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Michigan

The Department of Health and Human Services issued two bulletins announcing the upcoming termination of coverage for certain pharmacy services due to the upcoming expiration of the federal PREP Act.

  • 2419-Lab – Termination of COVID-19 Home Test Kit Coverage and Special Reimbursement for COVID-19 Specimen Collection and Clinic Vaccine Administration. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.
  • 2424-Pharmacy – End of the Federal Public Health Emergency (PHE) and Final Unwinding of Pharmacy COVID-19 Response Policies. Comments may be forwarded to the e-mail noted on the policy’s transmittal sheet.

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

2024-07-18T13:10:29-04:00July 18, 2024|Michigan|

Michigan

The Department of Health and Human Services (DHHS) released the presentation from the June Medicaid Pharmacy Liaison Meeting. The slides include information on performing MTM (Medication Therapy Management) for HIV (Human Immunodeficiency Virus) treatment and COVID extensions that will end on September 30, 2024.

Also in Michigan, the Board of Pharmacy has posted the minutes from the June 4 regulation workgroup meeting.

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

2024-06-13T14:42:20-04:00June 13, 2024|Michigan|

Michigan

Pharmacy Controlled Substance Administrative Rules have been revised and changes are effective as of May 31, 2024. One amendment of note is the removal of Gabapentin, meaning it is no longer classified as a controlled substance in the state. A prescriber without a controlled substance license can now prescribe Gabapentin, and Gabapentin no longer needs to be included in reporting to the Michigan Automated Prescription System (MAPS).

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

2024-06-06T16:02:13-04:00June 6, 2024|Michigan|

Michigan

Legislation introduced last week as HB 5435 and HB 5436 would allow pharmacists to prescribe and dispense self-administered hormonal birth control to patients. The companion bill would require insurers to reimburse pharmacies for the prescription and consultation or other ancillary services including testing. It also requires that the insurer allow the pharmacy to bill the items and services under a service code at adjudication of the prescription claim.

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

2024-02-23T10:31:40-05:00February 23, 2024|Michigan|

Michigan

The Department of Insurance and Financial Services (DIFS) updated instructions for pharmacies to file PBM complaints on its PBM website. As a reminder, the Pharmacy Benefit Manager (PBM) Licensure and Regulation Act, PA 11 of 2022, took effect on January 1, 2024. This law introduces new licensing obligations and regulatory standards for PBMs operating in the state.  

Also in Michigan: The Department of Health and Human Services (MDHHS) is soliciting comments from the public on the Michigan Medicaid Health Plan Common Formulary, which applies to pharmacy claims paid by Medicaid managed care organizations. The public may submit comments on the drugs included or not included on the Common Formulary, new drug products, prior authorization criteria, step therapy criteria and other topics related to drug coverage under the Common Formulary. Comments should be sent to formulary analyst Linda Van Camp by March 15. 

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

2024-02-09T09:51:16-05:00February 9, 2024|Michigan|

Michigan

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.

2024-02-02T10:18:51-05:00February 2, 2024|Michigan|

Michigan

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.

2024-01-12T11:52:43-05:00January 12, 2024|Michigan|
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