The Department of Insurance (DOI) updated its PBM compliance website.  

Updates include: 

• Updated fax number (Please note the PBM Compliance Department has an updated fax number: 334-241-4110; the old fax number should no longer be operational.) 

• Updated pharmacy complaint form (to remove patient PHI information) 

• Reimbursement complaint spreadsheet template 

• Best practices document 

• Updated PBM actions page 

• Links to PBM related laws and regulations 

• Consumer complaint form and 

• List of additional resources, including the National Association of Insurance Commissioners (NAIC), the Board of Pharmacy, stakeholder websites and Medicaid Average Acquisition Cost (AAC) reimbursement. 

DOI will still accept the old complaint forms but would prefer pharmacies to move over to the new template in the upcoming weeks. 

Also in Alabama, the Board of Pharmacy met last week and heard comments on its proposed rule for a Civil Penalty Schedule. This includes proposed fine ranges for violations by all license and permit holders. They voted to have an amended version published by next week and restart the public comment period. Be on the lookout for more information once the revised version is available. You can listen to the entire Board of Pharmacy meeting online.  

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

The Department of Insurance (DOI) PBM Compliance Division has taken its first action against non-compliant PBMs. Actions have been filed against two entities: one taken in October against Drexi, Inc. for operating without a PBM license in the state, and one taken against Express Scripts, Inc. (ESI) this week for several violations, including charging of illegal fees; under payment of reimbursements; and failure and refusal to provide accounts, documents, records, files, information and matters relevant to the substance of complaints. The Department is enforcing Act 2025-36, also known as the Community Pharmacy Relief Act. Stay informed by visiting the DOI PBM Compliance Division page and the PBM Actions page.  

Also in Alabama, the Board of Pharmacy proposed these rules for adoption. The required public comment period is now open, and we encourage all members to review them.  

File written comments directly with the Board of Pharmacy as directed in the cover sheet for the rule. Deadlines for comments are provided on the rule filings. All written comments should be sent to Wpassmore@albop.com by the deadlines noted.  

Finally in Alabama, the Board of Pharmacy scheduled several upcoming meetings for 2026, including April 15, May 20, June 17, July 15, August 19, September 16, October 14, November 18 and December 16. All meetings begin at 9:00 am CST/CDT unless otherwise noted.  

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

Medicaid announced a new form that should be used by all Medicaid providers to notify Medicaid that the provider has filed with a third-party resource other than the recipient’s own insurance for payment (as stated in Medicaid’s Administrative Code Rule No. 560-X-20-.02 (3)(d)). 

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

Medicaid issued an Alert announcing, effective October 1, Continuous Glucose Monitors (CGMs) were covered through the Durable Medical Equipment (DME) Program with prior authorization (PA) for recipients (children and adults) with one of the following: 

• type 1 diabetes mellitus 

• type 2 diabetes mellitus and are insulin treated with multiple (three or more) daily injections of insulin 

NOTE: CGMs are not covered through the pharmacy benefit; requests must be submitted by a DME-enrolled provider with an active National Provider Identifier (NPI). 

Also in Alabama, the Board of Pharmacy technician registrations expire December 31. The Board is accepting pharmacy technician renewals online at www.albop.com. Please don't wait until the last minute to renew.  

Important information for technicians and their employers: If you are completing the Alabama Pharmacy Association (APA) Pharmacy Technician Training or employing a technician completing the program, please take note. With the upcoming holidays, please be aware of the following important dates and plan accordingly. 

The APA office will be closed on Christmas Eve through January 1, 2026. If you complete the program after December 22, you may not receive a certificate of completion until January 5, 2026. If you need to complete the training before you renew your license, please do so before December 22. 

APA will email certificates of completion on the following dates in December: 

• Monday, December 1 

• Monday, December 8 

• Monday, December 15 

• Monday, December 22 

Please contact the APA office if you have any questions. 

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

Effective for dates of service on and after October 1, the Medicaid Agency (Medicaid) updated the laboratory fee schedule rates. Providers with billing questions may contact the Gainwell Technology Provider Assistance Center at 1-800-688-7989.

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

A new episode has dropped on “Off Script”, The Alabama Pharmacy Podcast, with some CE available. All episodes and links to CE (in show notes) or wherever you like to listen. Watch Episode 44 – Board of Pharmacy Meeting Update: September 2025. Join Garrett Aikens and Allyson Gilliam as they recap the Board of Pharmacy meeting that took place on September 17.

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

The Medicaid Agency (Medicaid) is required to conduct administrative desk reviews to ensure providers are following state policies and practices that comply with federal regulations. Medicaid coordinates with SafeGuard Services, LLC (SGS), a Unified Program Integrity Contractor (UPIC) working with the Centers for Medicare & Medicaid Services (CMS). SGS performs fraud, waste and abuse detection, deterrence and prevention activities for Medicaid claims through administrative desk reviews. See Medicaid’s ALERTs for details.

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

The Alabama Pharmacy Association is now accepting nominations for two Alabama Board of Pharmacy Seats.  

Nominations for the Pharmacy Technician position are being accepted through July 31. All candidates must be a resident of the state and must be nationally certified and registered in the state for a minimum of five years. They must also be actively engaged in the practice of pharmacy. Nominators should include CPhT documentation along with nomination. 

Nominations for the Specialty Pharmacist position are being accepted through July 31. All candidates must be a resident of the state. They must be licensed pharmacists who have been licensed in the state for a minimum of five years and who are actively engaged in the practice of pharmacy, or pharmacy administration, or both. 34-23-90 defines "Specialty" as "such as nuclear, home infusion, compounding only or consultant pharmacist". 

Nominations should be submitted in writing to LJones@aparx.org and should include the nominee's name and contact information along with the name and contact information of the individual submitting the nomination. 

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

The Board of Pharmacy announced an immediate position available for Executive Secretary. The deadline for applications is June 15.

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