Gov. Andy Beshear (D) signed SJR 26, a significant step toward payment parity for pharmacists’ clinical services in Medicaid and CHIP. The Resolution directs Medicaid to provide a detailed report regarding pharmacist payment parity for review by the General Assembly during the upcoming legislative interim. The detailed report will include information on the technology necessary to adjudicate these claims with a pharmacy. It will also highlight the value that access to pharmacy clinical services can contribute to patient outcomes and overall healthcare savings.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Gov. Andy Beshear (D) declared a state of emergency due to the severe storms that swept through the Commonwealth on February 14. In response, Medicaid has activated NCPDP procedures for pharmacies to override certain denials for members impacted by the storms. Gov. Beshear also activated the state’s emergency operations center and implemented the state’s price gouging laws to protect Kentuckians from overpriced goods and services as they recover from the storm.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

MedImpact, the Medicaid Single PBM, held its 1^st quarter pharmacy providers meeting this week. You can review the slide deck, as well as those from previous meetings on the provider portal page.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

MedImpact, the state Single PBM, issued a communication clarifying that the prohibition on automatic refills does not include 90-day fills.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

MedImpact announced that they identified Managed Care and Fee-for-Service claims adjudicated between August 23 and September 11, 2024, that were inadvertently paid at an inactive National Average Drug Acquisition Cost (NADAC) rate. Most of the rates utilized were lower than the active rate, but not all. The identified claims will be adjusted within 30 days to recalculate pricing to the NADAC pricing rates effective August 21, 2024, where appropriate. They will appear on your Remittance Advice (RA) or 835 to reflect the underpayment or overpayment. Impacted claims will not be recouped in totality; instead, they will only address the difference between the inactive and active NADAC rate.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

MedImpact issued an updated bulletin to pharmacies clarifying the coverage limits on naloxone 4 mg nasal spray. This applies to both brand and generic covered NDCs.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department for Medicaid Services (DMS) and MedImpact issued a bulletin to pharmacies promoting the administration of Human Papillomavirus (HPV) vaccines at pharmacies. Through December 1, 2024, pharmacies will receive a point-of-sale message when billing claims for Medicaid patients that DMS identified as HPV vaccine naive. Pharmacies may bill Medicaid for the product, the administration fee and counseling. NACDS serves on Medicaid’s Pharmacy Technical Advisory Committee (PTAC) that worked with DMS and the health plans to develop and advance the program. Fee-for-service and MedImpact contact information as well as the protocol have been provided to pharmacies.

Also in Kentucky, Medicaid and MedImpact issued bulletins related to MAC appeals and a reminder to pharmacies of their auto refill prohibition policy.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

MedImpact issued a communication to pharmacies this week as a reminder about each managed care organizations (MCO) lock-in policy, including a list of each MCO’s criteria.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The latest Board of Pharmacy newsletter announced revisions to four statewide protocols effective July 24, 2024. The updated protocols include Acute Influenza Infection Chemoprophylaxis treatment, and three related to self-care, including diabetes testing and injections, over-the-counter (OTC) dietary supplements and OTC probiotics.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.