The Board of Pharmacy met in-person earlier this week on September 13 and distributed the draft meeting minutes from its two prior meetings held on July 26 and August 16.  NACDS will share the draft meeting minutes from the September meeting once available.

Also in Nebraska, the Department of Health and Human Services (DHHS) issued several updates:

• The next COVID-19 Provider call will take place on September 22 at noon. Information to access the call has been posted on the DHHS website.
• Provider Bulletin 21-19 includes information related to the following:
  • Full approval of the Pfizer COVID-19 vaccine for individuals ages 16 and older, which does not change the reimbursement rate;
  • Coverage of an additional dose of some COVID-19 vaccines for immunocompromised individuals; and
  • A change in the number of additional fees that can be reimbursed for at-home vaccine administration.
• Provider Bulletin 21-18 includes a reminder that effective October 1, Heritage Health Adult will move from a two-tier benefit system to a single benefit package, including comprehensive physical and behavioral healthcare as well as vision, dental and over-the-counter drug coverage. A series of one-hour educational webinars have been scheduled for providers regarding these changes.  See bulletin for dates and times.

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

The Department of Health and Human Services is moving to an internet-based licensing system called LANCE (Nebraska Licensing and Certification Environment) in late 2021 with full implementation planned in 2022.

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

The Department of Health and Human Services announced the COVID-19 Ad-Hoc Schedule 3rd Dose Vaccine Update.  Effective date was August 12, 2021. 

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

The Centers for Medicare and Medicaid approved the Department of Health and Human Services’ State Plan Amendment for Medication-Assisted Treatment (MAT) on August 17.  MAT is a covered service for all Medicaid beneficiaries meeting the medical necessity criteria for the service beginning October 1 and ending September 30, 2025. 

Also in Nebraska, Provider Bulletin 21-18 includes two important updates: 

• Starting October 1, the Heritage Health Adult (HHA) will move from a two-tier benefit system to a single benefit plan, meaning all adults enrolled in HHA will receive full state plan coverage including comprehensive physical and behavioral healthcare plus vision, dental and over-the-counter drug coverage. 

• Medicaid and Long-term Care will be hosting one-hour educational webinars to provide information about the Medicaid Expansion program. 

Finally in Nebraska, the Department of Health and Human Services announced that COVID-19 Medicaid Provider Calls will resume on September 1. 

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

The DUR Board will meet on September 14.  The following materials have been posted on the website: agenda, policy statements and July 13, 2021 draft meeting minutes.   

Also in Nebraska, the Board of Pharmacy will conduct a conference call meeting on August 16.  The agenda with information to access the conference call and a link to the draft regulations (172 NAC 134) related to “delegated dispensing permits” have been posted. 

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

The Department of Health and Human Services (DHHS) released recent updates and information including the following:  

• The Heritage Health pharmacy reference guide has recently been updated (August 2021). 
• Because COVID-19 State of Emergency ended on June 30, those licensees, including pharmacy technicians, impacted by the original order (Executive Order 20-10) will be notified through a mailing that they need to renew their licenses before October 31. 
• The 471-000-540 Nebraska Medicaid Practitioner Fee Schedule for Injectables was updated effective July 1. 
• Provider Bulletin 21-13 includes changes to Preferred Drug List (effective July 15) and Hepatitis C (July 1) Criteria. 
• DHHS announced that all Nebraskans eligible for Medicaid expansion will receive equal benefits coverage, including OTC medications, starting October 1.
• DHHS issued notice of public hearing on August 18 to receive comments on proposed changes to Nebraska Medicaid Managed Care (NAC Title 482, Chapters 2, 4 and 5). The proposed changes include removing language restricting managed care organizations from offering certain coverage, including over-the-counter drug coverage, as value-added services. Also, the proposed changes include removing language that excludes Basic benefit plan enrollees from certain services, including pharmacy services. These changes align the rules with the withdrawal of Nebraska’s 1115 demonstration waiver and implementation of the Heritage Health Adult program. 

Also in Nebraska, the draft July 13 minutes from the recent Medicaid DUR Board Meeting and the Board Policy Statements are now available. 

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

The next meeting of the Medicaid DUR Board Meeting will be held on July 13.  

 Also in Nebraska, given the expansion of testing availability throughout the state and decreased volume of specimens submitted to Test Nebraska, the Department of Health and Human Services announced that Test Nebraska will no longer be collecting COVID-19 specimens after July 18.  

Finally in Nebraska, Gov. Pete Ricketts (R) announced the end of the coronavirus state of emergency at 11:59 p.m. on June 30. The Governor issued Executive Order (EO) 21-09 to rescind pandemic-related executive orders. With a few exceptions, the coronavirus executive orders will expire on July 30, which is thirty days after the state of emergency ends. NACDS researched and identified the following as impacting pharmacies, pharmacists, interns and/or technicians and expiring on July 30. 

• Executive Order 20-10  
• Executive Order 20-15  
• Executive Order 20-37  
• Executive Order 21-01  

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

Effective July 1, 2021, the METAVIR fibrosis score required for coverage by Nebraska Medicaid will be changed to F0. The current prior authorization criteria require a METAVIR fibrosis score of at least F2. These changes mean that patients with a METAVIR fibrosis score of F0 may have their prescribed antiviral medications to treat hepatitis C be covered by Nebraska Medicaid. Prior authorization for Hepatitis C antiviral medications will continue to be in place. See Provider Bulletin 21-11 for additional details.

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

On May 5, 2021, Gov. Pete Ricketts (R) signed LB 583, requiring Schedule II-V controlled substances prescriptions to be electronically prescribed with exceptions effective January 1, 2022.  However, dentists will be required to do so beginning January 1, 2024.

Also in Nebraska, the Department of Health and Human Services published the agenda for the next conference call meeting of the Board of Pharmacy on Monday, May 24, 2021.  The March 22 conference call meeting minutes are also available.

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