MedImpact gave this presentation that has details on the July 1, 2021 transition to a Single PBM in Medicaid as a result of the passage of SB 50 of 2020. It also includes a timeline and contact information for the MCOs.
Also in Kentucky, the Department of Medicaid Services is in search of a Pharmacy Director as Dr. Jessin Joseph has departed. Click here for more information or to apply.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 48, a bill that requires commercial insurances and the state employee health plan to pay pharmacists for both prescription drug claims and patient procedures or services within their scope of practice at a rate not less than that paid to other non-physician practitioners, was signed by Gov. Andy Beshear (D) last week and will be effective 90 days after sine die, which was March 30.
Also in Kentucky, NACDS has been informed that in a meeting this week DMS verbally shared that they have finalized the single PBM pharmacy reimbursement model as NADAC (including current FFS “lesser of” computation) + PDF of $10.64 — the current fee-for-service model. Notably, although SB 50 of the last session allowed Medicaid to implement tiering, the final proposal will reimburse all pharmacies equally. Commissioner Lisa Lee reported that MedImpact and the Managed Care Organizations are expected to and will be required to meet the July 1, 2021 implementation date. NACDS thanks the Kentucky Retail Federation and the Kentucky Pharmacists Association for their work on this issue during and after the passage of SB 50 of the last session. NACDS served on the Medicaid PTAC Committee which recommended this methodology to Medicaid.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 48, legislation that would mandate commercial insurance payments for clinical services to pharmacists has passed both Chambers unanimously and is headed to the Governor for signature. The bill was introduced by Rep. Danny Bentley (R), and mandates payment for services within a pharmacists’ scope of practice and would otherwise be paid if performed by a physician, advanced practice nurse, or physician assistant. NACDS advocated in favor of the passage of the bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy will hold a Public Hearing on February 23, 2021, on a proposed rule that would expand the board-authorized conditions allowing prescriber-approved protocols for dispensing of medications or other services to include alcohol use disorder; colorectal cancer prevention and screening; HCV infection screening; HIV infection prophylaxis, pre-and post-exposure; and HIV infection screening. Please send your comments by February 16, 2021, to jmccormack@nacds.org for inclusion in NACDS’ letter of support.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy published an emergency rule to allow pharmacists, pharmacy technicians, and pharmacist interns to order and to administer vaccinations to children between the ages of three and 17 in response to the COVID-19 pandemic and to comply with federal standards under the PREP Act. A hearing is scheduled for February 23, 2021, via teleconference and written comments are due February 28, 2021. The rule became effective November 23 and expires August 20, 2021.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department for Medicaid Services (DMS) is transitioning to a Single Preferred Drug List (PDL) for Kentucky Medicaid Fee-For-Service (FFS) and Managed Care and have published a provider notice detailing the changes. Beginning on January 1, 2021, all Managed Care Organizations (MCO) will follow the FFS (aka Single) PDL maintained by Magellan Rx Management. The Single PDL will be available for viewing on the Kentucky Medicaid Magellan Rx Portal.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy has filed an emergency regulation allowing pharmacists, interns, and technicians to order and administer vaccinations for individuals age 3 and up. Pharmacists who choose to take advantage of this regulation must receive 20 hours of ACPE training, otherwise, the state requirement of operating under a protocol must be met.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Representative Bentley, Pharm.D. (R) has pre-filed BR 328, which would require commercial insurance plans to reimburse pharmacists for claims submitted for services within their scope of practice, as well as require the insurer to credential pharmacists for these services.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Effective January 1, 2021, the Kentucky Cabinet for Health and Family Services (CHFS) will utilize Version 4.2B of the American Society for Automation in Pharmacy (ASAP) Prescription Drug Monitoring Program Standard for reporting controlled substance data to KASPER. Members may want to take the following actions to prepare:
Additionally, effective January 1, 2021, when the PAT02 value is 07 for Social Security Number, the vast majority of records, the PAT03 value must be nine numeric digits or the record will be rejected with a fatal error and will need to be corrected.
Lastly, to support EPCS, KASPER will track the DSP20 – Electronic Prescription Reference Number, and DSP21 – Electronic Prescription Order Number fields. Reporting these fields is optional, but KASPER is requesting that pharmacies report this if capable. For further detail, please contact KASPER administration at (502) 564-2815 or eKASPER.admin@ky.gov.
Also in KY. NACDS reminds members that Kentucky Revised Statute 218A.182 mandates the electronic prescribing of controlled substances (EPCS) effective January 1, 2021. The Kentucky mandate is similar to the federal Medicare Part D EPCS mandate effective January 1, 2021, but applies to all controlled substances prescribed in Kentucky. Click here for more information, including criteria and process for an exemption.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.