Louisiana

The Board of Pharmacy’s Regulation Review Committee has posted the agenda for the January 24 meeting in Baton Rouge.  

Also in Louisiana, the Department of Health’s (LDH’s) vendor Magellan will approve overrides for non-preferred products when the preferred product has a manufacturer shortage. Contact the Magellan Medicaid Administration help desk at (800) 424-1664 to get the override. The prescriber does not need to fill out a prior authorization. The current list of drugs with known shortages are Sabril® 500mg powder for oral solution, generic Concerta®, generic Focalin XR®, Trileptal® suspension and generic Mydayis™. 

Finally in Louisiana, LDH (Department of Health) issued Bulletin 24-1 informing providers that Medicaid is updating the Medicaid Fee-For-Service (FFS) files procedure codes.  

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

2024-01-19T10:59:18-05:00January 19, 2024|Louisiana|

New York

On January 16, Gov. Kathy Hochul (D) announced her current year budget proposal. The impactful sections are below:   

  1. Streamline Medicaid Drug Cap – to streamline and remove prior triggers to enable the state to get manufacturer rebates more quickly 
  2. Discontinue Prescriber Prevails – to eliminate prescriber prevails in Medicaid where clinical standards for approval are not met 
  3. Pharmacy Enhancements and Integration Specialty Drug Management – to create new benchmarks for physician administered drug reimbursement similar to pharmacy reimbursement under Medicaid Fee-for-Service (FFS); part of the goal is to bring drugs that do not have a NADAC up to WAC instead of current WAC-3%. Also, it includes requirement for all Medicaid enrolled pharmacies to submit annual cost reports in a form requested by the state Department of Health (DOH).  
  4. Reduce Coverage for Over-The-Counter (OTC) Pharmaceuticals – to enable DOH to modify the list of OTCs covered in the Medicaid program  

 

Also in New York, NYRx, the New York Medicaid Pharmacy Benefit Program, held its regular industry call on January 17. Updates are below; however, two other conversations occurred during the call, including Pharmacy Cost Reporting proposed in the budget and Inspector General (OMIG) audit protocols regularly updated to reflect Medicaid FFS pharmacy policies, e.g., change in signature on deliveries requirement. OMIG will be joining the February Pharmacy Sector call. 

  1. Covid-19 Oral Antivirals: DOH discussed new guidance related to billing for antivirals (Paxlovid™ and Lagevrio™). 
  2. Covid-19 Vaccine Billing for non-VFC (Vaccines for Children) Pharmacies: DOH discussed guidance for billing non VFC and admin code to use for VFC and non-VFC which can be found here. 
  3. 1115 Waiver: 3-year waiver approved totaling $7.5 billion through March 31, 2027.  

NYRx also revised its preferred drug list, effective January 18.  

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

2024-01-19T11:16:33-05:00January 19, 2024|New York|

North Carolina

During the 2023 Legislative Session, the General Assembly passed, and the Governor signed into law, a statute making gabapentin a drug whose dispensing must be reported to the Controlled Substance Reporting System (CSRS). Gabapentin becomes reportable on March 1, 2024. The Drug Control Unit, which administers the CSRS, has created an FAQ guidance document for dispensers. Pharmacists with additional questions should contact the Drug Control Unit. 

Note that based on an NC Retail Merchants Association amendment, pharmacies are not required to report gabapentin to the CSRS when gabapentin is a component of a compounded prescription that is dispensed in dosages of 100 milligrams or less; see new G.S. 90-113.73(c)(1). 

Also in North Carolina, on January 10, Medicaid released the following concerning pharmacy eligibility to serve as Medicaid providers. All questions should be directed to Medicaid. 

Beginning in May 2021, NC Medicaid started taking additional steps, as outlined in the NCTracks Changes to Provider Verification Process bulletin, to ensure providers meet their contractual obligation to maintain their credentials on their NCTracks provider enrollment record. Multiple bulletin articles were published to notify providers of the change, and providers receive four targeted reminders prior to their suspension notification. Regardless of these efforts to inform and assist providers with this responsibility, we continue to see a fairly large number suspended, and subsequently terminated, from the NC Medicaid program due to their expired credential.

For this reason, and as part of an additional outreach effort, we are notifying NC associations when the number of provider taxonomy suspensions exceeds a defined threshold of unique providers on the report received at the end of each month.

On December 31, 2023, approximately 115 Pharmacist providers were suspended due to an expired credential. These providers have sixty days from the date of suspension to ensure that their license is renewed, and their NCTracks provider enrollment record is updated to avoid termination. Providers may update their NCTracks provider record through the Manage Change Request process. NCTracks User Guides and Fact Sheets offer basic instructions for making the necessary update and any additional questions may be referred to the NCTracks Call Center at 800-668-6696. 

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

2024-01-19T10:56:47-05:00January 19, 2024|North Carolina|

Oklahoma

Pharmacists working in multiple locations must have their small wallet card pharmacy license, a copy of their immunization certificate and a copy of their CPR certificate available to produce to the Board’s compliance officers for inspection.

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

2024-01-19T10:56:02-05:00January 19, 2024|Oklahoma|

Texas

The next quarterly meeting of the Board of Pharmacy is Tuesday, February 6, at the new Barbara Jordan State office building. The agenda will be posted here when it becomes available. 

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

2024-01-19T10:54:40-05:00January 19, 2024|Texas|

Washington

On January 24, pharmacy professionals and students will gather at the Capitol in Olympia for the first of two legislative days which NACDS is proud to sponsor. The advocacy event allows pharmacists, students and pharmacy technicians to educate legislators about the importance of pharmacies as a convenient, accessible community healthcare destination, as well as an opportunity to promote pharmacists and technicians as vital members of the healthcare team.  

Also in Washington, Health Care Authority (HCA) created a new flyer that pharmacies can distribute to help reach Medicaid patients encouraging them to update their contact information and apply for or renew coverage. Pharmacies can order the free flyers in both English and Spanish. 

Also in Washington, the Heath Care Authority’s (HCA) first quarter Preferred Drug List (PDL) used by Uniform Medical Plan and the Department of Labor and Industry is available online. 

Finally in Washington, legislation expanding prescriptive authority for pharmacists, HB 2116, will be heard in the House Committee on Health Care & Wellness on January 24. Take action today to register your support for the bill. If you reside in the state, register your support with your legislator by filling out this form. To share your support with all Committee members, use this link to submit a supporting statement or testimony.  

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

2024-01-19T10:53:47-05:00January 19, 2024|Washington|

Alabama

To streamline the provider enrollment process, Alabama Medicaid provider enrollment applicants should gather all needed materials before applying. READ MORE for some of the most common reasons why applications are denied. If you have any questions regarding your application, please contact Provider Enrollment at (888) 223-3630.  

Also in Alabama, on January 17, at 2:00 pm CST, the Board of Pharmacy will hold a Practice of Pharmacy Workgroup Meeting, where they will delve into Alabama Administrative Code 680-X-2-.14. This code defines the pivotal roles and duties of pharmacy technicians within the healthcare system. For those who wish to attend in person, the meeting will be held at 111 Village Street, Birmingham, AL 35242. Virtual attendance is available here. Do not miss this chance to be a part of the conversation that shapes the future of pharmacy in Alabama.  

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

2024-01-12T12:06:32-05:00January 12, 2024|Alabama|

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