In response to questions posed to Medicaid (ODM) at the May Joint Medicaid Operations Committee (JMOC) meeting related to the implementation of the Single Pharmaceutical Benefits Manager, ODM issued a letter that contains further detail on the implementation timeline and other issues of import to members.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Medicaid (ODM (Ohio Department of Medicaid)) has published an important update regarding the implementation of the Single Pharmacy Benefit Manager (SPBM). The update clarifies that reimbursement rates for the new program will be announced later this month, that Gainwell has launched a new webpage that includes important program information and useful guides including the SPBM Pharmacy Reference Guide (Provider Manual). The website will continue to be updated with information for members, pharmacies, and prescribers. Lastly, they have also released an updated version of their SBPM FAQ (Frequently Asked Questions), which includes answers to many questions NACDS had previously submitted on behalf of members.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy published a bulletin announcing Board meeting dates for the remainder of 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Governor Mike DeWine (R) signed Executive Order 2022-05D to suspend the normal rulemaking process to allow the Ohio Board of Pharmacy to classify several bezimidazole-opioids as Schedule One drugs, meaning they have no accepted medical use in treatment and pose an imminent hazard to public health, safety, and welfare.
Also in Ohio, The Department of Medicaid (ODM (Ohio Department of Medicaid)) has posted the slides from its most recent pharmacy stakeholder online seminar that outlines their future process for reimbursing pharmacies for Specialty Drugs under the Managed Care Single Pharmaceutical Benefits Manager Program (SPBM). Additionally, ODM announced that the implementation of the SPBM program has been delayed until October of 2022. More information can be found on the SPBM webpage. Members should expect ODM to schedule the next online seminar, on which ODM intends to announce new pharmacy rates, to be scheduled for the week of May 16. NACDS will email the invite to members operating in Ohio as soon as we receive it.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Medicaid (ODM) held its second stakeholder webinar regarding the implementation of the Single Pharmacy Benefits Manager (SPBM) under the Next Generation of Managed Care program on April 15. The subject matter was the new Specialty Drug Program. Copies of the PowerPoint slides and other information regarding the program can be found on ODM’s SPBM webpage. The slides state the next webinar will be held in early May and will cover SPBM pricing.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Medicaid (ODM)announced that Myers and Stauffer have begun sending acquisition cost surveys to pharmacies to help them determine Ohio Average Acquisition Cost (OAAC). ODM intends to use OAAC as part of the “lower of” calculation for ingredient cost reimbursement, to include NADAC and Usual and Customary, when they implement “The Next Generation of Managed Care.” Completed surveys are due April 30 and can be submitted by email, U.S. Post, or fax, as noted below, though electronic submission is preferred.
To learn more about the Next Generation of Medicaid managed care, visit Ohio Medicaid Single Pharmacy Benefit Manager (SPBM) | Ohio Medicaid Managed Care or email ODM at MedicaidSPBM@medicaid.ohio.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Gov. Mike DeWine (R) has signed HB 37, legislation sponsored by Rep. Gayle Manning (R), that allows pharmacists to provide 30-day emergency refills without contacting the prescriber. NACDS and the Ohio Council of Retail Merchants advocated for passage of this legislation that aligns with our efforts to make COVID-19 business efficiencies permanent. The bill will be effective June 1.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Medicaid (ODM) announced the timeline for upcoming “catch up” payments of the managed care “supplemental” dispensing fee to pharmacies along with a revised FAQ with further detail on the amount of the payments and formula for determining which payment tier your company will receive. Members will recall that these payments, which pharmacies have been receiving over the last few years, were delayed in the first quarter of 2022 while awaiting CMS approval.
Also In Ohio, on March 11 ODM is hosting an online seminar for pharmacies to give further details about the upcoming contracting process with their new SPBM (Single Pharmacy Benefit Manager), Gainwell Technology. Click here to register.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 37, a bill that NACDS and the Ohio Council of Retail Merchants jointly supported, has passed both Chambers and is on its way to the Governor for signature. Sponsored by Rep. Gayle Manning (R), it authorizes pharmacists to dispense emergency refills three times a year and requires health insurers to cover these prescriptions.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.