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.

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.