On February 26, HF 555 passed the Senate with a unanimous vote (46-0). It returns to the House for concurrence with the Senate amendments. 

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

• INFORMATIONAL LETTER NO. 2563-MC-FFS-D RE: Pharmacy Provider Resources 
• INFORMATIONAL LETTER NO. 2562-FFS RE: Pharmacy System Issues 
• INFORMATIONAL LETTER NO. 2545-MC-FFS RE: Pharmacists Visits at FQHC (Federally Qualified Health Centers) 
• INFORMATIONAL LETTER NO. 2542-MC-FFS-D RE: Iowa Medicaid Pharmacy Program Update – Buprenorphine Age 
• INFORMATIONAL LETTER NO. 2540-MC-FFS RE: January 2024 Pharmacy Billing Reference 

Finally in Iowa, the Board of Pharmacy adopted and filed ARC 7617C to amend Chapter 10, “Controlled Substances”. The amendment temporarily places five substances (novel psychoactive substances of the benzodiazepine class, also known as “designer benzodiazepines”) to Schedule I of the Iowa CSA (Controlled Substances Act) in response to similar action taken by the federal Drug Enforcement Administration. The amendment is effective March 13.  

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

The Board of Pharmacy published ARC 7632C as a Notice of Intended Action to amend Chapter 10, “Controlled Substances”. The proposed amendments would temporarily add nine substances to Schedule I and one substance to Schedule IV of the Iowa Controlled Substances Act in response to similar scheduling action taken by the DEA. Comments may be submitted until 4:30 pm on March 12.

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

On January 24, the Insurance Commissioner, Doug Ommen, presented to the Senate Commerce Committee various issues including the Insurance Divisions’ work to regulate PBMs. To date, the Division has received 72,000 complaints and nearly $400,000 has been paid to pharmacies. The Division is currently pursuing additional authorities and policies via HSB 536/SSB 3079. 

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

The House Commerce Committee held a hearing on January 18 and recommended passage of HSB 536, related to PBMs. This study bill, proposed by the Department of Insurance and Financial Services, expands the PBM’s duty of good faith and fair dealing to pharmacies. It also prohibits retaliation by a PBM against a pharmacy for exercising its rights or remedy or in cooperation with the commissioner. Also, a PBM is prohibited from assessing, charging or collecting any form of renumeration that passes from any pharmacist, regardless of whether the pharmacist in a pharmacy network. The bill also requires a PBM to update the maximum allowable cost (MAC) list within seven days from the date of an increase of 10 percent more in the NADAC of a prescription drug on the list. Finally, it places additional reporting requirements on PBMs. 

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

The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2543-MC-FFS: Amerigroup Iowa, Inc. Rebranding to Wellpoint Iowa, Inc. 

Also in Iowa, on January 3, 2024, Wellpoint released Clinical UM Guideline (Guideline #CG-DME-42) regarding the use of continuous glucose monitoring devices (CGMs). Also review the Iowa Administrative Code and Department of Human Services Medical Equipment and Supply Dealer Provider Manual for related information; see pages 39-40. Please contact the following for assistance: Angela Dillon or Joely Anderson. 

Also in Iowa, in response to complaints by Iowa pharmacies, Andria Seip, Senior Health Policy Specialist, Iowa Insurance Division, sent a memo on January 4, 2024, to PBMs (Pharmacy Benefit Managers) licensed in the state that contracts requiring reimbursement models using “effective rates” are considered prohibited under Iowa Code section 510B.8C.  

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. 2537-MC-FFS-D: HHS New Website Launch and Content Changes 
• INFORMATIONAL LETTER NO. 2535-MC-FFS-D: January 2024 Iowa Medicaid Pharmacy Program Changes 
• INFORMATIONAL LETTER NO. 2531-MC-FFS: Member Cost Sharing Limits 
• INFORMATIONAL LETTER NO. 2528-MC-FFS-D: SUPPORT Act Section 5042(e)(I)(A) Reporting Requirements Survey for Federal Fiscal Year (FFY) 2023 
• INFORMATIONAL LETTER NO. 2522-MC-FFS: New Vaccine for Children (VFC) Program Codes 
• INFORMATIONAL LETTER NO. 2521-MC-FFS: New Respiratory Syncytial Virus (RSV) Vaccine Codes 
• INFORMATIONAL LETTER NO. 2511-MC-FFS: Date Span Billing for Durable Medical Equipment (DME) Rental and Medical Supplies; this replaces INFORMATIONAL LETTER NO. 2395 
• INFORMATIONAL LETTER NO. 2509-MC-FFS: Over-the-Counter COVID Test 

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

The Board of Pharmacy offices will move effective November 6 to 6200 Park Ave., Suite 100, in Des Moines, Iowa 50321. The move is the result of the Board now being part of the Department of Inspections, Appeals, and Licensing. The Board’s goal is to have no disruption in service during the move. Online services will not be affected.  

Also in Iowa, the Board of Pharmacy posted the November 7 meeting agenda. The meeting will be held via Zoom. To access the meeting, see the details below:  

Join Zoom Meeting https://us02web.zoom.us/j/88584737545?pwd=RzdsREtyVkpkcUFUeWtNMHRmWmNxUT09  

Meeting ID: 885 8473 7545  

Passcode: 746325 

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. 2515-MC-FFS RE: Clarification of Billing COVID-19 Vaccines and Administration, effectively immediately.
• INFORMATIONAL LETTER NO. 2507-MC-FFS RE: Request for Proposal (RFP) for Adolescent Health Pilot Projects, effective September 20, 2023 
• INFORMATIONAL LETTER NO. 2505-MC-FFS RE: Electronic Data Interchange Support Services (EDISS) Registration, effective immediately 
• INFORMATIONAL LETTER NO. 2510-MC RE: Reimbursement for Pharmacy Point-of-Care Testing – Influenza and Streptococcus A, effective immediately. 

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

The Department of Health and Human Services, Iowa Medicaid posted INFORMATION LETTER NO. 2503-MC-FFS – 2023 Annual Provider Training.

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