The Budget Conference Committee approved an amended version of the state budget that will soon be on Gov. Mike DeWine’s (R) desk. Though NACDS worked strategically with members and partners to include a meaningful commercial pharmacy rate floor, the conference committee fell woefully short, fueled by the Ohio Chamber of Commerce’s claims that a rate floor would raise consumer premiums. The final language, which only applies to pharmacies incorporated in the state, sets the ingredient cost floor at either the amount a PBM pays its affiliates or actual acquisition cost (ACC); however, it does not include a dispensing fee rate floor. NACDS is analyzing the impact of the language and will seek member feedback on any next steps.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

This week, the Senate released an amended version of the state budget bill, HB 96, which did not retain the House's provision requiring a pharmacy commercial rate floor. Both the Ohio Chamber of Commerce and the National Federation of Independent Business (NFIB) actively opposed the amendment. NACDS continues to collaborate with partners and members to promote commercial PBM reform, with a focus on restoring the pharmacy rate floor during the conference committee process.  

Also in Ohio, NACDS also submitted written testimony to the House General Government Operations Committee urging its support for HB 229, requiring PBM licensure and reporting. The bill had its second hearing this week.  

Finally in Ohio, Medicaid released an updated preferred diabetic supply list, effective June 1. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy issued the following bulletins:  

• Pharmacy Continuous Quality Improvement Programs for Dispensing Errors 

• Pharmacy Duty to Report Requirements 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy announced that they have developed and posted a new tool in the form of a dashboard that provides data on pharmacy trends and access in the state. The dashboard includes data on closures, openings and “pharmacy deserts” across communities.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Effective January 1, 2025, At-home COVID-19 test kits will no longer be covered under pharmacy benefits for Medicaid fee-for-service (FFS) and managed care members. Any claims received on or after January 1 will result in a rejection. Patients may obtain free At-home COVID-19 test kits and access additional resources for free testing by visiting the Department of Health and Human Services’ COVID testing page. If you have questions, please contact the Gainwell single PBM (SPBM) Customer Service Center at 833-491-0344.

Also in Ohio, the Board of Pharmacy released its 2025 meeting schedule.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department of Medicaid announced the selection of four managed care plans they will contract with for the “Next Generation of MyCare,” Medicaid’s dual eligible healthcare program. The new plan contracts will begin January 1, 2026.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The following Board of Pharmacy rules have been posted for public comment by the Commonsense Initiative:

• CSI – BIA – Sterile and Non-Sterile Drug Compounding (Comments Due 11.4.2024).pdf
• CSI – BIA – FYR 2024 (Controlled Substances) (Comments Due 11.1.24).pdf (combines existing rules into single section)
• CSI – BIA – FYR 2024 (Pharmacy Technicians) (Comments Due 11.1.24).pdf (extends training period for active-duty military)
• CSI – BIA – FYR 2024 (Prescription Drug Collection) (Comments Due 11.1.24).pdf
• CSI – BIA – FYR 2024 (Probation) (Comments Due 11.1.24).pdf
• CSI – BIA – FYR 2024 (Terminal Distributors of Dangerous Drugs) (Comments Due 11.1.24).pdf
• CSI – BIA – Zoning Requirements (Comments Due 11.1.24).pdf

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Gainwell delivered a communication this week to notify pharmacies that the 2025 Payment Error Rate Measurement (PERM) program is now in progress. The Department of Medicaid (ODM) is mandated to participate in PERM by the Centers for Medicare and Medicaid (CMS). The program will assess payment accuracy rate for the Medicaid and CHIP programs. If chosen in a random sample, your pharmacy will soon receive a Medical Records Request from the CMS review contractor, Empower AI. This cycle measurement will review Medicaid and CHIP payments made in Reporting Year (RY) 2025: July 1, 2023, through June 30, 2024.  ODM may recover payments made to providers who fail to cooperate by the established deadlines. Providers must retain recipient records for six years from the date of payment, under the terms of the Provider Agreement, even if they no longer do business with ODM. For more information about PERM, please visit the Provider link on the CMS PERM website. A video explaining the process is also available. For questions, please contact the ODM Medicaid Audit Coordination Team.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy published the following final rules:

• Pharmacist Duty to Report Requirements – Effective 3.1.2025.pdf
• Pharmacy Technician Duty to Report Requirements – Effective 3.1.2025.pdf
• Pharmacy Continuous Quality Improvement Programs for Dispensing Errors – Effective 3.1.2025.pdf
• Pharmacy Duty to Report Requirements – Effective 3.1.2025.pdf

For more information, contact NACDS’ Jill McCormack at 717-592-8977.