Arkansas
Gov. Asa Hutchinson (R) appointed Jennifer Dillaha, M.D., as Director of the Department of Health. Since 2001, she has worked at the Department of Health leading the Agency’s health promotion efforts focused on population-based interventions to improve the health and well-being of all Arkansans. The Governor also appointed Renee Mallory, RN, BSN to the position as interim Secretary of Health.
Also in Arkansas, the Department of Human Services Medicaid established a provider portal to accept applications for new providers as an individual practitioner so that pharmacists can order, render, and prescribe with the applicable CLIA (Clinical Laboratory Improvement Amendments) documentation. Recent legislation passed gave authority to pharmacists to test for flu and strep as well, along with other prescribing authority.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts and notices on the Medi-Cal Rx Web Portal.
- Prior Authorization Submission Reminders (May 16)
- Changes to the Family PACT Pharmacy Formulary (May 13)
- Medi-Cal Weekly Wrap-Up for May 6-12 (May 13)
- Medical Supplies Update: Update to the Maximum Allowable Product Cost (MAPC) for Female Condoms, Effective, July 1, 2022 (May 12)
- Medical Supplies Update: New Pharmacy Benefit, Blood Pressure Monitors, and Blood Pressure Cuffs, Effective July 1, 2022 (May 12)
- Medi-Cal Weekly Wrap-Up for April 29-May 5 (May 6)
- Medi-Cal Rx Weekly Wrap-Up for April 29-May 5 (May 6)
Also in California, on May 6, the Department of Health Care Services hosted a Medi-Cal Rx Multi-factor Authentication (MFA) – Chain Rx Kickoff meeting to explain current MFA policy and how the exception granted for some chain pharmacies to the MFA policy expires on December 31, 2022. As indicated in the slidesDHCS will schedule bi-weekly meetings to formalize requirements and timelines. Please feel free to send questions to:
- Rajesh Adoni Rajesh.Adoni2@dhcs.ca.gov
- Gina Connors Gina.Connors@dhcs.ca.gov
- Julie Cheung Julie.Cheung@dhcs.ca.gov
Finally in California, on May 17, the Department of Health Care Services (DHCS) released the “Medi-Cal COVID-19 Public Health Emergency (PHE) Operational Unwinding Plan”. This plan provides an overview of DHCS’ plan to unwind COVID-19 Medi-Cal flexibilities and resume normal Medi-Cal operations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The legislature adjourned on May 11th. Prior to adjournment, several bills of interest to pharmacies passed and will be sent to Gov. Jared Polis (D) to sign into law, including a telepharmacy bill eliminating the mileage restrictions SB-173, and a PBM 340b bill prohibiting additional fees and chargebacks HB-1122,
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
Earlier this month the finalized Connecticut State Budget, HB5506, included approved changes in the Collaborative Drug Therapy Management agreements between pharmacists and any prescribing practitioner and caregiving institutions to expand pharmacists’ authority to manage patient populations.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Florida
The Agency for Health Care Administration (Agency) has posted a Request for Information (RFI) relating to the procurement of the Statewide Medicaid Managed Care (SMMC) Program (AHCA RFI 014-21/22 Re-Procurement of the SMMC Program. The RFI may be viewed HERE.
In preparation for the upcoming procurement, the Agency is seeking information from entities and stakeholders with direct experience in the managed health and long-term care industries regarding best practices and innovations in business models as well as service delivery for Medicaid managed care.
The Agency is interested in innovative ideas and best practices to:
- Leverage the managed care delivery system, either through expanded benefits or other mechanisms, to promote sustainable economic self-sufficiency among Medicaid recipients in the short and long term.
- Improve birth outcomes for mothers and infants through and beyond 12-month postpartum coverage period.
- Utilize value-based payment designs to simultaneously increase quality and reduce costs.
- Maximize home and community-based placement and services through proactive aging-in place strategies.
- Improve integration of dental and primary care services for children and adolescents.
- Align quality metrics and outcomes with the Florida State Health Improvement Plan.
- Enhance specialty health plans services to improve outcomes for recipients. Increase the number of plans to address target populations with specific health conditions or needs.
- Increase access to community-based pharmacists within prescription benefit manager networks.
- Improve mental health outcomes for children and adolescents.
- Improve coordination of care for individuals enrolled in both the Medicare and Medicaid programs.
- Decrease mortality rates for recipients with complex chronic diseases and address payment strategies for high-cost therapies and prescription drugs in development.
- Consider innovative delivery methods, including care bundling, that empower recipients in making more informed health care decisions.
- Improve providers’ experience with the SMMC Program.
- Improve recipients’ experience with the SMMC Program.
- Increase timely access to providers and services.
- Achieve cost savings throughout the SMMC Program.
The Agency will consider information gathered from responses to this RFI in preparing the competitive procurement for the Statewide Medicaid Managed Care program which is scheduled for release in the fourth quarter of CY (Calendar Year) 2022.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
Governor JB Pritzker (D) has signed SB4018, effective May 13, 2022, this legislation clarifies prescription verification policies for pharmacy technicians and requires pharmacists to deliver proper notification and signage for temporary closures. Pharmacies may engage in remote prescription processing if the pharmacies have the same owner or a written contract describing the scope of services, the pharmacies share a common electronic file, and such an electronic system can produce a record at either location.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kansas
Prior to adjournment last month, Gov. Laura Kelly (D) signed into law SB (Senate Bill) 200, a bill expanding the pharmacist’s scope of practice to include initiation of therapy for flu, strep or urinary tract infection pursuant to a Statewide Protocol adopted by the existing Collaborative Drug Therapy Management Advisory Committee. Also signed into law was SB 28 that sets up a regulatory framework, adjusts the MAC (Maximum Allowable Cost) appeal law, and requires Pharmacy Benefit Managers to be licensed by the Insurance Department.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
This week, NACDS wrote the Commissioner at the Department of Public Health a letter to urge her to make permanent pharmacy practice modernization in alignment with allowances under the federal PREP (Public Readiness and Emergency Preparedness) Act.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Missouri
The legislature adjourned on May 13. Prior to adjournment, HB 3010, legislation that provides funding for the distribution of naloxone passed both houses and was sent to Gov. Mike Parsons (R). Also sent to the Governor for his signature was HB 2162, that will allow pharmacists to sell and dispense opioid antagonists under a physician protocol or statewide standing order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
Pursuant to MAR 24-174-78, the Board of Pharmacy’s final rule amendments were published in the Administrative Rules of Montana, effective March 26, related to elimination of the ratio of pharmacy technicians and interns to pharmacists and inclusion of other healthcare licensees for vaccine administration and corresponding changes to the technician utilization plan.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Dakota
On May 12, the Department of Human Services posted a reminder about the Timely Filing Policy for claim dates of service on or after January 1, 2022. See the ND Medicaid Provider Updates webpage for historical updates.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Board of Pharmacy published a bulletin announcing Board meeting dates for the remainder of 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Oregon Health Authority issued a Notice of Proposed Rulemaking for minor edits to the Oregon Health Plan Managed Care Rules. These edits are needed to align with Federal requirements, clarify language, remove outdated references, and correct typos. It also adds a definition for “Plan Type.” Comments are due at 5:00 p.m. on May 21.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The PACE Program has issued two Provider Bulletins: PPB-22-007 details a change in the Submission Clarification Code to be used on the first fill (shortened fill) in Medication Synchronization. PPB-22-009 details changes in Copay Collection on Incremental Fills. Both changes will be effective Monday, June 13, 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
The South Carolina Board of Medical Examiners recently met and approved the updated Joint Pharmacist Immunization Protocol. The protocol now includes the updated ACIP (Advisory Committee on Immunization Practices) recommendations for Pneumococcal vaccines. You can view a copy here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Drug Utilization Review (DUR) Board recently approved a list of recommended drugs for the Medicaid preferred drug list which will be discussed and finalized at the DUR meeting on July 22, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Board of Pharmacy announced a June 28 meeting; agenda is pending.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Washington
The Health Care Authority’s recently approved second quarter preferred drug list is now available.
Also in Washington, the Pharmacy and Therapeutics (P&T) Committee and Drug Utilization Review (DUR) Board meeting is scheduled for June 15, 2022, to review drug classes for the Washington PDL (Preferred Drug List), and the drug classes for the Apple Health (Medicaid) PDL. This meeting will be held by Zoom online seminar only and you will need to register in advance to receive the meeting link.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
Effective May 14, the Alaska Department of Commerce, Community, and Economic Development amended regulations under 12 AAC 02 to reduce application, license, registration, and renewal fees for pharmacists, pharmacy technicians, remote and other pharmacies, wholesale drug distributors, outsourcing facilities, and third-party logistics providers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
Effective April 1, 2022, Medicaid began accepting applications for new providers as individual practitioners. Pharmacists that intend to be an Ordering, Rendering, and Prescribing (ORP) provider for pharmacy and medical claim billing, must enroll with Arkansas Medicaid. Applications may be submitted to the Provider Portal. For more information, contact the Provider Assistance Center at (501) 376-2211.
Also in Arkansas, Gov. Asa Hutchinson (R) appointed Jennifer Dillaha, M.D., as Director of the Department of Health. Since 2001, she has worked at the Department of Health leading the Agency’s health promotion efforts focused on population-based interventions to improve the health and well-being of all Arkansans. The Governor also appointed Renee Mallory, RN, BSN to the position as interim Secretary of Health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal. Please note DUR Claims Edits were not reinstated on May 1 and the Electronic Claims Agreement Submission Deadline has been extended to July 31, 2022. Additionally, the Medi-Cal Rx 180-day prior authorization (PA) transition scheduled to go into effect July 1 will not take place. Medi-Cal Rx will continue to utilize historical PA and claims data beyond July 1. There is no new date for the transition. However, providers will be notified 90 days before the PA transition takes place.
- Diabetic Supplies – Therapeutic Continuous Glucose Monitoring (CGM) Systems (May 5)
- Medi-Cal Rx Operational Updates (May 5)
- Medi-Cal Rx Monthly Bulletin for May (May 1)
- Changes to Contract Drugs List (CDL) (May 1)
- Changes to Contract Drugs List (CDL) — Over-the-Counter Drugs (May 1)
- Updates to the Medi-Cal Rx Provider Manual (May 1)
- Update: Drug Utilization Review Claims Edits Will Not be Reinstated on May 1, 2022 (April 29)
- Electronic Claims Agreement – Submission Deadline Extended to July 31, 2022 (April 29)
- Medi-Cal Rx Weekly Wrap-Up for April 22-28 (April 29)
- Diabetic Supplies Update: Disposable Insulin Delivery Devices Updates (April 28)
- Medi-Cal Rx Compound Claims Processing Billing Tips (April 22)
- Prescriber Training Checklist (April 22)
- Pharmacy Training Checklist (April 22)
- Medi-Cal Rx Weekly Wrap-Up for April 15-21 (April 22)
- Medi-Cal Rx Billing Policy for Disposable Insulin Delivery Devices (April 21)
- Medi-Cal Rx Billing Policy for Continuous Glucose Monitoring Systems (April 21)
- Understanding Medi-Cal Rx for Beneficiaries (April 21)
Also in California, the Board of Pharmacy posted its agenda for the May 11 Board Meeting; see link below.
Finally in California, the Board of Pharmacy posted its May update.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
The Illinois Drug & Therapeutics Advisory Board will hold an Ad Hoc meeting on June 7, 2022, to review the ADHD (attention deficit hyperactivity disorder) class in detail.
Also in Illinois, the Department of Healthcare and Family Services has posted an Updated Medicaid Preferred Drug List Effective 07/01/2022. You may view the new List at the following link.
Also in Illinois, please join the Illinois Retail Merchants Association, in conjunction with the Cybersecurity and Infrastructure Security Agency (CISA) of the Department of Homeland Security, on Wednesday, May 18th at 8:30 a.m., to learn more about the current cybersecurity threats to retailers and what you can do to help mitigate your risk.
During the online seminar attendees will hear from Steve Lyddon, Protective Security Advisor for CISA, about a variety of topics surrounding cybersecurity including:
- Threats to Critical infrastructure
- Basic Cyber Hygiene and Security
- Understanding Mis – Dis – and Mal information
- CISA’s Shields-Up Program which deals with the defense of the nation’s cyber security and industrial control systems since the Russian Invasion of Ukraine.
Register HERE.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
NACDS submitted comments to the Board of Pharmacy in support of proposed rule changes that would make permanent the temporary allowances for remote processing. These were granted by Gov. Kim Reynolds (R) and the Board of Pharmacy in response to the COVID-19 public health emergency. If adopted, the proposed rule would permit pharmacists to provide remote counseling services and allow certified pharmacy technicians to perform delegated functions at a location that is not a licensed pharmacy.
Also in Iowa, the Board of The Board of Pharmacy has posted its meeting minutes from the March 1, 2022, meeting.
Finally in Iowa, the Department of Human Services issued INFORMATIONAL LETTER NO. 2337-MC-FFS announcing the following June 2022 Iowa Medicaid Pharmacy Program Changes effective June 1, 2022.
- Changes to the Preferred Drug List (PDL) Effective June 1, 2022
- New Drug PA [Prior Authorization] Criteria – Triheptanoin (Dojolvi)
- Changes to Existing PA [Prior Authorization] Criteria
- Apremilast (Otezla)
- Biologics for Arthritis
- Janus Kinase Inhibitors
- Selective Preventive Migraine Treatments (formerly CGRP Inhibitors)
- Point of Sale Billing Updates – ProDUR Quantity Limits
- Drug Utilization Review (DUR) Update
- Pharmacy Average Acquisition Cost (AAC)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
On May 5, the Department of Medicaid Service (DMS) issued a statement asking pharmacies to hold off on reprocessing and rebilling TPL claims as requested by MedImpact in a recent communication to pharmacies. The statement, issued by Dr. Fatima Ali, Senior Director, Medicaid Pharmacy Services, reads: “DMS is requesting that pharmacies hold off on reversing and reprocessing claims until further guidance is provided in the upcoming days. DMS is exploring alternative solutions around the TPL issue and will provide additional updates ASAP. Thank you!”
NACDS thanks the Kentucky Retail Federation and the Kentucky Pharmacists Association for their work on this issue and for sharing this information with us. We will keep members informed via email on any developments on this issue.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
HB (House Bill) 424 by Rep. Chris Taylor (R), legislation lowering the age to 7 and older for pharmacies to be able to provide immunizations without a prescription, fell one vote short of the 53 votes needed to pass the full House; final passage vote was 52 in favor and 37 opposed.
For more information, contact NACDS’ Mary Staples at 817-442-1155.