The state’s Health Coverage Programs (IHCP) provided updates on prior authorization (PA) criteria and Preferred Drug List (PDL) as approved by the Drug Utilization Review (DUR) Board at its June meeting. The provisions apply only to Medicaid fee-for-service.

Also in Indiana, a Medicaid state plan amendment (SPA) allowing pharmacists to be enrolled as providers was submitted to the Centers for Medicare & Medicaid Services (CMS). The SPA allows pharmacists to be enrolled as providers and includes provisions that would reimburse for all services pharmacists provide within their scope. Unfortunately, the state rulemaking process could take 18 months to two years to implement once approved by CMS. 

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

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.

The Health Coverage Programs (IHCP), Medicaid, issued a bulletin updating the prior authorizations, preferred dug list and over-the-counter formularies approved at the May meeting of the Drug Utilization Review (DUR) Board.

Also in Indiana, IHCP announced pharmacy benefit COVID updates in response to the expiration of the public health emergency (PHE).

Also in Indiana, the Office of the Secretary of Family and Social Services (FFSA) recently adopted a rule clarifying electronic signatures.

Also in Indiana, last week Gainwell Technologies migrated the Indiana Medicaid system (CoreMMIS) to the Amazon Web Services (AWS) Cloud. IHPC’s Provider Healthcare Portal also migrated to AWS as part of this initiative.

Finally in Indiana, on July 5, 2023, the FFSA will adopt a single Medicaid formulary, called the statewide uniform preferred drug list (SUPDL), which will align members enrolled in Healthy Indiana Plan (HIP), Hoosier Care Connect or Hoosier Healthwise managed care entity (MCE) with the fee-for-service (FFS) formulary.

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

On May 1, Gov. Eric Holcomb (R) signed into law HB 1568, legislation allowing pharmacists to prescribe and dispense hormonal contraception.

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

Legislation authorizing pharmacists to prescribe hormonal contraception passed both houses and was sent to Gov. Eric Holcomb (R) to be signed into law. (HB 1568)

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

HB 1568, legislation granting pharmacists independent prescriptive authority of a drug product, was amended in the Committee on Public Health to include a requirement for Medicaid to pursue a state plan amendment for payment for pharmacy services for the non-dispensing activities associated with prescribing a contraceptive. The bill was passed by the House by a vote of 167-86-12, and it is currently awaiting further action in the Senate Health and Provider Services Committee. The Family and Social Services Administration (Medicaid) has confirmed that with this authority they would pursue a state plan amendment (SPA) that would encompass all non-dispensing, clinical pharmacist services for reimbursement under Medicaid.

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

The Family and Social Services Administration (FSSA) posted several bulletins of interest to pharmacies. 

• BT202306 – Pharmacy updates approved by Drug Utilization Review Board January 2023 
• BT202304 – IHCP [Indiana Health Coverage Programs] announces end to member continuous eligibility 
• BT2022118 – Pharmacy updates approved by Drug Utilization Review Board December 2022 

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

NACDS was a sponsor of the January 24 Indiana Pharmacists Day at the Capitol. Pharmacists, technicians, interns and pharmacy students participated in advocacy training, provided health screening of legislators and staff and promoted the passage of several healthcare bills dealing with prescription drug rebates and pricing (SB 8, HB 1273), Medicaid reimbursement for clinical services (SB 152), prescribing and dispensing of hormonal contraceptives (SB 153, HB 1224), establishing a statewide standing order for dispensing naloxone (SB 214), “Test and Treat” (HB 1182) and auditing PBMs (HB 1445).

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

The legislature convened on January 10, 2023. Several bills of interest to pharmacies have been filed, including several different bills that will allow pharmacists to prescribe hormonal contraceptives – SB (Senate Bill) 153 & SB 206, and HB 1224. Test and Treat, HB 1182, requires the state health commissioner to issue a standing order for pharmacists to treat or screen, test, administer or dispense for respiratory illness including influenza, severe SARS-CoV-2, and RSV (Respiratory Syncytial Virus); group A strep; lice; minor skin conditions; and emerging or existing public health threats identified by the state health commissioner. Also filed was SB 214, legislation that would establish a standing order for pharmacists to prescribe naloxone. 

Also in Indiana, all are welcome to participate at the Indiana Pharmacists Association’s (IPA) annual Legislative Day at the Indiana State House starting at 9:30 am on January 24. This event will allow all pharmacists, pharmacy students and pharmacy technicians from all practice settings to connect with legislators and colleagues across the state. Register here before January 19.

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