The legislature convened its 60-day short session on January 8. 

Also in Indiana, the state Health Coverage programs (IHCP) issued two bulletins of interest to pharmacies: 

• Coverage removed from Pfizer and Moderna COVID-19 vaccination replacement codes 
• Pharmacy updates approved by Drug Utilization Review Board December 2023. 

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

The Health Coverage Programs (IHCP) issued a bulletin reminding pharmacy providers to submit claims with the appropriate DAW codes.

Also in Indiana, after four interim legislative hearings, the Health Care Cost Oversight Task Force issued a report with seven recommendations for legislation, including increasing transparency and prohibiting spread pricing by PBMs, third parties and insurers.

Finally in Indiana, the IHCP Bulletin 2023168 provides informational updates on the November Drug Utilization Review (DUR) Board.

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

The Family and Social Services Administration (FSSA) provided pharmacy updates approved by Drug Utilization Review Board in October.

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

The Indiana Health Coverage Programs (IHCP) posted Bulletin # BT2023138 regarding reprocessing claims for certain glucose monitor procedure codes. 

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

Health Coverage Programs (IHCP) issued Bulletin 2023132 announcing COVID-19 vaccine pharmacy benefit updates for 2023-2024 season.

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

The Department of Health issued the standing order and protocol for pharmacists to provide without a prescription self-administered hormonal contraceptives products.

• Statewide Standing Order for Administration of Hormonal Contraceptives (updated 9/1/23)
• Appendix A
• Appendix B
• Appendix C
• Appendix D
• Statewide Protocol for Hormonal Contraceptives (updated 9/1/23)

Also in Indiana, the state’s Health Coverage Programs (IHCP) Medicaid issued several bulletins:

• Pharmacy updates approved by Drug Utilization Review Board September 2023
• IHCP updates Preferred Diabetes Supplies List
• IHCP expands coverage for Vaxneuvance to the pediatric population
• Correcting the ages covered through the VFC (Vaccines for Children) program for members ages 6 weeks through 18 years of age
• IHCP updates pharmacy benefit long-acting reversible contraceptive coverage

IHCP removes cost-sharing obligations for pharmacist-administered adult vaccines

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

As a result of the passage of legislation earlier this year that NACDS supported, HB (House Bill) 1568 allowing pharmacists who meet certain requirements to prescribe and dispense hormonal contraceptive patches and self-administered hormonal contraceptives, CMS approved the SPA (State Plan Amendment) giving pharmacists the ability to bill Medicaid for services associated with the prescribing of hormonal contraceptives.  
 
Also in Indiana, the Family and Social Services Administration (FSSA) recently issued several Indiana Health Coverage Program (IHCP) bulletins of interest to pharmacies, including pharmacy updates approved by the DUR (Drug Utilization Review) Board, enhancements to the fee-for-service prior authorization submissions process and changes to the submission requirements for the FFS (Fee for Service) claim administrative review process. IHPC also provided new portal links to providers webpage.  

Also in Indiana, Cora Steinmetz, JD, is the new Medicaid Director, Family and Social Services Administration (FFSA). Previously, she was Senior Operations Director for health-related state agencies for Gov. Eric Holcomb (R).   

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

As a result of the passage of legislation earlier this year that NACDS supported, HB (House Bill) 1568 allowing pharmacists who meet certain requirements to prescribe and dispense hormonal contraceptive patches and self-administered hormonal contraceptives, CMS approved the SPA (State Plan Amendment) giving pharmacists the ability to bill Medicaid for services associated with the prescribing of hormonal contraceptives.

Also in Indiana, the Family and Social Services Administration (FSSA) recently issued several Indiana Health Coverage Program (IHCP) bulletins of interest to pharmacies, including pharmacy updates approved by the DUR (Drug Utilization Review) Board, enhancements to the fee-for-service prior authorization submissions process and changes to the submission requirements for the FFS (Fee For Service) claim administrative review process. IDPC also provided new portal links to providers webpage. 

Also in Indiana, Cora Steinmetz, JD, is the new Medicaid Director, Family and Social Services Administration (FFSA). Previously, she was Senior Operations Director for health-related state agencies for Gov. Eric Holcomb (R).  

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

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.