NC Medicaid has received reports of confusion in the field by providers and pharmacies when members do not present an ID card or when presented with a Medicaid member ID card that differs from the data shown in the NCTracks system. To mitigate any confusion associated with newly issued Medicaid Managed Care member ID cards, providers and pharmacies should always use NCTracks Recipient Eligibility Verification/Response to confirm eligibility and not rely solely on the information shown on a Member ID Card. Health plans are required to generate an identification card for each Member enrolled in their health plan that contains the Member’s North Carolina Medicaid or NC Health Choice Identification number. Some health plans also include their health plan member ID as well. However, member ID cards are not required to provide service, and this includes pharmacies as well. Therefore, members should not be turned away due to the lack of a Member ID card in their possession. For more information, please see the Medicaid bulletin Confirming Medicaid Coverage for Beneficiaries.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy announces a notice to issue a temporary rule that would adopt regulations under 21 NCAC 46 to establish standards under which a pharmacist can administer long-acting injectable pharmaceuticals formulated to produce sustained release and gradual absorption. The rule also would establish recordkeeping requirements. A hearing is scheduled for August 2 by teleconference. Comments are due August 3.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Beginning July 1, North Carolina will transition from a fee-for-service Medicaid program to Managed Care. More information on this transition can be found here. You may also find the June 16, 2021, Managed Care Transformation update for pharmacy stakeholders presentation here. Of note, 90-day fills and mail and delivery fees from local/community pharmacies, which were flexibilities granted during the COVID State of Emergency have been made permanent. Also Slide 18 on the presentation contains important Medicaid billing updates.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy issued a proposed rule to amend and adopt regulations under 21 NCAC 46 to establish new requirements for limited-service permits for certain pharmacies where services are provided by pharmacist-managers serving multiple pharmacies. The rule also would allow pharmacist-managers to be present at limited-service permits for less time than at regular pharmacy permits, allow pharmacist-managers to designate an assistant pharmacy-manager for limited-service permits, and provide that pharmacist-managers do not need to personally package drugs dispensed by nurse practitioners or physician assistants, among other conforming changes. A hearing is scheduled for July 20, 2021, via webcast and teleconference. Comments are due July 20, 2021.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy published a proposed rule to amend regulations under 21 NCAC 46 to require pharmacies to report information on compounded drugs to the National Association of Boards of Pharmacy’s e-Profile Connect system. The rule would implement the memorandum of understanding with the secretary of Health and Human Services on the distribution of compounded drug products. The rule also would update information on accessing U.S. Pharmacopeia compounding standards. A hearing is scheduled for June 15, 2021, via webcast and teleconference. Comments are due June 15, 2021.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The North Carolina Department of Health and Human Services (NCDHHS) has no-cost antigen tests they would like to share with retail businesses that are interested in screening their employees for COVID-19. The Department of Health and Human Services will also arrange an orientation call with any NCRMA member to discuss what you need to do to request and receive the free tests from DHHS. The North Carolina Department of Health and Human Services has a supply of Abbott BinaxNOW rapid, point-of-care antigen testing supplies available to support testing efforts to quickly identify and respond to cases of COVID-19. Facilities interested in receiving tests from the state must meet ALL the following requirements:

• CLIA Certificate — Obtain a CLIA certificate or partner with an entity with a CLIA certificate
• Physician Order — Secure a signed physician order or elect to use the Statewide Order
• PPE — Maintain an adequate supply of PPE to perform tests
• Medical Waste — Adhere to standards to properly handle and dispose of medical waste
• Training — Ensure all testing personnel have completed BinaxNOW training
• Reporting — Verify ability to complete DHHS reporting requirements. Reporting methods can be found at Getting Started with Automated Reporting.
• Quarantine & Isolation Support – Provide the necessary quarantine and isolation guidance for all individuals with suspected or confirmed cases of COVID-19 or who are close contacts of a COVID-19 case

Request process: All facilities that meet the above requirements may apply to request tests via the request form.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The North Carolina Medicaid Department issued a proposed rule to require Medicaid recipients to get a 90-day supply of non-controlled, maintenance medications and remove the requirement that Medicaid (or a managed care company after July 1, 2021) would have to pay NADAC or the State MAC Price for the prescription. More details can be found at the above link on page 8.  Comments can be submitted here and are due April 12, 2021.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy published a final rule which amends regulations under 21 NCAC 46 to establish a list of restricted drugs during the coronavirus (Covid-19) public health emergency. The rule also establishes that pharmacists can fill the prescriptions on the list only if the prescription bears a written diagnosis consistent with the evidence for its use.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.