The Department of Human Services issued a Medical Assistance Bulletin last week announcing that on August 8 Medicaid implemented an increase in the pharmacy Professional Dispensing Fee (PDF) from $7.00 to $10.00, based on negotiations with CMS regarding the SPA filed last year. Additionally, Medicaid intends to process retroactive payments to April 1, 2017. Retroactive payments will be processed during the fourth quarter of 2018 and will be received by providers by the end of the current calendar year. The Medical Assistance Bulletin states that the increase is a result of CMS’ concern that the originally-proposed $7.00 PDF did not reflect the PDFs of neighboring states. The amended SPA has been approved by CMS. NACDS thanks the Pennsylvania Association of Chain Drug Stores and the Pennsylvania Pharmacists Association for joining with us to advocate with both CMS and the legislature on this critical issue.

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

The Pharmaceutical Contract for the Elderly (PACE) Program has issued a Provider Bulletin that outlines changes to its policy on coverage of opioids, effective Wednesday, October 10. Please contact Amy Brewer of Magellan Medicaid Administration with any questions.

NACDS recently learned that beginning August 7, the Department of Human Services (DHS) began paying pharmacies an increased professional dispensing fee (PDF) of $10.00 for Medicaid fee-for-service pharmacy claims. The increased PDF was approved by CMS in late July. Last summer, DHS filed a SPA for NADAC + $7.00 PDF that NACDS opposed. In addition to filing comments with CMS and DHS expressing concerns with the SPA, NACDS met with Medicaid staff and supported the efforts of in-state partners with legislators to oppose the $7.00 PDF.

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

An Administration Budget Proposal that would have required data collection from pharmacies next year, in anticipation of a pharmacy tax the following year, was rejected by the House and Senate Republican Caucuses and did not make it into the final budget.

Also in Pennsylvania… two measures championed by pharmacy made advancements as the General Assembly broke for summer recess:

• HB 1800 – Medication Synchronization – was passed out of the Senate Banking and Insurance Committee, received two floor considerations and then was re-referred to the Senate Appropriations Committee for a Fiscal Note. We anticipate final action on this bill when they reconvene in the fall.

• HB 353 – Mandatory E-Prescribing for Controlled Substances – After extensive negotiations with the Pennsylvania Medical Society (PMS), the bill was voted out of the Senate Health and Human Services Committee last week with support from a number of allies. This bill also had two floor considerations and then was re-referred to the Senate Appropriations Committee for a Fiscal Note. We also anticipate this bill moving forward in the Fall.

Also in Pennsylvania… In the June 12, 2018, Provider Bulletin, PACE announced new edit criteria for benzodiazepines, sedative hypnotics, muscle relaxants and opioids effective Monday, July 23.

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

On Monday, April 30, the Department of Aging made available to prospective providers the ability to enroll via the web portal. Pharmacies, dispensing physicians and certified registered nurse practitioners will be able to use this web application to enroll in a variety of state health programs. Paper enrollment applications and agreements postmarked after Friday, May 25 will no longer be accepted. Providers submitting these documents will be contacted and directed to enroll using the portal. Additionally, beginning April 30, existing providers were able to update their information (i.e. a change in pharmacists) and enroll in additional programs using this web application. Questions may be directed to Provider Services at 1-800-835-4080.

Also in Pennsylvania…The House of Representatives voted unanimously (192-0) to advance HB 1800, legislation facilitating medication synchronization. The bill, sponsored by Rep. Eric Nelson (R), requires insurers to allow partial fills, prorated copays and payment of a full dispensing fee. The bill now moves to the Senate for consideration. NACDS continues to support the on-the-ground efforts of the Pennsylvania Association of Chain Drug Stores to advance this legislation.

For more information, contact NACDS’ Sandra Guckian at 703-837-4195.

On April 16, the House Insurance Committee unanimously approved HB 1800, legislation facilitating medication synchronization. The bill, sponsored by Rep. Eric Nelson (R), has 43 cosponsors. It requires insurers to allow partial fills, prorated copays and payment of a full dispensing fee. The bill is now eligible for a vote by the full House. NACDS is supporting the on-the-ground efforts of the Pennsylvania Association of Chain Drug Stores to advance the bill.

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

On April 16, the House Insurance Committee will consider HB 1800, legislation facilitating medication synchronization. The bill, sponsored by Rep. Eric Nelson (R), has 43 cosponsors. It requires insurers to allow partial fills, prorated copays and payment of a full dispensing fee. NACDS is supporting the on-the-ground efforts of the Pennsylvania Association of Chain Drug Stores to advance the bill.

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

HB 1800, legislation related to pharmacists performing medication synchronization, has been introduced with 43 co-sponsors. The bill, sponsored by Rep. Eric Nelson (R), requires insurers to allow partial fills, prorates copays and requires a full dispensing fee. Committee consideration of this legislation, an initiative of the Pennsylvania Association of Chain Drug Stores, is anticipated this spring.

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

Legislation what will allow pharmacists to provide emergency 30-day refills has been signed into law by Gov. Tom Wolf (D) as Act 8 of 2018. Specifically, Act 8 will allow pharmacist to provide a patient who is on a drug that is either essential to sustaining his life or to maintaining a consistent drug therapy, a 30-day refill without a prescription. Under current law, a pharmacist can only provide one refill of the prescription limited to a 72-hour supply. The act was effective upon signing.

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