Indiana
Health Coverage Programs (IHCP) issued Bulletin 2023132 announcing COVID-19 vaccine pharmacy benefit updates for 2023-2024 season.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2515-MC-FFS RE: Clarification of Billing COVID-19 Vaccines and Administration, effectively immediately.
- INFORMATIONAL LETTER NO. 2507-MC-FFS RE: Request for Proposal (RFP) for Adolescent Health Pilot Projects, effective September 20, 2023
- INFORMATIONAL LETTER NO. 2505-MC-FFS RE: Electronic Data Interchange Support Services (EDISS) Registration, effective immediately
- INFORMATIONAL LETTER NO. 2510-MC RE: Reimbursement for Pharmacy Point-of-Care Testing – Influenza and Streptococcus A, effective immediately.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
The Board of Pharmacy is reminding pharmacy technicians to act on the following items:
- Technician Registrations – Technicians unable to take or pass the PTCB (Pharmacy Technician Certification Board) or ExCPT certification exam by October 31, 2023, may request a six-month extension at least 30 days before the technician’s registration expiration date by completing a Technician Certification Extension Request Form (LA-75).
- Continuing Education (CE) – Technician registrations expiring October 31, 2023, must complete 20 hours of ACPE/Board approved CE between November 1, 2021 – October 31, 2023, before their renewal.
- Renewal – Technician licenses expiring October 31, 2023, can be renewed online. Failing to renew on or before 11:59 PM CST October 31, 2023, will result in the registration being cancelled.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health (LDH (Louisiana Department of Health)) Medicaid posted several new provider notices.
- Louisiana Medicaid Pharmacy Diabetic Supplies on the Preferred Drug List (PDL) for Outpatient Pharmacy Services – Effective October 28, 2023
- Louisiana Medicaid Pharmacy Counseling for Vaccines – Implementation Postponed to October 28, 2023
- Louisiana Medicaid Pharmacy COVID-19 Vaccines 2023-2024 Update
- Louisiana Medicaid Pharmacy Maintenance Medications Professional Dispensing Fee for Managed Care Organizations (MCOs) – Implementation Postponed to October 28, 2023
Also in Louisiana, the Single Pharmacy Benefits Manager (PBM) for Managed Care Organizations (MCO) original implementation of October 1 was postponed until October 28, 2023. Magellan Medicaid Administration Inc. will serve as the processor for all Medicaid MCO pharmacy for all six MCOs (Aetna, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections and United Healthcare). Currently Magellan is only processing test claims. If you would like to submit test claims, please e-mail RxPharmacyTesting@magellanhealth.com your contact’s name, phone number, pharmacy National Provider Identifier and Switch information to receive the testing packet.
Finally in Louisiana, two-term Attorney General Jeff Landry (R) triumphed in the Louisiana governor’s race in a crowded field with more than a dozen candidates. Landry flipped the seat to the GOP, receiving over 51% of the vote last Saturday in the state’s so-called “jungle primary” election where all the candidates in both parties are on the same ballot. Gov. John Bel Edwards (D) was termed limited and could not seek election to a third term. For those state legislative and statewide office races where no one received more 50% of the vote, the top two contenders will face off in the November 18 general election.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Board of Pharmacy updated its rulemaking for pharmacists to administer vaccines, consistent with Public Law 2023 Chapter 170. On October 6, 2023, the Board issued Written Statement #01-2023 indicating that the Board does not believe rulemaking is necessary before an appropriately licensed and ADV-certified pharmacist is permitted to administer vaccines consistent with the above-stated authorizations.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Massachusetts
On October 19, MassHealth updated a previous notice that outlined the upcoming discontinuation of brand Flovent products and several associated changes to MassHealth’s coverage of inhaled respiratory agents. To facilitate transition from Flovent products to alternative inhalers, MassHealth has removed the PA (prior authorization) requirement from Arnuity Ellipta (fluticasone furoate inhalation powder) earlier than anticipated. Claims for Arnuity Ellipta processed through the Pharmacy Online Processing System (POPS) will be paid without PA beginning October 19, 2023. The MassHealth Drug List will be updated to reflect this change in PA status on December 4, 2023.
The previously approved emergency regulations for pharmacists prescribing hormonal contraceptives were not published in the Friday, October 13 register by the Massachusetts Secretary of State. The next publishing date will be October 27, at which time they are expected to be published and will become effective upon publication. In the meantime, the Board of Pharmacy is developing a circular letter which will deal with all the operations issues regarding these regulations, including training and the screening risk assessment tools. These regulations come straight from the law that was signed as part of the Fiscal Year 23 Annual State Budget.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Montana
The Department of Public Health and Human Services (DPHHS) has received calls regarding denials and prior authorization requirements on stimulants due to the shortages. Many of these can be handled by the pharmacy by calling the prior authorization (PA) call center at 1-800-395-7961. Please try the PA call center before involving the provider or turning the patient away. The DPHHS is approving short term prior authorization to mitigate some of the issues caused by these shortages. If you have questions, please contact Dani Feist, Pharmacy and Home Infusion Program Officer at 406–444–2738.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services issued Provider Bulletin 23-26 announcing changes to the Coverage and Payment of Adult Vaccines effective October 1, 2023.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Provider call will be held on November 1 at noon (Central); see details below to join the call. Also, the recording from October 4 COVID-19 Provider call has been posted.
Join from the meeting link:
https://sonvideo.webex.com/sonvideo/j.php?MTID=mc307e2dda218d1060adfed7f454cfc16
Join by phone:
408-418-9388 (access code: 2480 661 3098)
Also in Nebraska, the Department of Health and Human Services posted the 471-000-540 Medicaid Practitioners Fee Schedule for Injectables (October 1, 2023).
Also in Nebraska, the Department of Health and Human Services posted the draft minutes from the September 12 Drug Utilization Review (DUR) Board Meeting. The next DUR Board Meeting will be held on November 14.
Also in Nebraska, the Department of Health and Human Services launched the iServe Nebraska Portal’s new integrated benefit application that will make it easier for Nebraskans to apply for Medicaid and Economic Assistance benefit programs. Nebraskans can apply for benefits such as food, heat, electricity, healthcare, childcare, and other essential needs at the same time using the single, online iServe Nebraska application.
Also in Nebraska, Gov. Jim Pillen (R) approved emergency regulations related to the Let Them Grow Act. Please note the requirements for picking up prescribed medications from a pharmacy. For both puberty blocking drug prescriptions and cross-sex hormone prescriptions for a patient who has not reached the age of majority, these prescribed medications picked up from a pharmacy are required to be picked up by the patient’s parent, legal guardian, or the patient if the patient is an emancipated minor. Additionally, these prescriptions must identify the drugs being prescribed are for the treatment of gender nonconformity or gender dysphoria. The process to implement final regulations for LB 574 will proceed pursuant to the Administrative Procedure Act. The anticipated public hearing date is November 28; a draft of the proposed final regulations will be posted at least 30 days prior to that hearing.
Finally in Nebraska, the Department of Health and Human Services (DHHS) released the final draft of regulations for the Let Them Grow Act. A public hearing will be held on November 28 from 7:00 AM to 7:00 PM at the Lancaster Event Center – Lincoln Room at 4100 N 84th St., Lincoln, NE 68507. People interested are encouraged to provide written comments via mail, fax, or email, no later than 11:59 PM on the day of the hearing. Comments may be faxed to 402-742-2382, emailed to dhhs.regulations@nebraska.gov or mailed to: DHHS Legal Services, PO Box 95026, Lincoln NE 68509-5026. Additional information can be found on the Frequently Asked Questions page on the DHHS website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
NACDS submitted a comment letter in support of the Proposed Rule published in the State Register by the Department of Financial Services on August 16, 2023, related to Definitions, Licensing of Pharmacy Benefit Managers (PBMs), Contracting with Network Pharmacies, Acquisition of PBMs, Consumer Protections and Audits
The Department of Health (NYSDOH (New York State Department of Health)) reported an update to the State Plan Amendment (SPA) allowing reimbursement for Medicaid covered professional services included within the pharmacist / pharmacy intern scope of practice and provided by a pharmacist / intern. For instance, once the new law on oral contraception is effective, this will apply to pharmacists dispensed oral contraception. Also, according to NYSDOH, the reimbursement will be provided to pharmacies, not to pharmacists per the New York SPA 23-0037: “This amendment proposes to allow pharmacists and pharmacy interns to provide Medicaid covered services to the limits of their scope of practice. We conducted our review of your submittal according to statutory requirements in Title XIX of the Social Security Act. This letter is to inform you that New York Medicaid SPA 23-0037 was approved on August 24, 2023, with an effective date of April 1, 2023.”
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.