The Department of Health and Human Services announced that effective December 22, 2023, Blue Cross Blue Shield of Michigan (BCBSM) is no longer a clearinghouse for Medicaid. Beginning February 2024, BCBS will no longer receive the 835/Electronic Remittance Advice (ERA). Providers who currently have BCBS associated and authorized as a billing agent in their CHAMPS provider enrollment information will need to update or modify their enrollment. To continue to receive the 835, providers will need to update their authorized billing agent in CHAMPS. For questions or assistance please

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

The Department of Health and Human Services announced that due to scheduled maintenance, the File Transfer Service (FTS) portal will be unavailable on January 14 from 10:00 am to 2:00 pm EST. They asked providers to refrain from submitting electronic files during this outage period. Billing agents or providers with additional questions can email AutomatedBilling@Michigan.gov for further assistance.

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

Gov. Gretchen Whitmer (D) signed HB 4276. The bill requires PBMs to reimburse pharmacies with no more than seven retail outlets at NADAC plus a professional dispensing fee comparable to the state Medicaid Dispensing Fee. It also prohibits the Department of Health and Human Services (department) from entering into a contract with a Medicaid managed care organization if its pharmacy benefit manager (PBM) does not do the following: reimburse for a legally valid claim at a rate not less than the rate in effect at the time the original claim adjudication was submitted at the point of sale; agree to move to a transparent pass-through pricing model, in which the PBM discloses the administrative fee as a percentage of the professional dispensing costs to the department; agree to not create new pharmacy administration fees and to not increase current fees more than the rate of inflation; and, agree to not terminate an existing contract with a pharmacy with no more than seven retail outlets for the sole reason of the additional professional dispensing fee authorized.

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

Medicaid issued a bulletin announcing prescription copay change for Healthy Michigan Plan enrollees.

Also in Michigan, The Department of Licensing and Regulatory Affairs (LARA) issued an email communication to pharmacies regarding the new Pharmacy Technician Administrative Rules that were effective on Oct. 2, 2023. They noted they are diligently working on updating relative information on their website to reflect the revision. Please send questions about the revised rules to BPLHELP@michigan.gov.

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

Medicaid issued proposed policy 2341 Documenting Beneficiary Consent Authorizing Automatic Refills of Prescribed Pharmacy Products for public comment. 

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

The Department of Health and Human Services issued a notice of proposed policy regarding Documenting Beneficiary Consent Authorizing Automatic Refills of Prescribed Pharmacy Products. Comments are due to MDHHS (Michigan, the Department of Health, and Human Services) (Michigan Department of Health and Human Services) on November 7, 2023.

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

The Board of Pharmacy has posted the public notice and agenda for the October 30 Rules Committee Work Group meeting and the minutes from the September 11 Rules Committee Work Group meeting.

Also in Michigan, MDHHS (Michigan Department of Health and Human Services) has proposed a rule regarding documenting patient consent for automatic refills that aligns with 2014 CMS guidance. Comments are due November 7 to the email noted on the policy’s transmittal sheet.

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

This week, Gov. Gretchen Whitmer (D) signed SB 219 effective July 19. The bill codifies PREP (Public Readiness and Emergency Preparedness) Act authority, allowing pharmacies to provide all ACIP (Advisory Committee on Immunization Practices) vaccines to patients aged 3 years and older. It also authorizes pharmacists to order and administer CLIA-waived tests for COVID, Flu and RSV and provide drugs that treat those conditions under CDC protocols. Many thanks to members, the Michigan Retailers Association, and the Michigan Pharmacists Association for their work with the Legislature on this critical patient access to care law. 

Also in Michigan, the Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA) sent a communication reminding pharmacy that the new Central Fill and Shared Pharmacy Services rules were effective as of May 19, 2023. The email asks that Licensee review the rules and statute for a complete understanding of all applicable requirements. Questions about the revised rules may be sent to BPLHELP@michigan.gov. 

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

The House Health Policy Committee reported a substitute version of SB 219 (H-2). The bill allows pharmacists to order and administer immunizations to patients aged three years and older; order and administer tests for COVID, flu or respiratory illness and furnish medications to treat COVID and flu. The bill is scheduled for a vote by the full House and must be returned to the Senate for concurrence.

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