Governor Kathy Hochul (D) issued an executive order that declares a state of emergency due to the spread of the monkeypox virus and directs all relevant state agencies to assist local governments in responding to the outbreak.
The executive order grants healthcare providers, including pharmacists, emergency permission to administer monkeypox vaccines through August 28, 2022.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
As you are aware, late in 2021 several PBM legislative packages were signed into law. Now as the NYS Department of Financial Services is developing regulations, the Department is seeking public comment on a series of issues. Those requests for comments can be found on the Department of Financial Services website: www.dfs.ny.gov/pbm.
The most recent Department request is for public comments about the applicability of the Pharmacy Benefit Manager (“PBM”) laws set forth in New York Insurance Law Article 29, as well as the need for rules to be promulgated thereunder, on PBM conduct while credentialing and re-credentialing pharmacies into a PBM network. View the Request for Public Comments (PDF)
Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-05” included in the subject line. Failure to include “PBM2022-05” in the subject line may result in your comment not being considered. The deadline for responses is September 9, 2022.
Also in New York, NYS Medicaid recently held a pharmacy sector meeting and discussed the work being done to ensure a smooth transition for pharmacy benefits from Medicaid Managed Care to Fee for Service (FFS). Here are the NYSDOH Pharmacy Benefit transition slides presented at the July 20th Medicaid meeting.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
As a result of PBM legislation enacted in 2021, the NYS Department of Financial Services is developing regulations, and the Department is seeking public comment on a series of issues.
Below are the three upcoming Public Notices with links for more details related to:
PBM Services to Medicare Part D Plans, Comments due August 1, 2022
View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-02” included in the subject line. Failure to include “PBM2022-02” in the subject line may result in your comment not being considered. The deadline for responses is August 1, 2022.
Reporting Requirements for PBMs (Pharmacy Benefits Managers), Comments due August 5, 2022
View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-03” included in the subject line. Failure to include “PBM2022-03” in the subject line may result in your comment(s) not being considered. The deadline for responses is August 5, 2022.
Practice of Patient Steering by PBMs due August 19, 2022
View the Request for Public Comments (PDF) Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-04” included in the subject line. Failure to include “PBM2022-04” in the subject line may result in your comment not being considered. The deadline for responses is August 19, 2022.
For more information about these Public Notices and DFS (Department of Financial Services) efforts to implement the law, please click here.
Also in New York, the Office of the Medicaid Inspector General (OMIG) published a Proposed Rule Making in the State Register related to Medicaid Program Fraud, Waste and Abuse Prevention with the stated purpose to establish requirements for providers to detect and prevent fraud, waste, and abuse in the Medicaid Program.
The full text of the proposed rule can be found here. Public comments are due within 60 days from when published on July 13, 2022. To read the new sections added to OMIG regulation through this rulemaking in their entirety, please click here.
In particular, the proposed rulemaking would repeal and add a new 18 NYCRR Part 521 to implement statutory changes resulting from the recommendations of the Medicaid Redesign Team II as adopted in the State Fiscal Year 2020-2021 Enacted Budget (Chapter 56 of the Laws of 2020, Part QQ) and to make other conforming changes related to:
(1) Provider Compliance Programs,
(2) Medicaid Managed Care Plan fraud, waste, and abuse prevention programs under the Medical Assistance (Medicaid) program, and
(3) The Obligation to report, return and explain Medicaid overpayments through OMIG’s Self-Disclosure Program.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
On June 8, 2022, the New York State Department of Health in consultation with the Department of Environmental Conservation, announced the approval of two Drug Take-Back programs, proposed and operated by Inmar Rx Solutions, Inc. and MED-Project, LLC. Pursuant to Chapter 120 Laws of 2018, the New York State Drug Take Back Act (DTB) mandates that manufacturers establish, fund, and manage a New York State-approved drug take-back program(s) for the safe collection and disposal of unused covered drugs. Pharmacies of ten or more establishments within NYS and non-resident pharmacies that provide covered drugs to NYS residents by mail must implement such programs by providing consumers with a pre-approved method(s) of collection and disposal, free of charge to the consumer and pharmacy.
For more information on the Drug Take-Back programs to be operated by Inmar and MED-Project, visit their sites:
The press release can be found here: New York State Department of Health and Department of Environmental Conservation Announce Approval of Two Drug Take Back Programs
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Before the New York State Legislature recently adjourned, both Houses passed legislation (A3040B-S4807B) which would authorize pharmacists to administer long-acting injectable medication for MH/SUD per a prescription or order. In addition, the legislature rejected efforts to delay or repeal the planned FFS (Fee for Service) transition of the pharmacy benefit set to take effect on April 1, 2023.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The Office of Health Insurance Programs of the New York State Department of Health has approved the release of the March 2022 Medicaid Update.
You may also go straight to an article or topic that pertains to you by selecting it from the current issue’s table of contents below.
Policy and Billing
All Providers
Pharmacy
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The State Education Department regulation expanding the pharmacist immunization authority which took effect on January 31, 2022, is set to expire on April 10. At the last Board of Regents meeting, the Board took emergency action effective April 11 to keep the regulation in effect until it can be permanently adopted at the Board May Meeting.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The New York State COVID-19 Vaccine Team has recently updated its Guidance for the NYS COVID-19 Vaccination Program for individuals 12 years of age and older. The updates reflect the recent CDC changes in COVID-19 vaccine clinical guidance. The updates include:
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
The New York State Department of Health (NYS DOH) announced the Centers for Medicare & Medicaid Services (CMS) approval of New York’s section 1115(a) demonstration waiver. This approval is effective from April 1, 2022 through March 31, 2027. In accordance with federal guidelines, the State has 30 days to accept the related Standard Terms and Conditions (STCs), which is an operating agreement between the State and CMS.
The NYSDOH 1115(a) waiver request included a white paper which structured the waiver request proposal around four subsidiary goals:
The CMS approval letter can be found on the NYS DOH website here.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.