Maryland
The Prescription Drug Affordability Board (PDAB) invites you to attend the August meeting of its Stakeholder Council at 2:00 pm on August 26 virtually. The agenda and other meeting materials and registration link will be available on the Stakeholder Council page of the PDAB’s website prior to the scheduled meeting. To register for oral public comments and for additional information, please refer to the Stakeholder Council page.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On July 22, the House Committee on Ways and Means released H4891, an act relative to pharmaceutical access, costs and transparency, that includes PBM reforms. The bill was brought to the floor of the House on July 24. NACDS worked with the Massachusetts Chain Pharmacy Council to offer several friendly amendments to improve the bill. NACDS will continue to work to ensure final passage of PBM reform in the Massachusetts legislative session that ends on July 31.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The MO HealthNet (MDH) Pharmacy Program (Medicaid) created several new resources:
- A 15-minute training course on Proper Drug Billing, covering National Drug Codes, how to determine and calculate what quantity to bill, who should bill for white and brown bagged medications and more.
- Medicaid Eligibility Codes – Includes descriptions of Medicaid Eligibility (ME) Codes and limited and comprehensive benefits.
- Contact Us – Provides provider contacts for MHD and more to assist with your questions
These resources, as well as many others, can be found on our MHD Education & Training page. - Provider Training Calendar – to register for a program specific training updated quarterly.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
Gov. Jim Pillen (R) announced a special session to address property tax reform beginning July 26 through August 15. The governor also recently released his Nebraska Property Tax Plan. Of interest, note inclusion of new revenue from advertising services from among new taxes on numerous goods and services.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Gov. Mike DeWine (R) signed SB 144, our immunization expansion bill into law at the Ohio State Fair. Early in 2024, NACDS was on the ground in Columbus to help members and partners develop the strategy that made it one of the few bills to make it to the Governor’s desk during a remarkable politically tumultuous year in the Ohio House. Sponsored and expertly championed by Sen. Mark Romanchuk (R), in clear and concise language, the bill simply deleted the age, vaccine-type and prescription restrictions and replaced it with a provision permitting pharmacists and technicians to administer “a vaccine for any disease” to patients aged 5 years and older.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The Board of Pharmacy published the July 2024 newsletter.
Also in Oklahoma, the next meeting of the Board of Pharmacy will be on September 18.
Finally in Oklahoma, the Office of the Bureau of Narcotics and Dangerous Drugs (OBNDD) director Donnie Anderson released a statement on pharmacies filling controlled substance prescriptions written by out-of-state practitioners.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Pennsylvania
The Board of Pharmacy posted the meeting agenda and remote access instructions for its July meeting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Dakota
The Board of Pharmacy posted its July 2024 newsletter, including a Prescription Drug Monitoring Program (PDMP) update, finalized rule revisions in effect as of June 2, 2024, pharmacist license renewals reminder and the retirement of Kari Shanard-Koenders.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
TennCare Diaper Program website now includes a billing guide, optional diaper request form and survey link for pharmacies to be included on the list of providers that will be available for TennCare and CoverKids members.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Hurricane Beryl made landfall on the Texas coast and caused significant damage and flooding in numerous counties earlier this month, forcing many to evacuate to temporary locations. The Health and Human Services Commission (HHSC) will allow pharmacies to override prescription claims rejected with error codes 79 (Refill Too Soon) or 76 (Plan Limitations Exceeded) for people enrolled in fee-for-service Medicaid, the Children with Special Health Care Needs Services Program and the Kidney Health Care Program that pharmacies identify as affected by Hurricane Beryl. For people enrolled in Medicaid managed care or CHIP, pharmacies should contact the person’s managed care organization (MCO) for instruction. Refer to the MCO Search for each MCO’s contact information and billing codes. Pharmacies can call the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, Monday through Friday from 7:00 am to 7:00 pm (central time) to request the override.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
State Health Commissioner Karen Shelton, MD, distributed a clinician letter to practitioners across the Commonwealth with updates on the national shortage of penicillin G benzathine (Bicillin L–A®) and the ongoing syphilis statewide outbreak trends and clinical manifestations in the state.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
Gov. Jay Inslee (D) announced two new appointments to his executive team. Pat Sullivan will be director of the Washington State Office of Financial Management, and Sheri Sawyer will be his new executive director of legislative affairs.
Also in Washington, the Heath Care Authority (HCA) began enrolling eligible individuals into Apple Health Expansion in mid-June with coverage beginning July 2024. Apple Health Expansion is a new program designed to provide full-scope health care coverage to people aged 19 years or older with certain immigration statuses.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
The Insurance Department issued a Proposed Amended Rule 118: Pharmacy Benefit Manager Regulations in advance of the Public Hearing on September 10, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for July 5-11.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Register now for the August 27 Department of Health Care Policy & Financing (HCPF) Stakeholder Webinar on Medicaid priority initiatives for Fiscal Year 2024-2025 and Public Health Emergency Unwind insights and opportunities going forward.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Agency for Health Care Administration (Agency) scheduled a hearing on July 29, 2024, at 1:30 pm for new Rule 59G-4.252, Diabetic Supply Services at the Agency for Health Care Administration (2727 Mahan Drive, Building 3, Tallahassee, FL 32308).
A virtual option or call-in number will not be available for this meeting.
Official notice of the meeting published in Vol. 50/No. 131, of the Florida Administrative Register (FAR) on July 5, 2024. A copy of the notice may be found at www.flrules.org. Please note that a preliminary draft of the reference material, if available, will be posted prior to the meeting on the Rules webpage.
Also in Florida, updated versions of the Medicaid Provider Agreements utilized in initial enrollment and renewal have been created. Starting July 15, 2024, these 2023 versions will be replacing the 2013 versions of the forms that are currently in use and available on the Medicaid web portal in the Enrollment Forms section.
There will be a two-month grace period from July 15, 2024, to September 15, 2024, during which either version of the forms will be accepted when submitting a new application or renewal. Starting September 15, 2024, only the 2023 version will be accepted.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
Gov. JB Pritzker (D) has signed SB 3268 Medicaid Omnibus legislation which includes a large expansion in the practice of pharmacy which will allow pharmacists to test and treat for influenza, SARS-COV 2, RSV, Group A Strep and adult-stage head louse. The bill also includes PBM transparency provisions.
Also in Illinois, please see the updated Department of Healthcare and Family Services Pharmacist Fee Schedule (updated July 11, 2024).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2605-MC-FFS Spravato® (Esketamine Nasal Spray) Billing & Coding Update
- INFORMATIONAL LETTER NO. 2597-MC-FFS Medical Foods Update
- INFORMATIONAL LETTER NO. 2587-MC-FFS Clinical Trials
- INFORMATIONAL LETTER NO. 2577-MC-FFS Services After Death Date
- INFORMATIONAL LETTER NO. 2594-MC-FFS-D Clarification to Medicaid Enrollment Options for Individual Practitioners
- INFORMATIONAL LETTER NO. 2599-FFS Medicaid Pharmacy Copayments Reinstatement
- INFORMATIONAL LETTER NO. 2596-MC-FFS New Vaccine for Children (VFC) Codes
- INFORMATIONAL LETTER NO. 2595-MC-FFS-D July 2024 Medicaid Pharmacy Program Changes
Also in Iowa, a Presidential Disaster Declaration for individual assistance was approved for four additional Iowa counties affected by extreme rainfall and flooding beginning on June 16, 2024. This declaration allows the Iowa Department of Health and Human Services to offer the Disaster Food Assistance, also known as Disaster Supplemental Nutrition Assistance Program (D-SNAP) for Iowans in Buena Vista, Cherokee, O’Brien and Woodbury counties. Disaster Food Assistance uses different qualifying rules than regular SNAP. Those who may not normally qualify for SNAP, based on income, may qualify for Disaster Food Assistance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact issued an invitation and online access instructions to the 3rd Quarter session of the KY Medicaid Pharmacy Network Provider Webinar Forum on July 31 from 10:00-11:00 am EST. The meeting is meant as an open forum to ask questions or raise issues and all pharmacy providers are invited.
Also in Kentucky, MedImpact announced that they will be reprocessing claims that were inadvertently paid at NADAC or WAC when they should have been a MAC claim.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Walmart pharmacist Jeremy Moffett was chosen by his colleagues as the 2024 Louisiana Chain Pharmacist of the Year. He received recognition during the awards ceremony at the annual meeting of the Louisiana Pharmacy Association in Lafayette on July 12.
Also in Louisiana, the Department of Health’s Medicaid Director Kimberly Sullivan issued a pharmacy provider memorandum on the diagnosis code policy.
Also in Louisiana, the Board published Bulletin No. 24-01 which contains notice and guidance in regard to Act 246 of the 2024 Legislative Session.
Finally in Louisiana, the Department of Health’s (LDH) Medicaid team and Myers and Stauffer held a Zoom stakeholder meeting on July 15, sharing its plans for conducting a pharmacy cost of dispensing (COD) study. The survey will be emailed to a key point of contact for each chain pharmacy on August 7. The survey results will be used to evaluate the Medicaid pharmacy reimbursement methodology.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Department of Health and Human Services issued two bulletins announcing the upcoming termination of coverage for certain pharmacy services due to the upcoming expiration of the federal PREP Act.
- 2419-Lab – Termination of COVID-19 Home Test Kit Coverage and Special Reimbursement for COVID-19 Specimen Collection and Clinic Vaccine Administration. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.
- 2424-Pharmacy – End of the Federal Public Health Emergency (PHE) and Final Unwinding of Pharmacy COVID-19 Response Policies. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
Due to the increase in the Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Medicaid-reimbursed prescriptions was increased effective July 1, 2024. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.42. Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85. Long-term care pharmacy providers supplying covered drugs to participants in long-term care facilities will continue to receive an additional $0.50 dispensing fee.
Also in Missouri, Gov. Mike Parson (R) allowed legislation NACDS supported, SB 751 relating to the distribution of 340B drugs, to become law without his signature, effective August 28, 2024.
Finally in Missouri, registration is open for the Board of Pharmacy’s “Lunch with the Chief Inspector” webinar on the 2024 legislative session and other Board of Pharmacy activities.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services posted the Excel file of the fee schedule for Injectables July 1, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
The Board of Pharmacy’s board book was posted in advance of the two-day July meeting in Las Vegas.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
On July 18, 2024, the Joint Legislative Committee on Administrative Rules is expected to make permanent Pharmacy Code of Conduct regulations that were previously proposed by the Board of Pharmacy. The regulations include a list of eleven ethical standards for pharmacists.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.