorization (PA) for Icosapent Ethyl (generic Vascepa). Brand Vascepa will be added as preferred.
  3. Require Prior Authorization (PA) for Colchicine capsules (generic Mitigare). Brand Mitigare will remain non-preferred.
  4. Treatments for COVID-19 will remain accessible and available through the pharmacy benefit on an outpatient basis through the Federal Public Health Emergency (PHE) period. Approval was granted to ensure any drug with an FDA-approved or EUA-authorized indication for the treatment of COVID-19 be made available as a preferred drug through the duration of the Federal PHE.

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

2023-10-10T09:02:28-04:00March 11, 2022|Alabama|

California

The following alerts have been posted to the Medi-Cal Rx Web Portal:  

Finally in California, the Board of Pharmacy will host the Pharmacy Technician Summit on April 19; details TBD. In advance of this summit, the board invites California pharmacists and California pharmacy technicians to participate in Pharmacist Listening Sessions and Pharmacy Technician Listening Sessions. For those unable to participate, the board is also accepting feedback via short online surveys for both pharmacists and technicians, respectively. 

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

2022-03-11T10:34:55-05:00March 11, 2022|California|

© National Association of Chain Drug Stores
All Rights Reserved | Privacy & Disclaimer

Go to Top