In The States – Page 196 – Weekly news about states

South Carolina

Effective Jan. 1, 2022, the South Carolina Department of Health and Human Services (SCDHHS) will increase the reimbursement rates for the services and supplies related to: Incontinence Supplies, Department of Alcohol and Other Drug Abuse Services (DAODAS) and Autism Spectrum Disorder (ASD) Services. These changes will be reflected on the SCDHHS website by Jan. 1, 2022.

Providers with questions regarding this bulletin should contact the SCDHHS Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday

Also in South Carolina, the Department of Insurance has provided a complaint form for pharmacies or interested parties to file complaints with the South Carolina Department of Insurance relating to pharmacy benefit manager (PBM) services. SC law requires pharmacies to make reasonable efforts to exhaust a PBM’s internal appeal requirements prior to filing a complaint with the SCDOI. A copy of the appeal outcome must accompany the complaint submission.

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

Michael Silber2021-12-10T12:03:15-05:00December 10, 2021|South Carolina|

Texas

The Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) semi-annual update of the Medicaid preferred drug list will occur on January 27, 2022. HHSC made the PDL changes based on recommendations made at the July and November 2021 Texas Drug Utilization Review Board meetings. Drug list decisions from those meetings are available.

Also in Texas, HHSC next Texas Vaccine Providers Webinar will be on Tuesday, December 14th at Noon Central. Register here.

Finally in Texas, in response to a request from the Texas State Board of Pharmacy, Gov. Greg Abbott (R) again temporarily suspended the requirement in §291.33(c)(1)(B)(iii) to have in-person contact for patient counseling in order to allow patient counseling to be performed by telephonic consultation. This remains in effect until March 31, 2022, or until the March 13, 2020, disaster declaration is lifted or expires, whichever is earlier.

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

Michael Silber2021-12-10T12:01:53-05:00December 10, 2021|Texas|

Vermont

The Vermont Department of Financial Regulations has issued draft guidance for commercial insurance coverage of COVID-19 at-home rapid antigen testing. The Department contemplates requiring commercial health insurers to cover at-home rapid antigen testing listed as “preferred” by Vermont Medicaid without member cost sharing. Under the draft emergency rule, the tests would be fully covered when prescribed, in which case the claim would process exactly like any other prescription medication, or if the member submits a claim form. This guidance, once finalized, will be effective December 1, 2021.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Michael Silber2021-12-10T12:01:03-05:00December 10, 2021|Vermont|

West Virginia

The Legislative Rule Making Review Committee adopted the PBM rule as currently written without any debate. The rule, based on the passage of HB 2263 or 2021, must now receive final approval by the Legislature during the 2022 session.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2021-12-10T11:59:36-05:00December 10, 2021|West Virginia|

Wisconsin

This week Governor Tony Evers (D) signed into law three pro-pharmacy bills. In specific the three bills are the Pharmacist Provider Status – providing pharmacist’s reimbursement for any clinical care services covered under the Medicaid program (SB 255), Pharmacy Technician Registration- establishing the registration of pharmacy technicians (SB 300) and Remote Dispensing Sites (SB 308) which licenses these sites and provides more flexibilities for remote supervision of site pharmacists. These laws will be in effect as the supporting regulations are finalized in 2022.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Michael Silber2021-12-10T11:58:48-05:00December 10, 2021|Wisconsin|

Alabama

As Alabama Medicaid continues to monitor the COVID-19 national emergency in Alabama, Medicaid is adding procedure codes for coverage. Providers may submit claims for dates of service on or after the effective dates for each procedure code as listed here. Providers may find the reimbursement rates for the COVID-19 testing procedure codes on Medicaid’s website at www.Medicaid.Alabama.gov by selecting Fee Schedules under the Providers tab.

Also in Alabama, effective January 1, 2020, all newly registered technicians are required to complete a Board approved training program within six (6) months of the registration. Technicians with Board approved training completed, PTCB or CPhT certifications, or registered prior to January 1, 2020, will be reflected as compliant with the training requirement on the technicians’ Board of Pharmacy website profile.

To view this data:

Go to albop.com
Click Online Services
Choose “Individual Verification” from the dropdown menu
Input the technician registration number or name of the technician and enter the verification code displayed and click Search
Identify the technician and choose the Print option to view the full license details including training information for technicians.

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

Erica Joyner2021-12-03T09:51:45-05:00December 3, 2021|Alabama|

Alaska

The Department of Commerce, Community, and Economic Development cut the initial registration and biennial renewal fees for the prescription drug monitoring program-controlled substance prescription database to $0 effective December 23, 2021.

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

Erica Joyner2021-12-03T09:50:35-05:00December 3, 2021|Alaska|

Arkansas

Gov. Asa Hutchinson (R) is convening a Special Session of the Legislature on Tuesday, December 6^th to deal with income tax reform and repeal of the Insulin Rebate law (Act 1104/HB 1709).

Also in Arkansas, the Department of Health final rules amending the Prescription Drug Monitoring Program to provide for an alternate method of reporting and allow the department to request prescription copies from dispensers for evaluation go into effect on December 3, 2021.

Finally in Arkansas. The Division of Medical Services adopted a rule revising the rate methodology and reimbursement rates for covered long-acting reversible contraceptives (LARCs) that went into effect on December 1, 2021.

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

Erica Joyner2021-12-03T09:46:54-05:00December 3, 2021|Arkansas|

California

The Medi-Cal Rx Monthly Bulletin for December has been posted. Below is an outline of this month’s updates. As a reminder, Medi-Cal Rx is schedule to be implemented effective January 1, 2021.

Changes to the Contract Drugs List (CDL), Effective December 1, 2021
Changes to the Contract Drugs List (CDL) – Over the Counter Drugs, Effective December 1, 2021
Changes to the Family PACT Pharmacy Formulary, Effective December 1, 2021
Medi-Cal Rx Medical Supplies Updates
Reimbursement for COVID-19 Vaccine Administration Claims
Updates to the Medi-Cal Rx Provider Manual
Adult Vaccination Administration Fee: Pharmacy Claims and Reimbursement
Maximum Allowable Ingredient Cost (MAIC) 30-Day Pharmacy Provider Notice
45-Day Pharmacy Provider Notice
Contract Drugs List (CDL) Flyer
Medi-Cal Rx Provider Training Details
Registering Multiple NPIs in UAC
UAC Registration and Sign-In Troubleshooting
UAC Registration Reminders and Helpful Tips
Introducing the Medi-Cal Rx Education and Outreach Team
Prescriber Training Checklist
Pharmacy Training Checklist

Also in California, NACDS submitted comments to the Board of Pharmacy in support of the proposed rule revising 16 CCR §1746.4 pertaining to requirements for notification to patients’ primary care provider following vaccine administration. In modifying the notification provisions of the rule to apply only when requested by a patient, the proposed rule change would reduce the administrative burden of preparing and forwarding potentially redundant information that is not always needed or desired by every primary care provider, especially considering that pharmacies also report administered vaccines to the California Immunization Registry. Considering pharmacist and pharmacy workload demands having amplified during the COVID-19 pandemic, eliminating unnecessary administrative requirements free up pharmacy personnel to focus on meeting public demand for increased pharmacy services.

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

Erica Joyner2021-12-03T12:15:42-05:00December 3, 2021|California|