The Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2352-MC-FFS outlining the following August 2022 Iowa Medicaid Pharmacy Program Changes effective August 1, 2022.

1. New Drug Prior Authorization (PA) Criteria
   • Finerenone (Kerendia)
   • Odevixibat (Bylvay)
   • Pegcetacoplan (Empaveli)
2. Changes to Existing PA Criteria
   • PCSK9 Inhibitors
3. Point of Sale Billing Updates:
   • ProDUR Quantity Limits
4. Drug Utilization Review (DUR) Update

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

The Iowa Medicaid Enterprise (IME) released the final July 2022 Cost of Dispensing (COD) Report with the following results:   

• The report reflects the mean cost of dispensing, weighted by Medicaid volume, was $10.97 per prescription for all pharmacies, including specialty pharmacies. 
• For non-specialty pharmacies only, the mean cost of dispensing, weighted by Medicaid volume, was $10.18 per prescription.    

IME stated the current dispensing fee of $10.38 will remain in place until additional state funding is appropriated by the Legislature next session to increase the dispensing fee to $10.97. A state plan amendment (SPA) would also be required, if funding is approved, and the increase would be prospective following CMS approval of the SPA. 

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

On June 13, Gov. Kim Reynolds (R) signed HF 2384 related to PBMs (Pharmacy Benefit Managers) including MAC (Maximum Allowable Cost) lists, claw backs and enforcement.  

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

NACDS submitted comments to the Board of Pharmacy in support of proposed rule changes that would make permanent the temporary allowances for remote processing. These were granted by Gov. Kim Reynolds (R) and the Board of Pharmacy in response to the COVID-19 public health emergency. If adopted, the proposed rule would permit pharmacists to provide remote counseling services and allow certified pharmacy technicians to perform delegated functions at a location that is not a licensed pharmacy. 

Also in Iowa, the Board of The Board of Pharmacy has posted its meeting minutes from the March 1, 2022, meeting. 

Finally in Iowa, the Department of Human Services issued INFORMATIONAL LETTER NO. 2337-MC-FFS announcing the following June 2022 Iowa Medicaid Pharmacy Program Changes effective June 1, 2022. 

1. Changes to the Preferred Drug List (PDL) Effective June 1, 2022 
2. New Drug PA [Prior Authorization] Criteria – Triheptanoin (Dojolvi) 
3. Changes to Existing PA [Prior Authorization] Criteria 
   1. Apremilast (Otezla) 
   2. Biologics for Arthritis 
   3. Janus Kinase Inhibitors 
   4. Selective Preventive Migraine Treatments (formerly CGRP Inhibitors) 

1. Point of Sale Billing Updates – ProDUR Quantity Limits
2. Drug Utilization Review (DUR) Update 
3. Pharmacy Average Acquisition Cost (AAC) 
   1. AAC Rate Setting Process 
   2. Rate Review Requests  

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

The Board of Pharmacy published the following Notices of Intended Action. Written comments may be submitted until 4:30 p.m. on April 26. A public hearing will be held at 10:00 a.m. on April 27 at the offices of the Board and via Zoom.

• ARC 6279C– amending Chapter 3, “Pharmacy Technicians” and Chapter 6, “General Pharmacy Practice to permit remote processing
• ARC 6280C – amending Chapter 12, “Precursor Substances” to add one chemical as a precursor substance in response to similar action taken by the DEA.
• ARC 6182C – amending Chapter 8, “Universal Practice Standards,” and Chapter 19, “Nonresident Pharmacy Practice” to provide modification of the handling of ownership changes, add requirements for nonresident pharmacies and other changes.

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

The Board of Pharmacy published the following final rules effective April 27: 

• ARC 6255C – places one substance into schedule I of the Controlled Substances Act in response to action taken by the federal DEA (Drug Enforcement Administration). 
• ARC 6256C – amends Chapter 13, "Telepharmacy Practice". 

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

The Board of Pharmacy issued its March 2022 newsletter that includes the following articles: 

• "Non-electronic Prescriptions – Reminder of Requirements" 
• "FDA Warning on Dissolvable Buprenorphine and Dental Problems" 
• "Get to Know Your Pharmacy Board Members – Gayle Mayer" 
• "Shipping Compounded Prescriptions Outside the State of Iowa? – Reports Due by April 1, 2022" 
• "Statewide Protocols" 
• "Technician Trainee Renewal/Reactivation Update" 
• "Interim Pharmacist-in-Charge – New Option for Pharmacies" 
• "Pharmacists Required to Report Serious Adverse Events to FAERS Following Medication Administration" 
• "Board Requests Code Change in 2022 Legislative Session" 

Also in Iowa, the Board of Pharmacy posted is January 11, 2022 Meeting Minutes. Interesting stats related to the Pharmacist Narcan® Dispensing Program, Pharmacist Disposal Kit Dispensing Program and Board -Sponsored Medication Disposal are reported on Page 6. "Rules and Legislation" section appears on pages 7-8. 

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

The Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2322-MC-FFS announcing three Program Integrity (PI)/Payment Error Rate Measurement (PERM) quarterly training sessions for Medicaid Providers. Sessions will be held via Zoom and details are available in the letter. Providers only need to attend one training session. For those unable to attend, session recordings will be posted to the department's website.  

 Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2320-FFS announcing the 2022 Refund Address. 

Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2316-MC-FFS announcing new Vaccine for Children (VFC) Program Codes. 

Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2324-MC-FFS-CVS stating that several monoclonal antibodies are no longer authorized for use and may not be administered for treatment or post-exposure prevention of COVID-19 under the EUA until further notice by the FDA. 

Finally in Iowa, Gov. Kim Reynolds (R) announced numerous appointments to the state's boards and commissions including the following appointments to the Board of Pharmacy: Dane Nealson, Story; Kathy Stone, Harrison; Bob Egeland, Polk and Joan Skogstrom, Polk.

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

The Department of Human Services published the following: 

• INFORMATIONAL LETTER NO. 2314-MC-FFS-CVD: This informational letter provides guidance to providers on billing for COVID-19 OTC home testing. This policy will remain in effect for the duration of the public health emergency. 
• INFORMATIONAL LETTER NO. 2315-MC-FFS-CVD: On February 3, Gov. Kim Reynolds (R) signed the final extension to the state's Public Health Disaster Emergency Proclamation that announced the Public Health Disaster Emergency would expire on February 15 at 11:59 p.m. Please note: The end of the state's Public Health Disaster Emergency does not impact Medicaid flexibilities currently in place.  

Also in Iowa, the Board of Pharmacy will meet on March 1 via Zoom and in-person; the meeting agenda has been posted. 

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