On June 4, the Department of Consumer Protection updated the proposed opioid warning label regulation upon some corrections from the Legislative Commissioner’s Office.
The Department of Consumer Protection has also given notice that it proposes to adopt a regulation concerning Emergency and Hormonal Contraceptives. Public comment period is 30 days from June 4.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The University of Florida (UF) Health has been selected by the Centers for Disease Control and Prevention to lead a program that could reduce the health disparity gap in some Jacksonville communities by connecting patients with community pharmacists for help managing high blood pressure.
The Hypertension Pharmacists’ Program is scheduled to start this summer with the goal of expanding access to blood pressure care for the city’s medically underserved, predominantly Black communities.
The program aims to increase treatment for high blood pressure by embedding clinical pharmacists within a patient’s primary care team. The effort, facilitated by the UF Health Jacksonville Office of Community Engagement, is a collaboration among the UF Health Total Care Clinic – Jacksonville, the UF College of Pharmacy and Panama Pharmacy, and it will allow patients to see a specially trained pharmacist at a community pharmacy and seek individualized care and education.
Also in Florida, beginning July 1, 2024, hearing services for UnitedHealthcare of Florida, Inc. (United) will be provided by Audiology Distributors, LLC dba HearUSA. United is a Statewide Medicaid Managed Care plan operating in regions 3, 4, 6 and 11.
Providers that are out of network for hearing services as of July 1, 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. All members were notified by mail of this transition. Members can still see their provider for up to sixty (60) days if they are currently receiving care from that provider. The continuity of care period will end on August 30.
If you are interested in becoming a participating provider with United for hearing services, please call HearUSA Member Services at 855-917-1967 or visit the HearUSA website.
For questions regarding this transition, contact United’s Customer Service Department at 1-877-842-3210.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Health Coverage Program (IHCP) provided Pharmacy updates approved by Drug Utilization Review Board May 2024.
Also in Indiana, the Family and Social Services (FSSA) is launching a new Medicaid program called Indiana PathWays for Aging starting July 1.
Finally in Indiana, IHCP (Health Coverage Program) issued a bulletin correcting errors on Vaccine for Children (VFC) vaccine administration codes.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2585-MC-FFS Avastin® (bevacizumab) Billing.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Effective June 1, 2024, the Department for Medicaid Services made changes to the vaccine coverage for Medicaid Fee-for-Service members.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The legislature adjourned sine die on June 3.
Also in Louisiana, several bills’ pharmacies supported passed both houses and were sent to Gov. Jeff Landry (R) to be signed into law.
HB 579 – Allows pharmacists to test and treat for PEP/PrEP (See NACDS’ letter to the governor supporting enactment of this legislation.)
SB 444 – Prohibits reimbursement below cost
HB 603 – PBM audits
SB 281 – PBM Enforcement and audits
Finally in Louisiana, the Department of Health issued the preferred drug list update for July 1, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Prescription Drug Affordability Board (PDAB) announced the June virtual meeting of its Stakeholder Council, scheduled for 2:00 pm on June 24. The agenda and other meeting materials will be available on the Stakeholder Council page of the PDAB’s website prior to the scheduled meeting. To register for the June 24 virtual meeting, please click on this link and enter the required information. After registering, you will receive a confirmation email containing details about joining the meeting. Also, to register for oral public comment and for additional information concerning public comments, please refer to the Stakeholder Council page.
Also in Maryland, please visit the Prescription Drug Affordability Board’s, Cost Review Study Process page on the Board’s website to learn more about the comment period for “Board Selected Drugs for Cost Review.” The 60-day comment period will close on July 22, 2024.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
MassHealth published its June “All Provider Bulletin 391” with orders ALL 361, ALL 376 and ALL 380 announcing the start dates for enforcing the ordering, referring and prescribing (ORP) requirements. With the exception of the information in the bulletin, all information in ALL 361, ALL 376 and ALL 380 remains in effect. Opportunity for payment of claims initially denied due to unenrolled ORP provider as described in ALL 376, billing providers should take certain steps to avoid claim denials due to unenrolled ORP providers. If a claim is denied because of an unenrolled or unauthorized ORP provider on or after June 9, 2024, the claim will be placed in suspense status. The claims system will continue to check to see if the ORP provider has enrolled with MassHealth for up to 90 days after the first date of service on the claim. Once the ORP provider is enrolled, the claim will then be payable. This will allow billing providers time to follow the steps related to unenrolled ORP providers outlined in ALL 376. If the ORP provider is not enrolled by 90 days from the first date of service on the claim, the claim will be denied. Also, effective June 9, 2024, billing providers can resubmit claims that were previously denied due to an unenrolled or unauthorized ORP provider if the first date of service on the claim is no earlier than September 1, 2023. If the ORP provider is enrolled with MassHealth within 90 days of the first date of service on the claim, the claim will be payable.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Pharmacy Controlled Substance Administrative Rules have been revised and changes are effective as of May 31, 2024. One amendment of note is the removal of Gabapentin, meaning it is no longer classified as a controlled substance in the state. A prescriber without a controlled substance license can now prescribe Gabapentin, and Gabapentin no longer needs to be included in reporting to the Michigan Automated Prescription System (MAPS).
For more information, contact NACDS’ Jill McCormack at 717-592-8977.