In advance of the April 12^th Senate Insurance and Banking hearing on HCR HB 1677, NACDS submitted a letter supporting certain provisions of the legislation that would strengthen Missouri’s PBMs laws to enhance patients’ ability to receive pharmacy care from their pharmacy of choice and improve provisions for fair and equitable standards for the management of pharmacy benefits. In our letter, NACDS specifically called out support for the provisions that would prohibit PBMs from preventing, penalizing or restricting patients’ ability to obtain services from a contracted pharmacy; the provisions that would enhance the appeals process to requiring PBMs to increase a pharmacy’s reimbursement in instances when reimbursement is found to be below a pharmacy’s cost for purchasing a drug; and the provisions that would prevent PBMs from imposing unwarranted fees on claims related to administering a health plan.

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

The MO HealthNet Division recently issued a new COVID vaccine provider bulletin.  

Also in Missouri, the Department of Commerce’s Department of Health, and Senior Services (DHSS) and Insurance issued a new Standing Order for COVID tests provided by pharmacies. DHSS’s previously issued Standing Orders are available here. 

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

MO HealthNet (Medicaid) issued an Opioid Policy update strengthening clinical policies and expanding coverage of non-opioid medications and services to treat chronic pain. MO HealthNet believes in a comprehensive approach to treating and managing pain while also reducing the risk of patient harm, continuing to encourage providers to evaluate non-opioid options to treat patient pain. 

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

The Department of Health and Senior Services (DHSS) issued a standing order on March 15th signed by the state Epidemiologist, Dr. George Turabelidze, enabling individuals to receive coverage for purchased tests for SARS-CoV-2. This policy authorizes Missouri pharmacies to charge an individual’s insurance carrier, whether it is private insurance, Medicaid, or Medicare coverage, for COVID-19 testing. Additional state testing resources are available at health.mo.gov/communitytest.  

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

Legislation that would expand pharmacists’ scope of practice bill, HB 2452 by Rep. Bennie Cook (R) was referred to the House Emerging Issues Committee. Hearing date has not been set. 

Also in Missouri, HB 2452 & SB (Senate Bill) 1126, legislation has been filed in both the House and Senate that proposes to modify  the definition of a medication therapeutic plan by repealing language defining it by the prescription order must be specific to each patient, The bills also would re-define the practice of pharmacy to include the ordering and administering of U.S. FDA-approved or authorized vaccines to persons at least 7 years of age or the CDC-approved age, whichever is older, pursuant to rules promulgated by the Board of Pharmacy and the Board of Registration for the Healing Arts or rules promulgated under a state of emergency.  

Finally in Missouri, effective February 4, 2022, an emergency rule reinstated pharmacy’s ability to use out-of-state vendors to help fill orders for drugs. 

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

The Department of Social Services MO HealthNet clarified coverage for At-home COVID-19 test kits. Per the PREP Act Declaration 3rd Amendment, pharmacists can prescribe at-home COVID-19 tests that were prescribed by an enrolled MO HealthNet provider for MO HealthNet to reimburse for the at-home COVID-19 test. Pharmacists must be enrolled as a MO HealthNet provider to receive reimbursement.

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

The Board of Pharmacy filed a revised emergency rule effective February 4, 2021, that will allow Missouri licensed interns and technicians located in other states to perform remote data entry.  

Also in Missouri, due to system limitation, MO HealthNet will reimburse pharmacy providers $0.01 for the full course of the therapeutic and the full dispensing fee. Pharmacy providers must submit a cost to MO HealthNet in excess of the Professional Dispensing Fee (PDF) to receive full reimbursement of the PDF. MO HealthNet will also cover home tests currently payable at $12 per test plus the PDF. 

Finally in Missouri, MO HealthNet in partnership with Missouri Board of Pharmacy’s Rx Cares for Missouri Program and the Missouri Department of Health & Senior Services (DHSS), kicked off the “Safe At Home” Patient Safety Opioid Initiative. It allows MO HealthNet to reimburse pharmacy providers who dispense at-home medication disposal packets to eligible MO HealthNet participants who are at risk of experiencing an opiate-related overdose. MO HealthNet has selected DisposeRx® packets as the preferred medication disposal packet. These convenient at-home medication disposal packets will allow MO HealthNet participants to dispose of unused opioids safely and easily, preventing accidental overdoses.  

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

Gov. Parson’s (R) ended the COVID-19 State of Emergency on December 31, 2021, ending all remaining COVID-19 related waivers authorized under EO 21-09. The Board of Pharmacy issued guidance on the expiration of the Emergency Declaration.  

Also in Missouri, the Department of Social Services MO Health Net (Medicaid) clarified reimbursement for COVID-19 antiviral treatment. Pharmacy providers filling prescriptions for Paxlovid or molnupiravir will be reimbursed the current professional dispensing fee at the time the prescription is dispensed. For pharmacies to receive the full dispensing fee, the Usual & Customary charge submitted to MO HealthNet must be more than the current professional dispensing fee. Non-pharmacy providers such as clinics, hospitals, and ERs do not receive a professional dispensing fee. 

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

The Board of Pharmacy is seeking comments by January 14, 2022, on proposed rules removing geographic restrictions on remote data entry sites and allowing pharmacy technicians and intern pharmacists to perform remote data entry from a site located in another U.S. state or territory. 

 Also in Missouri, the National Association of Insurance Commissioners (NAIC) selected the Missouri Department of Commerce and Insurance Director Chlora Lindley-Myers as President-Elect for 2022. 

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