Tennessee

The Tennessee Pharmacy Association has produced a flowchart to help guide pharmacists through the process of filing complaints when PBMs are not following the new law. This flowchart was developed after hearing from the Tennessee Department of Commerce and Insurance (TDCI) that they are receiving incomplete claims, claims that still need to go through the MAC Appeal Process, or claims for Medicare, over which TDCI has no jurisdiction. This will be the first in a series of educational materials that TPA will provide in the coming weeks.

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

2021-09-03T08:42:48-04:00September 3, 2021|Tennessee|

Alabama

After further review, the Agency will not resume the EPSDT referral requirement as referenced in the July 27, 2021 Provider ALERT. This allowance will continue through the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.

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

2021-08-27T12:44:38-04:00August 27, 2021|Alabama|

Alaska

The Department of Health and Social Services and the Alaska Pharmacists Association (AKPhA) have a four-question survey to understand chronic disease management practices in pharmacies operating in the state. Individuals who received continuing education credits from the AKPhA’s 55th Annual Convention & Tradeshow held earlier this year have already completed the survey.

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

2021-08-27T12:44:03-04:00August 27, 2021|Alaska|

Arizona

The Board of Pharmacy reminds prescribers and dispensers that mandatory e-prescribing of Schedule II controlled substances that are opioids resumed on July 9.   

Also in Arizona, the Board of Pharmacy issued a notice of proposed rulemaking allowing pharmacy technicians to perform additional tasks delegated by pharmacists, including administration of a vaccine. Oral proceedings will be held on September 21.

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

2021-08-27T12:43:34-04:00August 27, 2021|Arizona|

Florida

Magellan Complete Care Members will transfer to Molina Healthcare of Florida, Inc. Molina Healthcare of Florida, Inc. (Molina) acquired Florida MHS, Inc., D/B/A Magellan Complete Care (Magellan), a Medicaid specialty plan specializing in the care of those with Serious Mental Illness (SMI). The Agency for Health Care Administration will move Magellan’s membership to Molina effective September 1, 2021. Molina will be issuing new Medicaid ID cards. All billing and claims reimbursement will be provided by Molina for dates of service beginning September 1, 2021. All claims for service dates prior to September 1, 2021, must continue to be submitted through Magellan and related questions may be directed to Magellan at 1-800-327-8613. Providers that are out of network as of September 1, 2021, will be eligible for a 60-day continuity of care period where claims will be payable to allow time for members to transition to a new provider, if necessary. The continuity of care period ends on October 31, 2021.

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

2021-08-27T12:42:58-04:00August 27, 2021|Florida|

Illinois

SB1682, sponsored by Senator Scott Bennett (D), was signed by Governor JB Pritzker (D) on August 16, 2021. The measure will take effect on January 1, 2022, this measure amends statute to provide for additional drug pricing transparency from pharmacies.

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

2021-08-27T12:42:26-04:00August 27, 2021|Illinois|

Kentucky

The Department of Medicaid Services (DMS) and MedImpact have announced a delay in the implementation of the planned 7–day payment cycle. The plan to migrate to a 7-day cycle is the result of continued pharmacy provider confusion and cashflow concerns regarding the previously established MedImpact payment cycle (14-day cycle and payment transfer/EFT timing and visibility). The change may be effective for the cycle end date 09/02/2021, barring unforeseen circumstances. EOB/claim file production will be aligned with this new schedule.  If you have questions regarding your payments, you can contact MedImpact’s Pharmacy Network Department.

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

2021-08-27T12:40:15-04:00August 27, 2021|Kentucky|

Louisiana

At the August 18th Board of Pharmacy meeting, the Board approved proposed rules. 

Title 46 (la.gov) that allows pharmacy interns and pharmacy technicians to administer medications independently of the Prep Act, and also repeals the requirement to report immunizations to physicians.  

 Also in Louisiana, the Department of Health (LDH) announced that they will be reimbursing for pharmacist administered influence vaccines for the 2021-2022 flu season beginning on September 15, 2021. 

Finally in Louisiana, the Department of Insurance is soliciting feedback from stakeholders on the roles and responsibilities of Pharmacy Benefit Managers (PBM) and Pharmacy Services Administrative Organizations (PSAO). Submit comments to jeffrey.zewe@ldi.la.gov  under the title “Response to Act 192 Request for Information” by November 1, 2021. 

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

2021-08-27T12:39:34-04:00August 27, 2021|Louisiana|

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