South Carolina

Effective July 1, 2024, the South Carolina Department of Health and Human Services (SCDHHS) will implement a single, state-directed pharmacy benefit preferred drug list (PDL) for all members and providers enrolled in the South Carolina Healthy Connections Medicaid program; see MB #24-016 for details.

SCDHHS recently held live training webinars to answer questions from providers about the upcoming transition to a single PDL. The training sessions were intended for prescribers and dispensers. A recording is available on SCDHHS’ website for those who were unable to attend either training webinar. A frequently asked questions document, which is available in the pharmacy section of SCDHHS’ website, has also been updated.

The single PDL is based on SCDHHS’ current fee-for-service (FFS) PDL. The current FFS PDL is available in the pharmacy section of SCDHHS’ website.

As a reminder, South Carolina’s Medicaid managed care organizations (MCOs) are responsible for the authorizations, coverage and reimbursement related to the services described in MB #24-016 for Healthy Connections Medicaid members who are enrolled in an MCO.

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

2024-06-27T15:53:31-04:00June 27, 2024|South Carolina|

Tennessee

The TennCare pharmacy diaper program will launch on August 1, 2024. For children ages two years and younger, the program provides access to up to 100 diapers per month per child. Children with TennCare or CoverKids are eligible. Pharmacies can voluntarily participate as access points for the program; an informational webinar for pharmacies will be held on July 9 from 9:00-10:00 am CT.

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

2024-06-27T10:56:09-04:00June 27, 2024|Tennessee|

Texas

The Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) will update the Medicaid Preferred Drug List (PDL) on July 25. HHSC is making changes to the PDL based on recommendations agreed to at the January and April Drug Utilization Review (DUR) Board meetings. The April 26, Preferred Drug List recommendations and January 26 Preferred Drug List decisions are available for review.

Also in Texas, in advance of the July 1, 2024 deadline, NACDS submitted comments to the HHSC VDP in support of the draft policy change expanding the list of vaccines included on the Medicaid formulary. Importantly, adopting this updated policy would expand access to a broader portfolio of pharmacy provided vaccines for adults covered under the Medicaid program. NACDS also urged VDP to adjust the Medicaid pharmacy vaccine administration fee to align more closely with the administration fee that CMS has set for pharmacy-provided vaccines covered by Medicare.

Finally in Texas, the Prescription Monitoring Program (PMP) Advisory Committee met on June 27. The PMP Advisory Committee recommends to the Board of Pharmacy operational improvements, identifies data concerns and suggests methods to improve data accuracy, integrity and security.

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

2024-06-27T10:55:44-04:00June 27, 2024|Texas|

Washington

The Pharmacy Quality Assurance Committee (PQAC) held a one-day meeting on June 27.

Also in Washington, starting in July, Apple Health coverage is expanding to adults age 19 years and older with certain immigration status.

Finally in Washington, the Health Care Authority (HCA) published quarterly updates to many of the Apple Health billing guides that go into effect on July 1, 2024. Billing guides are located on HCA’s Provider billing guides and fee schedules webpage.

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

2024-06-27T10:55:11-04:00June 27, 2024|Washington|

California

2024-06-20T10:23:35-04:00June 20, 2024|California|

Indiana

The Family and Social Services Administration’s (FSSA) Health Coverage Programs (IHCP) issued BT202476 to update providers on Health Indiana Plan (HIP) preventive care services exempt from copayment. 

Also in Indiana, the Health Coverage Programs (IHCP) issued a bulletin reminding providers about the Fee-for-Service (FFS) prior authorization appeals process. 

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

2024-06-20T10:23:02-04:00June 20, 2024|Indiana|

Kansas

The Board of Pharmacy is meeting at 8:30 am on July 11 in Topeka via Teams; view the meeting’s webpage for a list of proposed rules and instructions on how to join the meeting in Teams. At 1:00 pm, the Board will be discussing the new proposed telepharmacy regulations.

Also in Kansas, Gov. Laura Kelly (D) convened a special session on June 18 to address taxes. The session was necessary because she vetoed the legislature’s tax bill. 

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

2024-06-20T10:22:31-04:00June 20, 2024|Kansas|

Louisiana

Gov. Jeff Landy (R) signed into law SB 281 – ACT 514, legislation pharmacies supported that will enhance the Attorney General’s enforcement authority over PBM audits, effective August 1, 2024.

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

2024-06-20T10:21:42-04:00June 20, 2024|Louisiana|

Massachusetts

NACDS will be joining the Massachusetts Chain Pharmacy Council and other members of the Patients Not PBMs coalition in support of PBM reform legislation at the Massachusetts State House on Wednesday, June 26, 2024, at 11:00am.  The event will include speakers from the pharmacy and patient communitiesNACDS encourages members to send as many pharmacists and associates as possible.  

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

2024-06-20T10:21:16-04:00June 20, 2024|Massachusetts|
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