In The States – Page 211 – Weekly news about states

Iowa

On December 6, the Board of Pharmacy transitioned to a new payment platform (Gov2Go) for online applications. Additional information about the Iowa eGovernment portal, Gov2Go, was posted later this week. For faster access to Gov2Go, please create a Gov2Go account at web.gov2go.com. If you experience any payment issues while applying for a new license/registration or renewing an existing license/registration, please contact Terry Witkowski.

Also in Iowa, the Department of Public Health (IDPH) posted a NEW Vaccine Information Brief (12.10.21) with update on the vaccine allocation survey on December 13 that will not include Pfizer Adolescent/Adult Vaccine in order to utilize existing inventory in the state and FDA expands eligibility for Pfizer-BioNTech COVID-19 Booster Dose to Individuals 16 and 17 years of age. Also note last week’s Vaccine Information Brief (12.3.21) announcing ACIP COVID-19 Vaccine Booster Recommendation, Moderna Shelf-Life Extension Update and Updated – Interim Clinical Considerations for Use of COVID-19 Vaccines and this week’s Vaccine Information Brief (12.8.21) with information about Pfizer transition to Comirnaty. Please direct questions to the COVID-19 Vaccine Call Center at 1-800-831-6293 ext. 1 or email.

Also in Iowa, the Department of Human Services, Iowa Medicaid Enterprise, issued INFORMATIONAL LETTER NO. 2295-MC-FFS announcing the alignment between Managed Medicaid and Medicaid Fee-for-Service to limit the number of diabetic needles that member may obtain per month. The managed care organizations currently allow 100 needles per month. Members enrolled in Medicaid Fee-for-Service were also be limited to 100 diabetic needles per month effective December 1, 2021.

Finally in Iowa, the Department of Human Services, Iowa Medicaid Enterprise, issued INFORMATIONAL LETTER NO. 2291-MC-FFS announcing several Medicaid Pharmacy Program Changes effective January 1, 2022, related to the following:

Changes to the Preferred Drug List (PDL);
Pharmacy benefit policy changes for albumin human, papaverine injection solution and Zoladex subcutaneous implant;
New Drug Prior Authorization (PA) Criteria for non-biologic agents for ulcerative colitis, Vericiguat (Verquvo) and Viloxazine (Qelbree)
Changes to Existing PA Criteria for Gonadotropin-Releasing Hormone (GnRH) Receptor Antagonist, Oral [formerly Elagolix Products], Omalizumab (Xolair) and Topical Acne and Rosacea Products
Point of Sale Billing Updates (ProDUR Quantity Limits) and
DUR Update

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

Michael Silber2021-12-10T12:09:31-05:00December 10, 2021|Iowa|

Kentucky

The Board of Pharmacy approved an emergency amendment to the pharmacy closure regulation at its Nov. 30 meeting. As an emergency regulation, once it is filed with the LRC it will be in effect immediately. The regulation changes the temporary pharmacy closure notification requirement from 5 days to 2 two days within a 14-day period or 9 days in a 30-day period and requires pharmacies to notify the board in immediately in writing of a closure meeting the threshold. Additionally, it has requirements for signage, control of prescriptions, notification of providers and post-closure claims adjudication.

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

Michael Silber2021-12-10T12:07:54-05:00December 10, 2021|Kentucky|

Missouri

The Department of Commerce and Insurance (DCI) Board of Pharmacy issued a bulletin on Vaccine Provider Healthcare Assistance in response to the Board of Pharmacy received regarding if pharmacies can use non-pharmacy healthcare providers to help provide both COVID-19 and non-COVID-19 vaccines.

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

Michael Silber2021-12-10T12:07:10-05:00December 10, 2021|Missouri|

Nebraska

The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on December 15 at noon (Central). 

Also in Nebraska, the Department of Health and Human Services (DHHS) updated the Janssen COVID-19 Vaccine Administration – Booster – Code: 0034A — $37.25 (effective November 2, 2021). DHHS also published its Provider Bulletin 21-21 – November 2021 COVID-19 Vaccines Updates, including COVID-19 booster doses and COVID-19 vaccinations for children. For questions, contact Medicaid.

Finally in Nebraska, the COVID rates have been added and been moved from the right-hand navigation list to the main list on the Department of Health and Human Service Medicaid Provider Rates and Fee Schedules website.

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

Michael Silber2021-12-10T12:06:19-05:00December 10, 2021|Nebraska|

North Carolina

In response to the U.S. Food and Drug Administration amended EUA for the Pfizer-BioNTech COVID-19 vaccine, authorizing the use of a single booster dose for administration to individuals 16 and 17 years of age at least six months after completion of primary vaccination with the Pfizer-BioNTech COVID-19 Vaccine and the CDC expanding the recommendation for boosters to include 16 and 17 year old, North Carolina has updated the Standing Order regarding vaccine administration.

Also in North Carolina, the Board of Pharmacy has issued new guidance concerning the application for Pharmacist-Technician Ratio of 1:6 or Greater.

Finally in North Carolina, please see Information regarding the Administration of Long Acting Injectables in Medicaid.

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

Michael Silber2021-12-10T12:05:08-05:00December 10, 2021|North Carolina|

Ohio

The Ohio Department of Health (ODH) shared flu communications toolkits for healthcare providers to use in promoting flu vaccination for their patients during the 2021 – 2022 flu season. The Centers for Disease Control and Prevention (CDC) offers a NIVW digital toolkit featuring social media language and graphics, sample newsletter language, and printable resources. ODH posted a Flu Communications Toolkit that offers social media language and graphics and sample newsletter language around the importance of flu shots, in addition to flu and COVID-19 shots, as the best defense. Healthcare providers can monitor flu activity in Ohio, including county-level data, on the ODH Ohio Flu Activity webpage.

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

Michael Silber2021-12-10T12:04:18-05:00December 10, 2021|Ohio|

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|