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.
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.
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.
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.
Effective April 1, 2022, the Alabama Medicaid Agency will:
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
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.
The Georgia Pharmacy Association presents “APhA’s Delivering Medication Therapy Management Services: A Certificate Training Program for Pharmacists” on March 27 from 8:00 a.m. to 5:00 p.m. This live training is being held via Zoom Meetings. Click here to register!
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
NACDS sent a letter to Medicaid detailing our concerns regarding tiered reimbursement rates that we raised with the Family and Social Services Administration (FSSA) and Myers and Stauffer on our February 11 Zoom call.
Also in Indiana, on March 3, Gov. Eric Holcolm (R) issued an Executive Order 22-09 rescinding the public health emergency disaster declaration for COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2322-MC-FFS announcing three Program Integrity (PI)/Payment Error Rate Measurement (PERM) quarterly training sessions for Medicaid Providers. Sessions will be held via Zoom and details are available in the letter. Providers only need to attend one training session. For those unable to attend, session recordings will be posted to the department’s website.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2320-FFS announcing the 2022 Refund Address.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2316-MC-FFS announcing new Vaccine for Children (VFC) Program Codes.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2324-MC-FFS-CVS stating that several monoclonal antibodies are no longer authorized for use and may not be administered for treatment or post-exposure prevention of COVID-19 under the EUA until further notice by the FDA.
Finally in Iowa, Gov. Kim Reynolds (R) announced numerous appointments to the state’s boards and commissions including the following appointments to the Board of Pharmacy: Dane Nealson, Story; Kathy Stone, Harrison; Bob Egeland, Polk and Joan Skogstrom, Polk.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.