On October 9, the Board of Pharmacy held its regular scheduled meeting.  The agenda included the report of the 2024 Pharmacy Workplace Survey.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Office of Health Insurance Programs of the State Department of Health has approved the release of the August 2024 Medicaid Update. Included in this month’s update:

• New York State Medicaid Pharmacy Policy for Coronavirus Disease 2019 Testing
• New York State Medicaid Coverage for Coronavirus Disease 2019 Vaccines for Eligible Vaccine For Children Program Members at the Pharmacy
• Introduction to Upcoming Pharmacy and Practitioner Administered Drug Changes Due to Enacted Budget

Also in New York, on September 23, 2024, the Medicaid Program made important changes to the coverage of blood glucose testing supplies, aligning with Medicare coverage criteria. This update is designed to promote effective testing habits to support individuals managing their diabetes. Changes to the supply limits for test strips and lancets and the implications for pharmacies and healthcare providers, are explained below:

Effective October 1, 2024, the Medicaid blood glucose testing supply coverage will align with Medicare policies. The new guidelines are as follows:

• Members using insulin: Those who require insulin for blood glucose management will be eligible to receive up to 300 test strips and 300 lancets every three months.
• Members not using insulin: For individuals managing their diabetes without insulin, the allowance will be up to 100 test strips and 100 lancets every three months.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On September 5, Governor Hochul signed into law the Retail Workers Safety Act, which requires employers to implement policies and training programs to prevent workplace violence. It requires a retail store with 500 or more employees to install panic buttons in all New York locations. The Department of Labor would be required to create a model workplace violence prevention training program, policy, and guidance document to be utilized by employers. The law is effective March 4, 2025, however the section requiring panic buttons would take effect January 1, 2027.

On September 13, 2024, the New York Pharmacy Conference held its regular meeting. The meeting included updates from Donate Life New York State, the Comprehensive Contraceptive Coverage Act, and Expansion of Collaborative Drug Therapy Management to offsite practices, and a legislative update from Assemblyman John McDonald. The next meeting of the conference will be held on Friday December 13, 2024, at 10 AM.

On September 18, 2024, the New York Department of Health held their monthly pharmacy industry call regarding NYRx, the Medicaid Fee-For-Service Program. This month’s call included updates on Blood Glucose Test Strip Coverage Policy and Covid Tests Coverage Policy Update.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On August 21, the State Department of Health held its monthly pharmacy call for NYRx transition, the Medicaid Pharmacy Benefit Program. Several relevant agenda items include the following:

1. Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) order acceptance policy
2. NYRx utilizes the NADAC file which contains historical information for rate/pricing changes. The following provides information on how to read the file:
   • The “Effective Date” is the effective date for each rate change. The effective date is designed to avoid overlapping date segments for a specific NDC.
   • The “As of Date” indicates the date a rate group first appeared on the NADAC.
   • The “Posting Date” is the date in which the NADAC is posted to eMedNY.
   • EMedNY cut-off time for file updates occurs every Friday (most NADAC prices show an “As of Date” every Wednesday).
   • Information in the pricing file will post to eMedNY every Tuesday.

3. NYRx, the Medicaid Pharmacy Program, is making significant changes to the coverage of diabetic testing supplies. These changes align with Medicare coverage criteria.
4. NYRx is conducting system enhancements to accommodate vaccine billing by NDC targeted for late October:

• eMedNY systems will automatically apply the administration fee in a single transaction,
• NYRx is committed to making this transition as smooth as possible.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

NYRx, the New York State Medicaid Pharmacy Program, provided an update to its prior authorization program, effective August 1, 2024.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On July 17, 2024, NYRx, the State Medicaid Prescription Drug Program, hosted its monthly pharmacy call. The agenda included:

1. Pharmacy Reimbursement & Dispensing Fee Calculations
2. Pharmacy Enrollment: Pharmacies Pending Medicare Part B Revalidation
3. Vaccine Billing

The next call will be August 21, 2024.

Also in New York, the Office of Health Insurance Programs of the State Department of Health has approved the release of the June 2024 Medicaid Update. It included the following:

• Reminder: Licensed Providers Must Enroll with State Medicaid to Serve Medicaid Members
• Attention Pharmacy Providers: Cold Storage Requirement

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

NYRx, the State Medicaid Prescription Drug Program, posted a Pharmacy Prior Authorizations Programs Update. This update is effective August 1, 2024.

Also in New York, the Office of Health Insurance Programs of the State Department of Health has approved the release of the May 2024 Medicaid Update. This update includes a pharmacy reminder that Medicaid providers are required to bill applicable third parties that may be liable for a claim before billing Medicaid. Medicaid is always the payor of last resort and federal regulations require that all other available resources be used before Medicaid considers payment.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The State Department of Health released a notice of reminders to pharmacy providers in case of severe weather events.  These include drug storage, vaccines for children, drug delivery and NYRx prior authorizations.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

NYRx, the Medicaid Pharmacy Benefit Program, announced updates to the Preferred Drug List. These changes were effective May 29. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.