The following bills are scheduled for hearing in the Banking, Commerce and Insurance Committee on February 27: 

• LB 990: legislation banning PBMs from restricting an enrollee’s ability to choose how a retail community pharmacy may dispense or deliver prescription drugs and clarifies that “reasonable terms” between PBMs and specialty pharmacies cannot exceed reporting requirements and performance requirements that are required for a nationally recognized independent accrediting organization among its various provisions. 
• LB 1232: legislation banning PBMs from reimbursing pharmacists or pharmacies for a drug at a lower rate than the cost required to dispense the drug. 

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

The Drug Utilization Review (DUR) Board posted the DUR Board Meeting Minutes from November 14, 2023. The next DUR Board Meeting will be held virtually on May 7.

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

The Department of Health and Human Services uploaded the February 7 COVID-19 Provider Meeting Recording. The next call will be held on March 6 at 12:00 noon (Central). 

Join from the meeting link:
https://sonvideo.webex.com/sonvideo/j.php?MTID=mc307e2dda218d1060adfed7f454cfc16
Join by phone:
408-418-9388 (access code: 2480 661 3098 ) 

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

Effective January 1, 2024, Nebraska Total Care transitioned to Express Scripts as its PBM (Pharmacy Benefit Manager). Members have been provided with new member ID cards. If a pharmacist needs a member’s specific prescription processing information or other help with a claim, visit the Express Scripts Pharmacist Resource Center. If a pharmacist needs assistance processing a claim, call the Express Scripts Pharmacy Help Desk at 1-833-750-4471 

Also in Nebraska, the Department of Health and Human Services posted the Excel file of the fee schedule for Injectables January 1, 2024.  

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

The Department of Health and Human Services issued the following provider bulletins: 

• Provider Bulletin 23-32: Summary of Member Reimbursement Opportunities 
• Provider Bulletin 23-30A: Claims for Reinstated Medicaid Members (Updated December 11, 2023); this is an update to provider bulletin 23-30.  

Also in Nebraska, the Department of Health and Human Services posted the Excel file of the fee schedule for Injectables October 1, 2023 (Revised). 

Also in Nebraska, the Department of Health and Human Services received approval from CMS for State Plan Amendment 23-0015: Adult Vaccines related to coverage of vaccines and vaccine administration in accordance with current Advisory Committee on Immunization Practices (ACIP) recommendations. 

Finally in Nebraska, the Department of Health and Human Services posted the meeting recording from the December 6 COVID-19 Provider Call. The next meeting will be held on January 3, 2024, at noon (Central). To participate, use either the meeting link or phone number and access code below. 

Join from the meeting link:
https://sonvideo.webex.com/sonvideo/j.php?MTID=mc307e2dda218d1060adfed7f454cfc16
Join by phone:
408-418-9388 (access code: 2480 661 3098 ) 

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

The Department of Health and Human Services issued Provider Bulletin 23-31: Hepatitis C Virus (HCV) Antiviral Treatment to notify Medicaid providers of upcoming changes to HCV antiviral treatment requirements.

Also in Nebraska, the Department of Health and Human Services issued Provider Bulletin 32-30: Claims for Reinstated Medicaid Members to inform Medicaid providers of members whose coverage has been reinstated due to recent federal guidance. Additional information on Medicaid member reimbursement is also available online, including copays for prescription drugs paid to pharmacies.

Finally in Nebraska, the Department of Health and Human Services posted the draft minutes from the November 14 Drug Utilization Review Board meeting. The next meeting will be held on January 9, 2024.

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

The Board of Pharmacy distributed its November 6 meeting agenda and the September 18 draft meeting minutes.

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

The Department of Health and Human Services issued Provider Bulletin 23-26 announcing changes to the Coverage and Payment of Adult Vaccines effective October 1, 2023. 

Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Provider call will be held on November 1 at noon (Central); see details below to join the call. Also, the recording from October 4 COVID-19 Provider call has been posted. 

Join from the meeting link:
https://sonvideo.webex.com/sonvideo/j.php?MTID=mc307e2dda218d1060adfed7f454cfc16 

Join by phone:
408-418-9388 (access code: 2480 661 3098)   

Also in Nebraska, the Department of Health and Human Services posted the 471-000-540 Medicaid Practitioners Fee Schedule for Injectables (October 1, 2023). 

Also in Nebraska, the Department of Health and Human Services posted the draft minutes from the September 12 Drug Utilization Review (DUR) Board Meeting. The next DUR Board Meeting will be held on November 14. 

Also in Nebraska, the Department of Health and Human Services launched the iServe Nebraska Portal’s new integrated benefit application that will make it easier for Nebraskans to apply for Medicaid and Economic Assistance benefit programs. Nebraskans can apply for benefits such as food, heat, electricity, healthcare, childcare, and other essential needs at the same time using the single, online iServe Nebraska application. 

Also in Nebraska, Gov. Jim Pillen (R) approved emergency regulations related to the Let Them Grow Act. Please note the requirements for picking up prescribed medications from a pharmacy. For both puberty blocking drug prescriptions and cross-sex hormone prescriptions for a patient who has not reached the age of majority, these prescribed medications picked up from a pharmacy are required to be picked up by the patient’s parent, legal guardian, or the patient if the patient is an emancipated minor. Additionally, these prescriptions must identify the drugs being prescribed are for the treatment of gender nonconformity or gender dysphoria. The process to implement final regulations for LB 574 will proceed pursuant to the Administrative Procedure Act. The anticipated public hearing date is November 28; a draft of the proposed final regulations will be posted at least 30 days prior to that hearing. 

Finally in Nebraska, the Department of Health and Human Services (DHHS) released the final draft of regulations for the Let Them Grow Act. A public hearing will be held on November 28 from 7:00 AM to 7:00 PM at the Lancaster Event Center – Lincoln Room at 4100 N 84th St., Lincoln, NE 68507. People interested are encouraged to provide written comments via mail, fax, or email, no later than 11:59 PM on the day of the hearing. Comments may be faxed to 402-742-2382, emailed to dhhs.regulations@nebraska.gov or mailed to: DHHS Legal Services, PO Box 95026, Lincoln NE 68509-5026. Additional information can be found on the Frequently Asked Questions page on the DHHS website. 

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

The Department of Health and Human Services announced new income guidelines have increased the number of families who could qualify for the Women, Infants, and Children (WIC) nutrition assistance program. Some families who were not eligible for the program in the past may now qualify. Current Medicaid, SNAP (Supplemental Nutrition Assistance Program) or ADC (Aid to Dependent Children) recipients are income-eligible for the WIC program. All foster children under five years of age and pregnant teen moms in foster care are income-eligible for WIC. 

Also in Nebraska, the Board of Pharmacy posted the agenda for the September 18 meeting and the draft minutes from the July 10 Board of Pharmacy meeting.  

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