All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is May 30, 2020, or at the conclusion of the COVID-19 National emergency, whichever occurs first.  

Also in Alabama… the Board of Pharmacy is providing Notice and guidance to pharmacists on testing for coronavirus, including conditions under which pharmacists, and pharmacy interns under the immediate supervision of a pharmacist, can perform the allowed tests with appropriate training. Pharmacy technicians can only be involved in completing required paperwork, including the required reporting.  Pharmacies must also provide staff with appropriate personal protective equipment.  Note: Pharmacies conducting COVID-19 tests are subject to the reporting requirements specified on the Alabama Department of Public Health web page.  

Also in Alabama… Alabama Medicaid is providing notice that the State Plan Amendment (SPA) request to modify the default/backup pharmacy reimbursement methodology when no AAC is present on brand drugs only from WAC + 0% to WAC – 4% has been approved by CMS.   The plan is now to proceed with the Administrative Code change for an implementation date to be determined later this year.   

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

 Alabama Medicaid has extended all expiration dates for temporary allowances to April 30, 2020. This alert and other related updates can be found at the Agency COVID-19 page here. 

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

In response to the Coronavirus Disease 2019 (COVID-19) pandemic, Medicaid is temporarily waiving copayments for all services including, but not limited to doctor visits, optometric services, certified nurse practitioner visits, health care center visits, rural health clinic visits, inpatient hospital, outpatient hospital, prescription drugs, medical equipment, supplies and appliances, and ambulatory surgical centers.

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

The Alabama Medicaid Agency had modified the recipient signature requirement for services provided during the state of emergency effective March 16th.  More information can be found at this link:  https://medicaid.alabama.gov/alert_detail.aspx?ID=13755. Comprehensive data related to the state’s COVID response can be found on this link:  https://medicaid.alabama.gov/news_detail.aspx?ID=13729 

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

Effective April 1, 2020, the Alabama Medicaid Agency will implement hard edits on cumulative daily MME claims exceeding 150 MME/day. A phase-in period for claims exceeding 120 MME/day, but less than 150 MME/day, will also be implemented. To view the full ALERT, click here.

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

The CURES Act Fee Schedule has been updated and is available on the Alabama Medicaid website under the DME Fee Schedules section. All claims with dates of service on or after January 1, 2020 will be reimbursed with the 2020 rate. Additional questions may be directed to the Alabama Medicaid Agency DME Policy Unit at (334) 242-5050.

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

The Legislature convened on Tuesday, February 4, 2020

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

On September 26, NACDS participated in a Medicaid meeting/conference call, during which the agency discussed potential pharmacy reimbursement modifications. In accordance with current market evidence, the agency proposed modifying the default reimbursement methodology from WAC + 0% to WAC – 4%, if no AAC exits for a drug product. Medicaid asked for all stakeholders to submit comments; those comments and responses, along with all other items discussed that day, may be found on the website. On November 15, the agency announced its plan to move forward with a State Plan Amendment (SPA) for the proposed change.  

Also in Alabama… A reminder that gabapentin became a Schedule V medication on November 18. You may recall on May 15, the State Committee of Public Health voted to change gabapentin to a Schedule V medication, effective November 18, 2019. This was at the request of the Board of Medical Examiners. Pharmacies should have completed the necessary changes required when moving a legend medication to a scheduled medication. These changes may include software requirement changes, increases in physical space to store scheduled medications and changes in procedures for prescribing/dispensing a controlled substance. Questions can be directed to Nancy Bishop, State Pharmacy Director, Department of Public Health.

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

Effective December 2, 2019, the Alabama Medicaid Agency will implement hard edits on cumulative daily MME claims exceeding 200 MME/day. A phase-in period for claims exceeding 150 MME/day, but less than 200 MME/day, will also be implemented. For more information please see the Medicaid Alert dated November 4, 2020.

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