Effective April 1, the Division of Medicaid (DOM) updated its Voluntary 90-Day Drug Maintenance List for prescribing/pharmacy providers. This list is a resource to help clinicians manage a Medicaid beneficiary’s monthly prescription drug limit, unless clinically contraindicated.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

On October 1, the Division of Medicaid (DOM) began requiring an FDA-approved indication or compendia-supported indication for each stimulant prescription. It has come to DOM’s attention that the MississippiCAN pharmacy claims systems do not interface with the medical claims systems and may not be able to perform a search for diagnoses in the past 24 months of medical claims. The fee-for-service system is capable of performing this look-back function. To ensure that stimulant prescriptions process without delay or the need for prior authorization, DOM advises providers to write the diagnosis and ICD-10 code on each of their patient’s ADHD (attention deficit hyperactivity disorder) prescriptions. Pharmacy providers must then enter the ICD-10 code on prescription claims. A list of FDA-approved or compendia-supported indications covered by DOM, along with corresponding ICD-10 codes, can be found on DOM’s Pharmacy Resource webpage.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Effective Thursday, November 1, the Division of Medicaid (DOM) is implementinga mandatory billing policy whereby providers must identify 340B purchased drugs on claims. This billing policy is in response to CMS’ requirement that DOM define its policies and oversight activities related to 340B purchased drugs as outlined in CMS State Release No. 161, dated October 26, 2012. This represents a mandatory change to DOM billing policy only and will not impact 340B reimbursement.

Also in Mississippi…The Mississippi Headache Symposium will be held on October 17-18. All licensed healthcare providers interested in improving outcomes for headache sufferers are welcome to attend.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Division of Medicaid has placed new requirements on the MississippiCAN Coordinated Care Organizations that will take effect Monday, October 1. The purpose of these requirements is to enable pharmacy providers to identify and separate PBM lines of business in their front-end claims processing systems.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Effective July 1, the Division of Medicaid (DOM) allowed certain physician-administered drugs to be billed and reimbursed as either a medical claim or a pharmacy point-of-sale (POS) claim. Currently, many physician-administered drugs may only be billed as a medical claim. In order to implement this change, DOM has created a new category of drugs and drug-system devices, which may be billed as either medical or pharmacy POS claims. This new category is known as Clinician Administered Drugs and Implantable Drug System Devices (CADD). The list of drugs included in the CADD category is available online. To create the current list, DOM identified the drugs where reimbursing only by medical claims has caused the greatest access issues and targeted those for the CADD category. Additional drugs may be added to the category in the future.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Legislative amendments made during the 2018 Legislative Session provided a variety of new flexibilities to the Division of Medicaid, including the removal of the statutory cap on physician visits per year and prescription drugs per month. As the agency explores these possibilities, Medicaid-enrolled providers, beneficiaries and other stakeholders should be aware the current DOM policy remains in place and will not change Sunday, July 1.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy issued a statewide standing order allowing pharmacists to dispense by request naloxone without a prescription. Pharmacists are required to maintain proof of completion of a board-approved training program, to maintain a copy of the standing order, to fill and file the prescription as a legend drug and to provide proper counseling on the use of naloxone.

Also in Mississippi…The Division of Medicaid was instructed by CMS to change the way it reimburses for medical supplies, equipment and appliances and subsequently published a news notice. The agency is actively working with CMS and other stakeholders to address compliance with the rule while ensuring that non-physician providers continue to serve as a vital access point for patients enrolled in the Medicaid program.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.