The Michigan Department of Health and Human Services (MDHSS) has updated the Medicaid PDL (Preferred Drug List) effective 6/1/2022.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

At the Michigan Pharmacy Provider Liaison Quarterly Meeting. Discussion focused on clarifications of several policy documents. The next pharmacy liaison meeting will be held on June 9. 

Final Policies Issued 

HASA 22-02: COVID-19 Response: Coverage of FDA Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers 

Published L-Letters 

L 22-05: Clarification of Michigan Automated Prescription System (MAPS) 

Record Retention 

L 22-04: Additional Guidance and Clarification for the Coverage of COVID- 19 Prevention, Treatment, and Support Services. 

Proposed Policy: 

2156-Pharmacy: Signature Log and Proof of Delivery Requirements 

2202-Pharmacy: COVID-19 Response: Coverage of U.S. Food & Drug Administration (FDA) Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers 

2155-Pharmacy: Update to Contraceptive Supply Limit 

Web Announcements: 

Summary of Michigan Single PDL (Preferred Drug List) Changes – effective 2/01/2022 https://michigan.magellanrx.com/provider/external/medicaid/mi/doc/en­ us/MIRx PDL changes.pdf 

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

Governor Gretchen Whitmer (D) signed into law on February 23 three bills — HB 4348,  HB 4351, and HB 4352 aimed at lowering the costs of prescription drugs, ensure that pharmacists can provide advice to patients about treatment options, and provide oversight and transparency for pharmacy benefit managers. The laws will require that PBMs be licensed with the Department of Insurance and Financial Services. In addition, the legislation provides government oversight on pharmacy audits and appeals with help from state regulators. The law takes effect January 1, 2024 

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

This week both houses of the state legislature overwhelmingly approved HB 4348 which would help enhance patient access to pharmacy services and enhance transparency into the practices of pharmacy benefit managers (PBMs). The legislation will now go to Governor Gretchen Whitmer (D). The Governor has indicated that she does intend to sign the proposal into law.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

At the June quarterly Michigan Medicaid pharmacy provider liaison meeting, companies asked that Medicaid provide each of their corporate staff a list of claims for their respective stores tied to Medicaid errors that may have caused processing errors regarding cost share responsibility. They wanted their corporate staff to reprocess the claims for the stores and determine if there are any issues with the claims.  Michigan Medicaid staff is looking for the most appropriate contact for each company. Medicaid is looking for each company to email a list of their pharmacy NPIs to MDHHSPharmacyServices@michigan.gov.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

The Michigan Department of Health and Human Services has asked NACDS how pharmacies are billing insurances/payers for the COVID-19 home/point-of-care testing devices able to be purchased at pharmacy locations.  In specific the department wants to know if the billings are through the payer’s medical benefit for a medical claim. CMS recently released some guidance requiring State Medicaid and CHIP programs to cover these home COVID testing solutions.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

The Michigan Department of Health and Human Services has scheduled a Medicaid Pharmacy Provider Liaison meeting to allow Medicaid staff and Medicaid Pharmacy Providers to meet and discuss policy and operational issues. This quarter’s Pharmacy Liaison Meeting Notice contains the link and phone number to join, and will take place Thursday, September 9th from 2:30-4:30pm.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.