In The States – Page 84 – Weekly news about states

California

The Department of Health Care Services (DHCS) posted the following alerts and monthly bulletin on the Medi-Cal Rx Web Portal.

30-Day Countdown: Changes to Continuous Glucose Monitoring Systems Coverage Criteria and Prior Authorization Bundling (November 1)
Policy Update: Use of “Inner” and “Outer” NDCs for Claim Submission (November 1)
How to Resolve Reject Code A6 for Orally Administered Enteral Nutrition Claims (November 1)
Medi-Cal Rx Monthly Bulletin for November (November 1)
Changes to the Medi-Cal Rx Contract Drugs List (November 1)
Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations (November 1)
Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs (November 1)
Updates to the Medi-Cal Rx Provider Manual (November 1)
Updates to Medi-Cal Rx Web Portal Appearance and Resources (October 29)
Medi-Cal Rx Weekly Wrap-up for October 20-26 (October 27)
Reinstatement Spotlight (October 27)

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2023-11-03T11:51:31-04:00November 3, 2023|California|

Eleven entities have responded to the statewide Medicaid Managed care invitation to negotiate, including all of the health plans that currently participate in the program. Two of the respondents, ImagineCare and Sentara Care Alliance, do not currently participate in the program. The Agency of Health Care Administration is soliciting comments from providers who have experience with the 11 respondents. The comments are a component of the Invitation to negotiate and are considered when the state decides which entities to award contracts. Providers have until 5:00 pm on November 9 to electronically submit their comments to the state. The agency will only consider comments submitted by providers in the same region as the plan.

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

Michael Silber2023-11-03T11:50:54-04:00November 3, 2023|Florida|

Iowa

The Board of Pharmacy offices will move effective November 6 to 6200 Park Ave., Suite 100, in Des Moines, Iowa 50321. The move is the result of the Board now being part of the Department of Inspections, Appeals, and Licensing. The Board’s goal is to have no disruption in service during the move. Online services will not be affected.

Also in Iowa, the Board of Pharmacy posted the November 7 meeting agenda. The meeting will be held via Zoom. To access the meeting, see the details below:

Join Zoom Meeting https://us02web.zoom.us/j/88584737545?pwd=RzdsREtyVkpkcUFUeWtNMHRmWmNxUT09

Meeting ID: 885 8473 7545

Passcode: 746325

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2023-11-03T11:50:26-04:00November 3, 2023|Iowa|

Kentucky

MedImpact will host its quarterly pharmacy webinar on November. 16 from 11 to 12am Eastern. The meeting provides a forum for pharmacies to ask questions about the SPBM (Single Pharmacy Benefit Manager) program. Click here to join.

Also in Kentucky, in preparation for the 2024 legislative session, NACDS will host a joint conference call to discuss legislative and regulatory issues with the Kentucky Retail Federation and the Kentucky Pharmacists Association on November 13 at 2:30pm Eastern. If you have not received the invitation and would like to join, please contact NACDS’ Jill McCormack.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2023-11-03T11:49:54-04:00November 3, 2023|Kentucky|

Maryland

The Prescription Drug Affordability Board posted the presentation from their October meeting. They are in the process of developing a plan to implement Upper Payment Limits on certain drugs in the commercial market. NACDS intends to submit comments to the PDAB prior to their November meeting urging them to consider the impact on pharmacy as they move forward. The next meeting is scheduled for November 27. To register, click here.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2023-11-03T11:49:16-04:00November 3, 2023|Maryland|

Massachusetts

On October 30th, the Massachusetts Joint Committee on Health Care Financing reported a bill favorably to the Senate. The bill, S 2492 “An Act relative to pharmaceutical access, costs and transparency,” combined several previously pending bills that NACDS had been monitoring and advocating. The new bill includes PBM (Pharmacy Benefit Manager) regulation, PBM transparency, and drug cost containment. The bill is now pending action before the Senate Ways and Means Committee. The Massachusetts legislative session will continue until July 31, 2024.

The Massachusetts Board of Pharmacy announced three new updated policies on November 2nd:

Prescribing and Dispensing of Contraceptives;
Update on Compliance Packaging and Reusable Dose Planners; and
CE requirements for pain management training for CDTM pharmacists

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

Michael Silber2023-11-03T11:48:44-04:00November 3, 2023|Massachusetts|

Minnesota

The Department of Health (MDH (Minnesota Department of Health)) shared the implementation timeline for expanded prescription drug price transparency reporting on drugs of significant public interest and ways to stay connected. Beginning in January 2024, pharmacies will be required to report pricing information.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Michael Silber2023-11-03T11:48:04-04:00November 3, 2023|Minnesota|

Mississippi

Telligen to replace Alliant Health Solutions and Kepro as Medicaid UM/QIO Vendors:

Early in 2024, the Division of Medicaid (DOM) will transition to a new Utilization Management/Quality Improvement Organization (UM/QIO) vendor, Telligen.

Telligen will replace the following vendors:

Alliant Health Solutions, who was responsible for medical authorization requests for fee-for-service (FFS) Medicaid members, and

Kepro (formerly eQHealth Solutions), who was responsible for advanced imaging authorization requests for FFS Medicaid members.

To ensure a smooth transition, Telligen web portal registration instructions and educational materials will be shared in the upcoming weeks through a variety of communication avenues to ensure no provider lacks access to necessary resources and assistance. Updates will also be publicized on the DOM website and Late Breaking News.

Please note: Prior authorizations for members enrolled in MississippiCAN and CHIP will continue to be handled by the respective coordinated care organization.

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

Michael Silber2023-11-03T11:47:32-04:00November 3, 2023|Mississippi|

Montana

On November 28 at 1:00 pm, a public hearing will be held via remote conferencing to consider proposed adoption of New Rule I pertaining to pharmacist prescribing [MAR Notice No. 24-174-80]. The 2023 legislature passed SB 112, allowing for independent prescribing authority for pharmacists in limited situations; it is necessary to set standards for patient care, evaluation, recordkeeping, and provider notification required of pharmacists prescribing under SB 112’s authority. In addition to oral testimony at the hearing, written comments may be submitted at dli.mt.gov/rules or P.O. Box 1728; Helena, MT 59624-1728; comments must be received no later than 5:00 pm on December 1.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2023-11-03T11:46:57-04:00November 3, 2023|Montana|