The Health Coverage Programs (IHCP) expanded provider enrollment to include licensed pharmacists. This new provider specialty allows eligible pharmacists to enroll as rendering providers linked to a group provider. Group providers may be reimbursed for evaluation and management (E/M) services related to hormonal contraceptives provided by IHCP-enrolled pharmacists, as outlined in Indiana Code (IC 25-26-25). Pharmacists may enroll as IHCP rendering providers using the IHCP Provider Healthcare Portal or via paper application. An active pharmacist license and successful completion of training as specified in IC 25-26-25 are required for IHCP pharmacist enrollment.   

Also in Indiana, the Health Coverage Programs (IHCP) Drug Utilization Board (DUR) approved updates to the prior authorization (PA) criteria, Statewide Uniform Preferred Drug List (SUPDL) and Preferred Brand Drug List. 

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

The Family and Social Services Administration (FSSA) Health Coverage Programs (IHCP) issued a Bulletin documenting requirements clarified for claims billed to Medicaid for dually eligible members. 

Also in Indiana, IHCP reminded providers about the benefits of submitting claims electronically and provided pharmacy updates approved by the Office of Medicaid Policy and Planning. 

Also in Indiana, IHCP announced that effective July 1, they will expand provider enrollment to include licensed pharmacists. This new provider specialty will allow eligible pharmacists to enroll as rendering providers linked to a group provider. Group providers may be reimbursed for evaluation and management (E/M) services related to hormonal contraceptives provided by IHCP-enrolled pharmacists, as outlined in Indiana Code IC 25-26-25. 

Finally in Indiana, the Office of Medicaid Policy and Planning is seeking applicants to serve on the Medicaid Advisory Committee which provides feedback on the program policies and proposed policies that ensure the program is responsive to concerns as well as providing transparency and accountability.  

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

Gov. Mike Braun (R) signed into law SB 140, PBM reform legislation establishing commercial reimbursement floors. The bill, effective January 1, 2026, requires reimbursement not less than the greater of the reimbursement level paid to PBM-owned or affiliated pharmacies, one of the following reimbursement methodologies depending on whether pharmacies hold permits to sell liquor. For pharmacies not holding permits to sell liquor, the reimbursement floor is NADAC, plus the professional dispensing fee from the Medicaid fee-for-service program. For pharmacies holding permits to sell liquor, the rate floor will be the actual acquisition cost (AAC) plus a “fair and reasonable” dispensing fee. 

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

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.