Alabama
Please find an ALERT describing the addition of state-licensed pharmacist Paxlovid prescribing to eligible patients in accordance with the FDA. This ALERT has been disseminated to all enrolled pharmacies.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- Diabetic Supplies: Update to the Minimum Quantity for FreeStyle Libre 3 (October 14)
- Medi-Cal Rx Weekly Wrap-Up for October 7-13 (October 14)
- Medical Supplies: Continuous Glucose Monitoring Systems and Disposable Insulin Delivery Devices Updates (October 7)
- Medical Supplies: Disposable Insulin Delivery Devices Updates (October 7)
- Medi-Cal Rx Weekly Wrap-Up for September 30-October 6 (October 7)
Also in California, Medi-Cal posted the following:
- Coming Soon: Monkeypox Vaccine Reimbursement at the Medicare Rate (October 14)
- October 2022 Pharmacy Medi-Cal Update Bulletin 1025 (October 14)
- October 2022 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin 565 (October 14)
Also in California, Gov. Gavin Newsom (D) announced the State of Emergency and the associated Executive Orders N-39-20 and N-75-20 will end on February 28, 2023. The Department of Consumer Affairs subsequently posted that upon the State of Emergency ending, active waivers that were used under the authority of the State of Emergency and Executive Orders will also expire. For future updates, check the DCA waiver webpage or the Board of Pharmacy website.
Finally in California, the Board of Pharmacy posted the following:
- Standard of Care Agenda and Meeting Materials – October 25 at 9:00 a.m. PDT
- Full Board Agenda and Meeting Materials – October 25 at 1:30 p.m. PDT and October 26 at 9:00 a.m. PDT
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Delaware
On October 13, Gov. John Carney (D) extended the Public Health Emergency (PHE) another 30 days permitting medical providers to continue COVID-19 vaccination and testing programs. This is the 8th extension of the PHE.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Department of Revenue Executive Director Jim Zingale announced extended due dates for corporate income tax filers impacted by Hurricane Ian following the recent declaration from the Internal Revenue Service (IRS). Eligible taxpayers that file Florida corporate income tax returns, as well as Florida corporate income tax installment payments, with original due dates or extended due dates falling on or after September 23, 2022, and before March 2, 2023, will now have a due date of March 2, 2023. This tax relief is applicable to affected businesses anywhere in Florida.
Additional information is available on the Tax Relief for Victims of Hurricane Ian webpage on IRS.gov. Taxpayers outside Florida who require assistance with corporate tax filing may contact the Department’s taxpayer services at (850) 488-6800 or GTAHurricaneHelp@floridarevenue.com.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
In advance of the October 20 Interim Study Committee on Financial Institutions and Insurance joint hearing on market concentration of the health insurance industry, NACDS submitted a letter focusing on market concentration in the PBM (Pharmacy Benefits Managers) industry and its impact on retail community pharmacies and patient health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy posted its agenda and meeting materials for the October 25 meeting. The meeting will be held via Zoom and in-person at the Board of Pharmacy office.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
Gov. John Bel Edwards (D) appointed several members to serve on the Board of Pharmacy — independent pharmacist Richard Mannino and Walmart pharmacist Jennifer Dupree.
Also in Louisiana, Medicaid continues to enroll providers who have missed the September 30, 2022, deadline.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
Effective December 19, 2022, MassHealth will make it mandatory for certain designated generic drugs, other designated low-net-cost drugs and drugs listed as preferred in the Brand Name Preferred section of the MassHealth Drug List to be dispensed in a 90-day supply. These drugs will be designated on the MassHealth Drug List A-Z list with a footnote of M90. Policy details can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
New York
On Tuesday, October 18, 2022, the New York State Department of Health (DOH) hosted a public online seminar about the transition of the pharmacy benefit from Medicaid Managed Care to NYRx, the Medicaid Fee-For-Service (FFS) pharmacy program. A copy of the presentation is now available. Valuable information and resources for Medicaid members and providers are also available on the DOH pharmacy transition website. Questions about the transition should be directed to NYRx@health.ny.gov. Please include “Pharmacy Benefit Transition” in the subject line.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Nebraska
On October 13, the Department of Health, and Human Services (HHS) posted the COVID-19 Fee Schedule Bivalent Booster Update.
Also in Nebraska, the HHS posted the Aducamumab (Aduhelm) prior authorization form for Fee-for-Service to its website.
Finally in Nebraska, the Credentialing Review (407) Program will meet on October 26 regarding Pharmacy Technicians. The agenda has been posted on the Credential Review (407) Pharmacy Technician webpage.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
Sen. Ryan Aument’s (R) bill allowing the Auditor General to conduct a full-scale audit of subcontracts with pharmacy benefit managers (PBMs) in Medicaid Managed Care unanimously passed the Senate Health and Human Services Committee this week and is expected to be considered by the full Senate next week.
Also in Pennsylvania, the Office of Medical Assistance Programs has issued a new bulletin regarding billing and payment for the Moderna SARS-CoV-2 Vaccine Booster. This bulletin as well as past bulletins can be found on DHS’ Bulletin search page.
Finally in Pennsylvania, the Board of Pharmacy has posted the agenda for the November 1 meeting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
In collaboration with researchers at the UTHSC College of Pharmacy and grant support from Genentech, Tennessee Pharmacy Association would like to share an opportunity for community-based/outpatient pharmacies to enroll in a study investigating pharmacists’ management of influenza using point-of-care testing. Click here to learn more and enroll.
Also in Tennessee, updated versions of the Preferred Drug List (PDL), criteria PDL and interim criteria PDL are available, as well as the monthly provider notice for October 2022. Below is a summary of the updates:
- The following agents will be added to the PDL as non-preferred:
- Adlarity, Bylvay, Epsolay, Livmarli, Livtencity, Norliqva, Opzelura, Rezurock, Skytrofa, Tavneos, Tarpeyo, Triumeq PD
- Clinical criteria and/or quantity limits will be updated for the following agents:
- Nubeqa, Nucala, Olumiant, Skyrizi
- The following agents will be added to the interim criteria PDL:
- Radicava ORS, Vtama
- Proventil HFA will be moved to preferred on the PDL in response to marketing discontinuation of Proair HFA
Updates to clinical criteria/quantity limits from the Q3 PAC meeting will also became effective on October 1 and were summarized in the September provider notice.
These documents are available on the TennCare website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy’s posted the agenda for the November 1 meeting.
Also in Texas, save the date for the next PMP Advisory Committee remote Zoom meeting on December 1. Information will be posted on the Board of Pharmacy’s Committee & Task Force Meetings webpage as it becomes available.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The COVID-19 Standing Order has been updated to include the most recently authorized bivalent boosters
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- Diabetic Supplies: Updates to Continuous Glucose Monitoring Systems (October 4)
- Medical Supplies: Continuous Glucose Monitoring Systems and Disposable Insulin Delivery Devices Updates (September 30; Revised October 4)
- Medi-Cal Rx Monthly Bulletin for October (October 1)
- Changes to Contract Drugs List (CDL) (October 1)
- Changes to Contract Drugs List (CDL) – Over-the-Counter Drugs (October 1)
- Changes to Contract Drugs List (CDL) – Authorized Drug Manufacturer Labeler Codes (October 1)
- Changes to Family PACT Pharmacy Formulary (October 1)
- Updates to the Medi-Cal Rx Provider Manual (October 1)
- Diabetic Supplies: Continuous Glucose Monitoring (CGM) Systems Billing Units Reminder, Effective October 1, 2022 (October 1)
- Enteral Nutrition Update: Changes to the List of Covered Enteral Nutrition Products, Effective November 1, 2022, December 1, 2022, and January 1, 2023 (October 1)
- Medical Supplies: Removal of Prior Authorization Requirement for Covered Blood Pressure Cuffs, Effective November 1, 2022 (October 1)
- Medical Supplies: Continuous Glucose Monitoring Systems and Disposable Insulin Delivery Devised Updates (September 30)
- Coming Soon: Bivalent COVID-19 Vaccines (September 30)
- Medi-Cal Rx Weekly Wrap-Up for September 23-29 (September 30)
Also in California, Medi-Cal posted the following:
- Policy Update and Billing Guidance for COVID-19 Oral Antiviral, Paxlovid
- 2022 HCPCS Quarter 4 Update
- 2023 ICD-10-CM/PCS Codes Update
- Medical Supplies Update: MAPC Change for Nonsterile Gloves
- Medi-Cal Update – Pharmacy – September 2022 – Bulletin 1024
Also in California, the Board of Pharmacy posted its Board of Pharmacy Update – October 2022.
In California, Medi-Cal Rx will provide an educational opportunity regarding Brand Medically Necessary Prior Authorizations (DAW 1) and implications for pharmacy providers related to the Dispense as Written (DAW), Brand Medically Necessary (BMN), and Reimbursement – Frequently Asked Questions (FAQs) and Submission of Pricing Prior Authorization for Brand Medically Necessary Medications: Dispense as Written 1 (DAW1), released on September 29. Please join the Zoom meeting on October 10 at 1:00 p.m. Pacific using the following:
https://magellanhealth.zoom.us/j/93157317543?pwd=ZzlGRE9FNWtZWWtqb2FRZzcyMmE3Zz09&from=addon
Password: 924224
or iPhone one-tap (US Toll): +16699006833,93157317543# or +13462487799,93157317543#
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Delaware
Governor John Carney (D) signed HB 399 authorizing a pharmacist to order, test, screen and treat certain health conditions pursuant to a statewide written protocol for CLIA-waived tests approved by the Division of Public Health. These health conditions include flu; Strep A; COVID or other respiratory illness, condition or disease; lice; skin conditions including ring worm and athlete’s foot or other emerging and existing public health threats identified and permitted by the Division of Public Health. A pharmacist may also delegate the administration and technical performance of the CLIA-waived test to an intern or pharmacy technician acting under the supervision of the pharmacist.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Due to Hurricane Ian, and effective immediately, retail food stores licensed by the Food and Nutrition Service and located in the State of Florida may accept SNAP benefits in exchange for HOT foods and foods intended to be consumed on retailer premises.
These special rules are in effect through October 31, 2022.
When hot foods are purchased with SNAP EBT benefits through October 31, 2022, the purchases are NOT subject to sales tax, as these foods are considered SNAP eligible during this period.
All SNAP authorized retail food stores in the State of Florida are encouraged to post a special notice in the store letting SNAP customers know that they can use their SNAP EBT benefits to purchase hot foods and, where practical, may remain on the premises to consume those foods.
Thank you for your assistance in aiding those impacted by Hurricane Ian.
Also in Florida, the state has Starlink Internet Provider units available to businesses. These are the portable wifi providers donated to the state by Elon Musk. Each unit can provide internet service to 2,000 square feet and can have 120 maximum concurrent devices connected at a time. Multiple units are available to primarily allow a business to have connectivity and secondly to provide hotspots to the public. The first priority is to assist businesses. The ESF in charge of this will assist with set up and provide technical support. Please contact Lorena@FRF.org for more information.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Department of Healthcare and Family Services has posted a new Provider Notice regarding Post Kidney Transplant Preferred Drugs under the Emergency Medical Program.
Also, the Department of Healthcare and Family Services has posted a new Provider Notice regarding Prior Approval Requests for Synagis Dosing.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
On October 20, the Interim Study Committee on Financial Institutions and Insurance is holding a joint hearing on market concentration of the health insurance industry, hospital industry, health care practitioners, retail pharmaceutical industry, pharmacy benefit manager industry and pharmacy services administration organization industry.
Also in Indiana, Health Coverage Programs (IHCP) posted important information for providers, including:
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services, Iowa Medicaid issued the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) Medicaid Pharmacy Program issued the following updates:
- Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Updates for Select Medications – Effective October 1, 2022
- Louisiana Medicaid Pharmacy Point of Sale (POS) Edits – Effective October 1, 2022
- Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective October 1, 2022
- Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code – Effective October 1, 2022
- Louisiana Medicaid Pharmacy Point of Sale (POS) Edits for Tramadol/Celecoxib (Seglentis®) – Effective October 1, 2022
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
A statewide standing order is now available for the dispensing of emergency contraception pills (ECP). While not required to dispense ECP under the standing order, a training program is available through the MGH Institute of Health Professions that also offers continuing education credits.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Maryland
The Maryland Department of Health (MDH) is currently accepting applications and nominations for pharmacists to serve on the Maryland Medicaid Drug Use Review (DUR) Board beginning January 2023. The DUR Board is comprised of up to twelve (12) licensed and actively practicing physicians and pharmacists in Maryland. Members are appointed by the Secretary of MDH and serve one term of three (3) years from the date of their appointment with the option to serve an additional three (3) year term. All interested applicants are required to submit a formal application through the Maryland Department of Health’s Office of Appointments and Executive Nominations application link and indicate DUR Board. The deadline to submit applications is October 19, 2022.
Also in Maryland, the Maryland Department of Health (MDH) announced the targeted launch of a new Pharmacy Point of Sale Electronic Claims Management System. They have published a bulletin with details on the functionality of the new system and instructions to attend training in-person or virtually.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Minnesota Department of Human Services (DHS) held a pharmacy stakeholder meeting this week to discuss the upcoming 2022 fee-for-service pharmacy cost of dispensing survey that will be conducted by Myers and Stauffer. The surveys will be delivered on October 19 to pharmacies via mail (corporate headquarters for chains) and electronically to the email address they have on file. Surveys are to be completed by November 16. Myers and
Stauffer has set up a dedicated email for questions. The same email address may be used for pharmacies to provide an alternative email address for electronic survey delivery or to request an extension, if needed. For more detail on the survey process, see the meeting slide deck and draft survey instrument.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy is soliciting comments due October 15 on a proposal establishing requirements for authorized pharmacists dispensing HIV post-exposure prophylaxis as authorized by section 338.730, RSMo.
For more information, contact NACDS’ Mary Staples at 817-442-1155.