The Board of Pharmacy amended rule 20 CSR 2220-4.010 governing new Board fees, that took effective on October 30.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

MO HealthNet completed the annual review of all drug coverage criteria for the Prior Authorization Process.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Consolidated Health Care Plan (MCHCP) issued an Emergency Rule clarifying member eligibility and responsibility for charges, effective January 1, 2025.  

Also in Missouri, the Department of Commerce and Insurance Board of Pharmacy posted a list of fee increases that went into effect on October 30, 2024. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Due to numerous questions on the drug shortages caused by the recent hurricanes, the Board of Pharmacy issued guidance to assist licensees.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Looking for ways to reduce healthcare costs for Missourians, six Senators have been named to the newly formed Senate Interim Committee on Driving Down the Cost of Healthcare. The committee will issue a report and recommendations by the end of the year

Also in Missouri, effective October 1, the MO HealthNet Pharmacy program discontinued coverage for at-home COVID-19 tests dispensed as a kit for at-home use. COVID-19 testing will continue to be covered for MO HealthNet participants when administered by a MO HealthNet enrolled provider.

Finally in Missouri, St. Louis Public Radio Morning Edition published online a PBM reform story about St. Louis-based Express Scripts being sued by the Federal Trade Commission (FTC). Pharmacists and patient advocates are advocating for lower drug prices.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Effective September 6, 2024, brand name Adderall XR^® will no longer be preferred on the MO HealthNet Preferred Drug List (PDL). Dextroamphetamine/Amphetamine ER capsules (generic Adderall XR^®) is currently a preferred agent on the PDL and will continue to remain a preferred agent. Please reference the List of Preferred & Non-Preferred Products, as well as the ADHD, Amphetamines Long Acting PDL edit for more information. Maximum Allowable Cost (MAC) rates will apply to brand and generic products. Providers who dispense the brand product without a prior authorization (based on medical necessity) will receive MAC reimbursement.

Also in Missouri, on August 29, the Medicaid Audit & Compliance (MMAC) launched the new secure Provider Communications Portal, which is an efficient method for providers and MMAC to communicate and exchange information and records.

Finally in Missouri, effective August 29, MO HealthNet expanded coverage of Continuous Glucose Monitors (CGMs) to participants currently diagnosed with Gestational Diabetes allowing this vulnerable population to obtain a CGM without prior authorization. Claims for a CGM will auto-approve if the participant has had a gestational diabetes diagnosis billed to MO HealthNet recently or if the pharmacy submits the appropriate gestational diabetes diagnosis code with the claim. Any MO HealthNet participant who currently utilizes insulin can also obtain a CGM without prior authorization.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Effective August 1, 2024, MO HealthNet (Medicaid) no longer covers DisposeRx packets.

Also in Missouri, if a pharmacy does not have a drug take-back receptacle, the Board of Pharmacy provides one for free through its Rx Cares for Missouri Medication Destruction and Disposal Program.

Finally in Missouri, the Board of Pharmacy adopted rules expanding pharmacy technician duties published in the August 1, 2024 Missouri Register (20 CSR 2220-2.715).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The MO HealthNet (MDH) Pharmacy Program (Medicaid) created several new resources:  

1. A 15-minute training course on Proper Drug Billing, covering National Drug Codes, how to determine and calculate what quantity to bill, who should bill for white and brown bagged medications and more.
2. Medicaid Eligibility Codes – Includes descriptions of Medicaid Eligibility (ME) Codes and limited and comprehensive benefits.
3. Contact Us – Provides provider contacts for MHD and more to assist with your questions
   These resources, as well as many others, can be found on our MHD Education & Training page. 
4. Provider Training Calendar – to register for a program specific training updated quarterly. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Due to the increase in the Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Medicaid-reimbursed prescriptions was increased effective July 1, 2024. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.42. Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85. Long-term care pharmacy providers supplying covered drugs to participants in long-term care facilities will continue to receive an additional $0.50 dispensing fee.

Also in Missouri, Gov. Mike Parson (R) allowed legislation NACDS supported, SB 751 relating to the distribution of 340B drugs, to become law without his signature, effective August 28, 2024.

Finally in Missouri, registration is open for the Board of Pharmacy’s “Lunch with the Chief Inspector” webinar on the 2024 legislative session and other Board of Pharmacy activities.

For more information, contact NACDS’ Mary Staples at 817-442-1155.