The Department of Health and Human Services (HHS) announced the intent to award a Managed Care Organization (MCO) contract to Iowa Total Care. The new Iowa Medicaid contract period begins July 1, 2025, with no change in operations. This RFP and resulting contract aligns all three MCO contracts (Iowa Total Care, Molina, and Wellpoint Iowa, Inc.) to provide health care services to Iowans to the same contract cycle. All three MCO contracts will have a final contract end date of June 30, 2031.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Board of Pharmacy was moved from the Department of Health and Human Services (DHHS) to the Department of Inspections, Appeals and Licensing (DIAL). Upon the transition to DIAL, all health profession programs were combined into one with one set of rules, requiring a common naming convention. The Iowa Monitoring Program for Pharmacy Professionals (IMP3) will now be the Iowa Professional Health Program – Pharmacy (IPHP-Pharmacy). The program’s role is to provide pharmacy professionals and student pharmacists with support for recovery from substance use, mental health issues and other physical conditions.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Inspections, Appeals & Licensing (DIAL) announced a meeting of the Pharmacy Health Committee on July 31. The agenda and information to access the meeting are available in the DIAL Public Meeting Calendar. 

Also in Iowa, the Department of Health and Human Services, Iowa Medicaid posted the following: 

• INFORMATIONAL LETTER NO. 2615-MC-FFS-D Providers Displaced by Flooding 

• INFORMATIONAL LETTER NO. 2618-MC-FFS Upcoming Electronic Visit Verification (EVV) Meetings 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health and Human Services, Iowa Medicaid posted the following:

• INFORMATIONAL LETTER NO. 2605-MC-FFS Spravato® (Esketamine Nasal Spray) Billing & Coding Update
• INFORMATIONAL LETTER NO. 2597-MC-FFS Medical Foods Update
• INFORMATIONAL LETTER NO. 2587-MC-FFS Clinical Trials
• INFORMATIONAL LETTER NO. 2577-MC-FFS Services After Death Date
• INFORMATIONAL LETTER NO. 2594-MC-FFS-D Clarification to Medicaid Enrollment Options for Individual Practitioners
• INFORMATIONAL LETTER NO. 2599-FFS Medicaid Pharmacy Copayments Reinstatement
• INFORMATIONAL LETTER NO. 2596-MC-FFS New Vaccine for Children (VFC) Codes
• INFORMATIONAL LETTER NO. 2595-MC-FFS-D July 2024 Medicaid Pharmacy Program Changes

Also in Iowa, a Presidential Disaster Declaration for individual assistance was approved for four additional Iowa counties affected by extreme rainfall and flooding beginning on June 16, 2024. This declaration allows the Iowa Department of Health and Human Services to offer the Disaster Food Assistance, also known as Disaster Supplemental Nutrition Assistance Program (D-SNAP) for Iowans in Buena Vista, Cherokee, O’Brien and Woodbury counties. Disaster Food Assistance uses different qualifying rules than regular SNAP. Those who may not normally qualify for SNAP, based on income, may qualify for Disaster Food Assistance.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2585-MC-FFS Avastin® (bevacizumab) Billing.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2589-MC-FFS-D “Discover IA SAIL: Planning for and Addressing Aging Issues Across the Lifespan”.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

As a reminder, the cost of dispensing survey was to be mailed to pharmacies on May 22 and the deadline to respond is July 31. For details, see the Department of Health and Human Services, Iowa Medicaid’s INFORMATIONAL LETTER NO. 2584-MC-FFS Pharmacy Cost of Dispensing Survey 2024.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health and Human Services, Iowa Medicaid posted the following: 

• INFORMATIONAL LETTER NO. 2564-MC-FFS Avastin® (bevacizumab) Billing 
• INFORMATIONAL LETTER NO. 2575-MC-FFS Updated Respiratory Syncytial Virus (RSV) Vaccine Codes 
• INFORMATIONAL LETTER NO. 2576-MC-FFS New Vaccine for Children (VFC) Program Codes 
• INFORMATIONAL LETTER NO. 2579-MC-FFS-D Change of Ownership (CHOW) 
• INFORMATIONAL LETTER NO. 2584-MC-FFS Pharmacy Cost of Dispensing Survey 2024 
• INFORMATIONAL LETTER NO. 2586-MC-FFS-D June 2024 Iowa Medicaid Pharmacy Program Changes 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Gov. Kim Reynolds (R) signed the following bills: 

• HF 555, legislation modernizing the Pharmacy Practice Act by implementing a standard of care model reflecting the education and training of pharmacists licensed to practice in the state.  Accordingly, various definitions have been amended to reflect a pharmacist’s authority to “issue prescription drugs” and to be defined as a “practitioner” in the state.  The board of pharmacy, in consultation with the department of health and human services, may develop statewide protocols.  There are also some efficiencies gained, e.g., refill authority for non-controlled drugs and therapeutic substitution.

• HF 2099, legislation proposed by the Department of Insurance and Financial Services that oversees PBM (Pharmacy Benefit Managers) practices in the state. The bill deems that PBMs (Pharmacy Benefit Managers) owe pharmacies a duty of fair dealing and good faith, prohibits PBMs from retaliating against a pharmacy filing a complaint to or cooperating with the commissioner, requires PBMs to update the maximum allowable cost list within seven days of a 10% increase in NADAC, and prohibits a PBM from assessing or collecting charges/fees. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.