The Family and Social Services Administration (FSSA) issued Bulletin202538 providing updates to the Point-of-Sale Quick Check (PSQC) automated prior authorization (PA) system, PA criteria, mental health utilization edits, Statewide Uniform Preferred Drug List (SUPDL) and Preferred Brand Drug List.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
NACDS launched an NACDS RxImpact Action Alert urging members to contact their hometown legislators to help advance SB 140, critical legislation that ensures PBMs pay pharmacies a reasonable reimbursement rate. Opponents are spreading misinformation across radio, print and TV, falsely labeling this bill as a “pill tax” on consumers. The bill passed the Senate and is stuck in the House Insurance Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
SB 140, the commercial rate floor bill establishing a minimum reimbursement rate of the pharmacy’s acquisition cost plus a professional dispensing fee equal to the Medicaid fee-for-service dispensing fee, was amended, passed the Senate and was referred to the House Committee on Insurance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
SB 96, immunization legislation NACDS supports because it removes the list of vaccines a pharmacist can administer, allowing them to provide any vaccine recommended by the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices that has been approved by the federal Food and Drug Administration under a drug order, under a prescription, or according to a protocol approved by a physician. The bill was amended, giving the Indiana Commissioner of Health the authority to remove a specific vaccination from the list of vaccines recommended and approved by the federal agencies, and then unanimously approved by the Senate.
Also in Indiana, NACDS rallied members to contact their senators to urge support for the rate floor bill that is scheduled for a Senate vote this week. SB 140 would establish a minimum dispensing reimbursement rate of NADAC plus a professional dispensing fee equal to the Medicaid Fee for Service fee, which is currently $10.64.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
NACDS sponsored the Indiana Pharmacists Legislative Day, where over 350 pharmacists, students and technicians gathered at the Statehouse to engage in advocacy for the profession. The priority legislative issues included securing fairer reimbursement for dispensing, PBM reforms and reimbursement for services. The advocates also promoted bills securing authority for pharmacists to provide “test and treat” services and substance use disorder treatments; lowering the vaccination age from 11 years and allowing administration of any FDA-approved vaccines if operating under a physician protocol or health commissioner standing order; allowing nationally certified technicians the ability to perform any task delegated to them by a supervising pharmacist that does not require the training or judgment of a pharmacist, including receipt of verbal orders and final product verification; and 340B protections.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Family and Social Services Administration (FSSA) posted a notice of intent to submit an application to the Centers for Medicare and Medicaid Services under section 1115 of the Social Security Act seeking a five-year extension of the current waiver authorities for the substance use disorder and serious mental illness demonstrations. The current demonstration is authorized through December 31, 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Health Coverage Programs (IHCP) posted provider Bulletin BT20244172, pharmacy provider updates approved by the Drug Utilization Review Board in October 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The General Assembly’s Health Care Cost Oversight Task Force held a meeting on October 8 on PBM oversight and contracting. Two years ago, legislation was adopted that funded a state audit. RxConnection was hired to review five years of data from the state’s major PBMs. Unfortunately, the data the auditors obtained was incomplete due to an ongoing lack of transparency surrounding the specific details regarding PBM contracts with the state’s medical plans and the terms of the rebate systems negotiated by PBMs, which prompted the Office of the Attorney General to file civil investigative demands.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Health Coverage Programs (IHCP) issued a Medicaid provider bulletin BT2024166 reminding providers to use the new Gainwell Technologies addresses.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
