On June 17, the Department of Public Health and Human Services will hold a public hearing via remote conferencing to consider proposed amendments to Medicaid and non-Medicaid provider rates, fee schedules and effective dates. For pharmacy providers, the following are proposed changes to outpatient drugs reimbursement for both dispensing fees and vaccine administration fees. 

(f) The outpatient drugs reimbursement dispensing fees range as provided in ARM 37.86.1105(3)(b) is effective July 1, 2023 July 1, 2024:  

(i) for pharmacies with prescription volume between 0 and 39,999, the minimum is $5.11 $5.28, and the maximum is $16.36 $17.01;  

(ii) for pharmacies with prescription volume between 40,000 and 69,999, the minimum is $5.11 $5.28, and the maximum is $14.16 $14.73; or  

(iii) for pharmacies with prescription volume greater than or equal to 70,000, the minimum is $5.11 $5.28, and the maximum is $11.98  $12.46.  

(g) remains the same.  

(h) The outpatient drugs reimbursement vaccine administration fee, as provided in ARM 37.86.1105(6), will be $21.32 for the first vaccine and $18.65 $15.53 for each additional vaccine administered on the same date of service, effective July 1, 2023 July 1, 2024. 

Concerned persons may submit their data, views or arguments either orally or in writing at the hearing. Written data, views or arguments may also be submitted to: Bailey Yuhas, Department of Public Health and Human Services, Office of Legal Affairs, P.O. Box 4210, Helena, Montana, 59604-4210; fax (406) 444-9744; or e-mail hhsadminrules@mt.gov, and must be received no later than 5:00 pm on June 21. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Labor and Industry is looking for a pharmacist to serve in a new third inspector position for the Board of Pharmacy. This position is responsible for performing pharmacy inspections around the state, issuing inspection reports, verifying licensure of pharmacy personnel and facilities, verifying compliance with state and federal statutes and regulations, and communicating with a variety of licensees and stakeholders. The application closing date is May 30. The job posting and instructions for applying are available online. If you have any questions, please contact Marcie Bough, Executive Officer, at (406) 841-2371.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

On December 22, 2023, the Board of Pharmacy published a final rule (MAR 24-124-80) and adopted New Rule I (ARM 24.174.505, Pharmacist Prescribing: General Requirements) implementing SB (Senate Bill) 112 (Statute: 37-7-106, MCA, Pharmacist Prescribing Authority – exceptions), that allows for independent prescribing authority for pharmacists in limited situations. The new rule was adopted as proposed and became effective December 23, 2023. Additional information will be available soon on the Board’s webpage. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Board of Pharmacy and the Board of Veterinary Medicine posted the Joint Full Board Meeting Agenda for December 7. The meeting will be held by teleconference only; see agenda for details. Information is available on the Board meetings page.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

On November 28 at 1:00 pm, a public hearing will be held via remote conferencing to consider proposed adoption of New Rule I pertaining to pharmacist prescribing [MAR Notice No. 24-174-80]. The 2023 legislature passed SB 112, allowing for independent prescribing authority for pharmacists in limited situations; it is necessary to set standards for patient care, evaluation, recordkeeping, and provider notification required of pharmacists prescribing under SB 112’s authority. In addition to oral testimony at the hearing, written comments may be submitted at dli.mt.gov/rules or P.O. Box 1728; Helena, MT 59624-1728; comments must be received no later than 5:00 pm on December 1.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Public Health and Human Services (DPHHS) has received calls regarding denials and prior authorization requirements on stimulants due to the shortages. Many of these can be handled by the pharmacy by calling the prior authorization (PA) call center at 1-800-395-7961. Please try the PA call center before involving the provider or turning the patient away. The DPHHS is approving short term prior authorization to mitigate some of the issues caused by these shortages. If you have questions, please contact Dani Feist, Pharmacy and Home Infusion Program Officer at 406–444–2738.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Based on the annual survey conducted by the Department of Public Health, this year’s survey results provide data to support a proposed minimum dispensing fee of $5.11. Also, the maximum dispensing fee, for each volume range, is proposed to increase to incorporate the legislatively approved provider rate increase. 

The Department of Public Health and Human Services issued a Notice of Public Hearing on Proposed Amendment to ARM 37.85.105, updating effective dates of Medicaid fee schedules effective July 1, 2023. The public hearing via remote conferencing will be held on July 27 at 9:00 a.m. Below are the proposed changes to pharmacy reimbursement. 

(f)The outpatient drugs reimbursement dispensing fees range, as provided in ARM 37.86.1105(3)(b) is effective July 1, 2022 July 1, 2023: 

(i) for pharmacies with prescription volume between 0 and 39,999, the minimum is $4.32 $5.11 and the maximum is $15.73 $16.36;  

(ii) for pharmacies with prescription volume between 40,000 and 69,999, the minimum is $4.32 $5.11 and the maximum is $13.62 $14.16; or  

(iii) for pharmacies with prescription volume greater than or equal to 70,000, the minimum is $4.32 $5.11 and the maximum is $11.52 $11.98.  

(g) remains the same.  

(h) The outpatient drugs reimbursement vaccine administration fee, as provided in ARM 37.86.1105(6), will be $21.32 for the first vaccine and $15.65 $18.65 for each additional administered vaccine, effective July 1, 2022 July 1, 2023. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

On May 1, Gov. Greg Gianforte (R) signed SB 112 (Chapter Number: 322), legislation allowing pharmacists to prescribe certain medications with limitations. In the coming months, the Board of Pharmacy will promulgate rules.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Gov. Greg Gianforte (R) signed the following bills: 

• HB 379 (Chapter Number: 259), extending the prohibition on PBMs to require federally certified health entities to identify 340B drugs from June 1, 2023, to June 1, 2025. 
• HB 710 (Chapter Number: 216), permitting a pharmacist to delegate the administration of immunizations to a pharmacy technician or licensed intern, who has completed requirements for education and training. Administration of immunizations by technicians and interns will be supervised by the pharmacist. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.