Medicaid is ready to process at home COVID antigen tests. The necessary changes to be able to process the tests were completed last Friday (1/21/22), the pharmacy fax blast was sent out Friday afternoon as planned and is also posted online. Medicaid has issued a notice along with a standing order from DHHS for the at home tests that pharmacies may use. Dr. Ballard’s NPI number is on the order.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Board of Pharmacy has finalized three regulations dealing with patient counseling documentation requirements, increased out of state permit fees, and removal of waiting period to retake pharmacist exams.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Dr. Betsey Tilson, State Health Director, rescinded the following Statewide Standing Orders due to the high prevalence of the Omicron variant of SARS-CoV-2 virus in North Carolina for which these therapies are not an effective treatment:
The recission orders can be accessed here: https://covid19.ncdhhs.gov/guidance#vaccination-info-for-providers
These Statewide Standing Orders may be reactivated in the future depending on the effectiveness of the therapies on circulating variants.
Also in North Carolina, reminder effective Jan. 10, 2022, NC Medicaid-enrolled pharmacies may bill for FDA approved over the counter (OTC) COVID-19 tests dispensed for use by NC Medicaid beneficiaries in a home setting, with or without a prescription issued by an NC Medicaid-enrolled provider. NC Medicaid Direct beneficiary implementation date is Jan. 10, 2022. Refer to beneficiaries’ managed care plan for guidance on the specific plan’s implementation date.
Finally, NC Medicaid will cover one kit per claim per date of service, with a maximum of four test kits every 30 days. Covered test kits are listed below. Please note that some kits will include two tests.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy recently posted the following documents on their webpage:
Updated COVID Therapeutics Guidance
Authorization for National Guard to Serve as Pharmacy Technician Trainees
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The National Association of Insurance Commissioners (NAIC) announced that Oklahoma Insurance Commissioner Glen Mulready would serve as chair of the NAIC Health Insurance and Managed Care (B) Committee for the 2022 term.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy posted the agenda and meeting materials for the February 9-11, Board Meeting.
Also in Oregon, the Board of Pharmacy issued a notice requesting fiscal impact for Pharmacy Prescription Lockers (PPL) from stakeholders. Note: any information provided to the Board becomes a public record.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The state has reissued billing guidance for the Pharmacy Naloxone Copay Assistance Program, because of claims – otherwise eligible- but rejected due solely to coding errors. The claims are eligible for correction for payment. NACDS reminds members that naloxone claims from any patient, regardless of type of insurance coverage, are eligible for the copay to be reimbursed to the pharmacy. The program, which NACDS and PACDS helped the Governor’s Opioid Taskforce develop with member input, is funded through federal grants and meant to incentivize greater naloxone access to all Pennsylvanians. It is run on the PACE program system merely to streamline the adjudication process for pharmacies.
Also in Pennsylvania, The Department of Human Services published a Bulletin for COVID Oral Antiviral Treatments billing procedures and codes for pharmacies.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy issued the following clarification regarding pharmacy technicians’ authority to administer vaccines:
As part of his COVID Action Plan, Governor Glenn Youngkin signed Executive Order 11, to give flexibility and support to healthcare providers, hospitals and other healthcare facilities. Paragraph 13 of Executive Order 11 increases the number of persons performing the duties of a pharmacy technician that a pharmacist may supervise to five (5) and exempts pharmacy technicians performing COVID-19 administrative tasks from being counted in the ratio. Please be advised that the administration of a CLIA-waived test or vaccine does not constitute an administrative task. Additionally, the decision regarding the number of pharmacy technicians a pharmacist will supervise, and whether any other duty constitutes a COVID-19 administrative task, is a decision that must be made by the Pharmacist-in-Charge or pharmacist on duty, pursuant to 18VAC110-20-112(A) and 18VAC110-20-110(C). The Executive Order shall remain in effect until February 21, 2022, unless sooner amended or rescinded by further executive order or directive.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Apple Health (Medicaid) covers over–the–counter (OTC) COVID-19 tests with or without a prescription for clients. An adjudicated pharmacy claim is required for reimbursement. Pharmacies may not bill for test administration of an OTC COVID-19 test as these tests should be used by the patient in the home setting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.