Effective June 1, 2024, the Department for Medicaid Services made changes to the vaccine coverage for Medicaid Fee-for-Service members.  

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

Gov. Andy Beshear (D) signed HB 274, sponsored by pharmacist Rep. Danny Bentley (R). The bill authorizes pharmacists to order and administer vaccines to patients aged 5 years and older under a prescriber-approved protocol. The law takes effect 90 days after the General Assembly adjourns sine die. This date will officially be set by the attorney general after April 15. 

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

MedImpact recently issued communications to pharmacies regarding the State of Emergency Override and opportunities to reverse claims affected by the migration of Medicaid fee–for–service claims.

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

MedImpact issued a communication to pharmacies regarding reprocessing managed care claims for Lagevrio. Prescriptions dispensed using the commercially distributed product for Managed Care members prior to February 8, 2024, may be reversed and reprocessed to include the ingredient cost in the final paid amount. They will automatically reprocess claims that pharmacies have not resubmitted within the next 60 days. This does not apply to fee-for-service claims.

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

A bill that would apply many of the PBM reforms adopted in Medicaid to commercial and state employees’ plans has been introduced. SB 188 is sponsored by Sen. Max Wise (R), a longtime advocate of PBM reform. A few of the provisions included in this comprehensive bill include: a NADAC and Medicaid Dispensing Fee rate floor, anti-steering and anti-mandatory mail order language, a broad definition of specialty pharmacy and a formula to determine network adequacy.

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

This week, the House unanimously passed HB 274, a bill that would allow pharmacies to administer ACIP (Advisory Committee on Immunization Practices) vaccines to children aged 5 years and older. The bill also removes the current vaccine prescription requirement for children. The Kentucky Medical Association stood down following negotiations that raised the age from 3 years to 5 years. The bill now goes to the Senate.

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

MedImpact will host the First Quarter 2024 pharmacy provider online seminar on January 31 from 11:00 am- 12:00 noon. The meeting topic is "provider updates and provider Q & As." You can use one of the following options to join the online seminar:   

• Webinar URL 
• Entering Meeting ID In Microsoft Teams Meeting ID: 218 939 299 642 

Attendee Passcode: omNFva 

• Call In (audio only) 1-858-252-2734; passcode138312994# v

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

The Medicaid Advisory Committee approved several motions suggested by the Pharmacy Technical Advisory Committee (PTAC), that NACDS serves on, to improve access to pharmacy vaccines in the Medicaid program: 

• A written communication will be delivered to pharmacies clarifying that, per the rule passed last year, enrollment in VFC (Vaccines for Children) program is not required and claims will be reimbursed. 
• They will work with PTAC to change policy to allow pharmacies to bill for vaccines in Medicaid FFS (Fee-for-Service).  
• They will work with PTAC on a statewide protocol for pharmacists to administer HPV (HUMAN PAPILLOMA VIRUS) vaccines to increase adolescent vaccination rates. 

Members are encouraged to share their thoughts and suggestions on these proposed policy changes with NACDS' Jill McCormack.  

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

NACDS reminds members that as of October 16, the MedImpact vaccine administration fee was raised to $27.49 for the first dose in a vaccine series and $9.80 for each subsequent dose in a series. Currently, pharmacies are permitted to administer all vaccines to patients 9 years of age and older (including adults) by protocol. Also notable, DMS (Department for Medicaid Services) no longer requires pharmacies to enroll in VFC (Vaccines for Children) to be reimbursed for children's vaccines if the patient meets the age requirements in statute.  

Also in Kentucky, Medicaid issued Provider Notice #315 regarding September P&T PDL (Preferred Drug List) changes. 

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