Gov. Jared Polis (D) announced his new chief of staff, David Oppenheim, replacing Alec Garnett, who has been in that role since January 1, 2023. Garnett has accepted the position of vice president for government and regulatory affairs for the University of Colorado Health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The purpose of this alert is to provide an update to the previous provider alert issued on August 4, 2024, regarding Hurricane Debby.
The following flexibilities/waivers offered to providers in the alert issued on August 4, 2024, expired at 11:59 pm on September 3, 2024:
Additional questions from providers may be directed to the Florida Medicaid Contact Center at 1-877-254-1055
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Department of Healthcare and Family Services’ (HFS) Pharmacy Benefit Management System (PBMS) for the fee-for-service program, Change Healthcare, experienced a nationwide system outage as noted in the provider notice dated February 22, 2024. During the system outage, HFS was unable to add new National Drug Codes (NDCs) to the formulary. Providers were asked to hold fee-for-service (FFS) claims until the issue was resolved.
The new NDCs are now available and have been added to the formulary; therefore, providers may release all FFS claims that have been held pending the update.
Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) is hosting an informational online seminar on the PathWays for Aging program on September 12 at 9:00 am. The presentation by OMPP staff will provide a post-implementation update of the PathWays program which launched on July 1, 2024. The online seminar will be recorded and posted on the PathWays stakeholder engagement website. You can view the online seminar on Zoom or the FSSA YouTube page at the time of the event.
Also in Indiana, FFSA pharmacy updates were approved by Drug Utilization Review Board at the August 2024 meeting.
Finally in Indiana, the Health Coverage Programs (IHCP) posted a bulletin reminding providers of administrative review requirements for fee-for-service prior authorization.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health and Human Services (HHS) announced the intent to award a Managed Care Organization (MCO) contract to Iowa Total Care. The new Iowa Medicaid contract period begins July 1, 2025, with no change in operations. This RFP and resulting contract aligns all three MCO contracts (Iowa Total Care, Molina, and Wellpoint Iowa, Inc.) to provide health care services to Iowans to the same contract cycle. All three MCO contracts will have a final contract end date of June 30, 2031.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Medicaid issued a bulletin revising the launch date for its Medicaid Provider Enrollment Rebaseline, which means new managed care organization (MCO) credentialed providers that have not enrolled with Medicaid will receive an invitation letter to enroll through the web portal. The invitation letter will provide specific provider information along with detailed instructions needed for the enrollment process.
Also in Louisiana, Medicaid issued a revised bulletin with contact information outlining the available options to providers for pursuing resolution of issues with Medicaid managed care organizations (MCOs) and the state’s fee-for-service claims processor, Gainwell Technologies. Unless explicitly notated, providers should first seek resolution with the MCO or Gainwell directly, prior to engaging the Department of Health or other third parties.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
On September 5, the Board of Pharmacy held its regular meeting. The agenda included licensure by endorsement and a central fill data collection pilot project.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Prescription Drug Affordability Board (PDAB) has rescheduled its September 23 Board meeting for September 10. Registration is required to participate. The Board welcomes public comment and input on all its work. Additional information about providing public comment can be found on the Board Meetings page of the PDAB’s website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy issued notice that licensing of non-resident pharmacies will become available in the coming months. At least one pharmacist at each non-resident pharmacy must hold a Massachusetts pharmacist license. (This pharmacist does not have to be the store’s pharmacist-in-charge.) In preparation for non-resident pharmacy licensing, it is strongly recommended to begin the licensing process for the pharmacists as the process can take 30-60 days. Applications and instructions can be found online. Please see the FAQ document for other information regarding non-resident pharmacy licensing.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.