The Department of Insurance posted a notice to announce Bulletin 2021-02 to require all health insurers to cover the administration of coronavirus (Covid-19) vaccinations and forego any cost-sharing such as copayments, deductibles, or coinsurance.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy issued a final rule effective December 29 revising the standards for electronic transmission of prescriptions. The rule adds provisions on exemption certificates, defines “technologic or electronic failure,” and removes references to the transmission of controlled substance prescriptions via fax.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy issued a final rule effective December 15 allowing the transfer of an original unfilled noncontrolled substance prescription and prescription adaptation permitting changes to quantity and dosage. The rule also requires the electronic prescribing of controlled substances.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
As of January 17, pharmacists can enroll as providers in Ohio and obtain a Medicaid ID number for billing purposes. The final rule on payment for certain pharmacy-based services can be found here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Gov. Wolf (D) has granted a waiver to broaden eligible supervisors of pharmacy interns administering COVID–19 vaccines to include other licensed and trained healthcare professionals whose current scope of practice allows them to immunize. Specifically, appropriate supervisors include other licensed healthcare professionals who are trained in the administration of immunizations and emergency care of patients. The waiver applies solely to COVID-19 vaccines and shall be valid for the duration of the Governor’s disaster emergency declaration plus an additional 90 days thereafter unless terminated sooner.
Also in Pennsylvania. At NACDS’ request, a State Interagency call was held with staff from the Pennsylvania Medicaid, and the Departments of Insurance, State, and Health to discuss barriers pharmacies are experiencing in billing for administration fees for COVID-19 vaccines. As a result, Medicaid verbally announced a modification of current guidance for billing of COVID-19 vaccines by pharmacies. For Fee For Service, claims must still be processed on the medical side, however, they are now accepting pharmacist NPIs in the ordering provider field. Additionally, Medicaid stated that all eight MCOs are billing through the patient’s pharmacy benefit and will accept the pharmacist NPI in the prescriber ID field. If the claim is rejected because the NPI is not on file, the NCPDP override code 42 can be used (SCC=42).
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 2079, sponsored by Del. Sam Rasoul (D) has passed the House. The bill would allow pharmacists to prescribe HIV Pep and PreP treatment; CDC immunizations to adults; tuberculin purified protein derivative for tuberculosis testing; and drugs, devices, controlled paraphernalia, and other supplies and equipment available over-the-counter, covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase the over-the-counter equivalent. A joint workgroup of the Boards of Pharmacy and Medicine would be charged with developing protocols for each. NACDS filed a letter of support for the bill which is an extension of legislation we were instrumental in passing in 2020 that allowed pharmacists to prescribe contraceptives and offer other therapies. The bill now goes to the Senate.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy has published a proposed rule to amend regulations under AAC 680-X-2 to clarify the penalty for late payment of the annual permit fee for manufacturers, wholesale drug distributors, private label distributors, repackagers, third-party logistics providers, outsourcers, and reverse distributors. A hearing is scheduled for March 17, 2021, in Birmingham. Comments are due March 6, 2021.
Also in Alabama. All previously published expiration dates related to the COVID-19 emergency have once again been extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of February 28, 2021, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERTs and notices related to the health emergency is available by selecting the Agency’s COVID-19 page in the bottom section at the following website: https://medicaid.alabama.gov/news_detail.aspx?ID=13729.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Board of Pharmacy voted to pursue legislation in 2021-22 to make the Department of Consumer Affairs (DCA) temporary waiver allowing pharmacists to order and administer CLIA-waived tests for COVID and influenza permanent.
Also in California. The Department of Health Care Services (DHCS) continues to make significant progress and movement toward a full assumption of operations of all pharmacy services on April 1, 2021, to Medi-Cal Rx.
Also in California. Pharmacies can submit batch and hard copy claims for COVID-19 vaccine administration. More information can be found about claims submission can be found here.
Also in California. In 2019, the Department of Health Care Services (DHCS) had temporarily suspended retroactive pharmacy claim adjustments. DHCS will resume retroactive pharmacy claim adjustments beginning in February of 2021. Refer to Frequently Asked Questions on the Medi-Cal Website for additional information.
Also in California. In response to members’ requests, NACDS submitted a joint letter with the California Retailers Association to the San Diego County Health and Human Services Agency urging them to remove the Vaccines-for-Children enrollment barrier so citizens can receive COVID vaccines at their local convenient community pharmacies.
Also in California. The Department of Managed Care provided notice and guidance on Covid-19 vaccine coverage and administration for the Medi-Cal managed care program. Please visit the above link for more information.
Also in California. Gov. Gavin Newsom (D) issued an Executive Order extending liability protections for healthcare providers during state and local emergencies to healthcare providers participating in the state’s vaccine administration program. The Order applies to both pharmacists and pharmacy technicians. More information can be found here.
Also in California. The DHCS issued guidance reminding Medi-Cal providers that they are prohibited from illegally discriminating against Medi-Cal members. Also, in the context of the COVID-19 PHE, providers are prohibited from illegally discriminating against Medi-Cal members in determining how to allocate scarce resources for the treatment of COVID-19. DHCS’ Office of Civil Rights has an established discrimination complaint process for Medi-Cal consumers to file grievances of alleged discrimination. More information is available on the DHCS website.
Lastly, in California. The DHCS held a webinar to provide an overview of the relaunch of the California Advancing and Innovating Medi-Cal (CalAIM) initiative. CalAIM builds upon prior successes in health care delivery and proposes to provide more services and supports for patients with complex needs. Key goals of CalAIM include promoting whole-person care, reducing program complexity, and modernizing systems. For more information, please visit the CalAIM webpage.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Gov. Jared Polis (D) announced that the Department of Health Care Policy & Financing (HCPF) is seeking multiple vendors to bid by April 26, 2021, for the State’s Canadian Drug Importation Program. More information is available on the Colorado Vendor Self Service (ColoradoVSS) website. The Program website has been updated to include an Importation Fact Sheet For Wholesalers and FAQs.
For more information, contact NACDS’ Mary Staples at 817-442-1155.