Indiana

The Family and Social Services Administration’s (FSSA) Office of Medicaid Policy and Planning’s Medicaid Director Allison Taylor is retiring later this summer. FSSA Secretary Dr. Dan Rusyniak announced that Cora Steinmetz, Gov. Holcomb’s senior operations director for health-related state agencies, will be the next director of Indiana Medicaid. Steinmetz and Taylor will work closely during the weeks ahead to ensure a smooth transition.  

Also in Indiana, the Health Coverage Programs (IHCP) updated its member eligibility and benefit coverage manual.  

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

2023-06-23T10:42:36-04:00June 23, 2023|Indiana|

Michigan

The House Health Policy Committee reported a substitute version of SB 219 (H-2). The bill allows pharmacists to order and administer immunizations to patients aged three years and older; order and administer tests for COVID, flu or respiratory illness and furnish medications to treat COVID and flu. The bill is scheduled for a vote by the full House and must be returned to the Senate for concurrence.

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

2023-06-23T10:42:00-04:00June 23, 2023|Michigan|

Minnesota

As result of the passage of 2023 Session Law Chapter 70 (Article 2, Sections 8-21, 43), pharmacies and wholesalers will be required to report on Drugs of Significant Public Interest beginning in 2024. The Minnesota Department of Health (MDH) is in the initial stages of developing the reporting initiative. As work progresses, they will provide updates on implementation, opportunities for public comment and resources to support reporting entities newly engaging in this reporting initiative. NACDS will pass on all information to members. If you are interested in directly receiving announcements on prescription drug price transparency from MDH, you may subscribe to Prescription Drug Price Transparency updates.

Also in Minnesota, the MIIC (Minnesota Immunization Information Connection) forecaster has been updated to ensure all people ages five years and older are recommended to receive one dose of COVID-19 vaccine and people under five years to receive two or three doses, depending on the product and appropriate intervals. The forecaster cannot recommend a specific COVID-19 vaccine schedule based on the date of an administered dose or recommend bivalent (updated) doses only. The forecaster’s updates will now validate the first dose received by clients ages five years and older and the first two or three doses received by clients under the age of fvie. Doses will be validated regardless of when they were received. All other doses will be recorded in a client’s immunization record but not evaluated. Unevaluated doses will display in MIIC but will not contain information in the series column. 

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

2023-06-23T10:41:28-04:00June 23, 2023|Minnesota|

Nebraska

The Department of Health and Human Services (DHHS) posted the COVID-19 Fee Schedule effective May 31, 2023. 

Also in Nebraska, the Department of Health and Human Services Division of Children and Family Services Economic Assistance issued Pandemic Electronic Benefits Transfer (P-EBT) benefits to households for school-age children eligible for free or reduced-priced school meals during the 2022-2023 school year. Children with an eligible COVID-19 absence from school will receive monthly support ranging from $25 to $139. 

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

2023-06-23T10:40:54-04:00June 23, 2023|Nebraska|

New York

The New York Department of Health held a webinar  on the enacted Medicaid budget including NYRx, the Medicaid Fee-for-service pharmacy benefit transition.  The scorecard highlighted in the webinar shows additional savings for the state beyond what was projected by the transiition – $410 million to $547.8 million.

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

2023-06-23T10:40:15-04:00June 23, 2023|New York|

Ohio

NACDS reminds members that beginning July 1, Medicaid Fee-for-Service (FFS) pharmacy claims should be submitted to Gainwell with the BIN of 024251, a PCN of OHRXPFFS and the same 12-digit Medicaid ID number used to bill FFS today. All ODM-enrolled pharmacies will be able to submit FFS claims. No separate contracting with the SPBM is required. 

Additionally, prior authorization management will also transition to Gainwell beginning July 1. On this date, prescribers should begin submitting prior authorization requests to Gainwell, using the same forms and processes as used under the SPBM managed care program. All active prior authorizations on file with Change Healthcare will be transferred to Gainwell and will be honored through their original expiration date. 

Pharmacies and pharmacists can find the FFS Pharmacy Reference Guide and Payer Sheet at: Pharmacy Billing Information | pharmacy.medicaid.ohio.gov. 

Also in Ohio, The Common Sense Initiative (CSI) is reviewing the following Board of Pharmacy proposed rules to assess any adverse impact on the business community. To review the Board’s Business Impact Analysis and provide comments to CSI, please click on the links below. 

  • 29:6-3-09 – Satellite Distribution Sites During a Public Health Emergency 
  • 4279:5-3-21 – Point of Dispensing Locations During a Public Health Emergency  
  • 4729:7-3-06 – Allows pharmacists to conduct medication validation (e.g., the final check) of a drug compounded in a prescriber clinic. 

The Board of Pharmacy is also seeking comments by July 28 on adding Nalmefene Nasal Spray under the definition of an overdose reversal drug to make it be available for widespread lay distribution in Ohio without a prescription, like naloxone. 

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

2023-06-23T10:39:38-04:00June 23, 2023|Ohio|

Oregon

The Board of Pharmacy announced a rulemaking hearing on July 26 and is proposing to adopt the following rules. The rulemaking hearing will be held virtually and begins at 9:30 a.m. If you plan to testify, please complete the sign-up form on the website. Written comments may be submitted by 4:30 p.m. on July 26 via email. 

 Also in Oregon, the Board of Pharmacy announced it will receive public comments on the following proposed compounding rules at the July 26 rulemaking hearing beginning at 9:30 a.m. If you plan to testify or submit written comments, see the above section for guidance.  

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

2023-06-23T10:38:47-04:00June 23, 2023|Oregon|

South Carolina

A phoned-in prescription for promethazine/dextromethorphan was called into CVS, Lancaster, SC by an unknown person stating their identity as Dr. Allen Glimerm with Prisma Health Urgent Care, Greer, SC. This physician is no longer with this clinic. Rx was not called by the physician or any other authorized representative. Rx verification should be requested by calling 864.255.5638.  

Also in South Carolina, the South Carolina Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments to accommodate the Fourth of July holiday. Friday, June 30 at 5 p.m. is the deadline to submit claims for payments scheduled for Friday, July 7. Payments will be made on Monday, July 3. Electronic remittance advice will be available Thursday, July 6. Payments will be dated Friday, July 7, as usual. The schedule will return to a normal payment cycle on Friday, July 7. 

Any questions or concerns regarding this bulletin should be directed to the Provider Service Center (PSC) at (888) 289-0709. The PSC’s hours of operation are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday. The PSC will be closed Tuesday, July 4, in observance of the Independence Day holiday.

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

2023-10-10T09:00:58-04:00June 23, 2023|South Carolina|

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