Long-awaited Board of Pharmacy regulations allowing pharmacy interns to immunize have been released in final form by the Independent Regulatory Review Commission (IRRC), where they are scheduled for a vote on May 19. After IRRC passage, the regulations will go to the Attorney General and be published in the Pennsylvania Bulletin. The regulations will be final 30 days after the official publication date. The rulemaking is pursuant to the Pharmacy Act amendments made by Act 8 of 2015, the same law that allowed pharmacists to administer influenza vaccines to children aged 9 years and older.  

Also in Pennsylvania, the PACE program issued a bulletin regarding Program audit procedures. It includes clarification regarding who is responsible for providing information related to the requested documents. 

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

Physician General Dr. Denise Johnson issued an updated naloxone standing order to include a form of eight milligram naloxone nasal spray. NACDS reminds members that Pennsylvania has a broad program that will reimburse pharmacies for patient copayments for naloxone when the patient is hesitant to pay and any patient with any type of insurance coverage is eligible. For more detail, see the program bulletin and detailed adjudication specifications. 

For more information, contact NACDS’ Jill McCormack at 717-525-8962. 

Tennessee: Renee Williams-Clark has left TennCare as Chief Pharmacy Officer. Lorraine Buerhaus has been named interim CPO. Pharmacists interested in applying for this position can do so here.  

Also in Tennessee, The Institute for Safe Medication Practices (ISMP) will present its free online seminar, “Diversion is a Threat to Patient Safety: Adopting Best Practices for Safe Management of Controlled Substances,“ on April 6, 1-2 pm ET. 

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

The Department of Human Services released a new bulletin announcing SARS-CoV-2 Monoclonal Antibody Product Updates that includes pharmacy reimbursement rates and billing procedures.

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

The Department of Human Services has issued a bulletin announcing that Chartwell Pennsylvania will be the new Specialty Preferred Pharmacy Provider for Fee-For-Service beginning July 1, 2022. Further details are included in the bulletin.

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

The Department of Human Services Office of Medical Assistance Programs has issued a new bulletin with billing instructions for COVID-19 at-home test kits.

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

The state has reissued billing guidance for the Pharmacy Naloxone Copay Assistance Program, because of claims – otherwise eligible- but rejected due solely to coding errors. The claims are eligible for correction for payment. NACDS reminds members that naloxone claims from any patient, regardless of type of insurance coverage, are eligible for the copay to be reimbursed to the pharmacy. The program, which NACDS and PACDS helped the Governor’s Opioid Taskforce develop with member input, is funded through federal grants and meant to incentivize greater naloxone access to all Pennsylvanians. It is run on the PACE program system merely to streamline the adjudication process for pharmacies. 

Also in Pennsylvania, The Department of Human Services published a Bulletin for COVID Oral Antiviral Treatments billing procedures and codes for pharmacies. 

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

The Office of Medical Assistance Programs (OMAP) has announced by bulletin that they will now reimburse pharmacies a $10 administration fee for any vaccine provided to adult Medicaid patients consistent with the Pharmacy Practice Act, retroactive to Nov. 1, 2021, in both FFS and MC.  Historically OMAP has only paid for ingredient costs. Billing codes are in the bulletin. Pharmacies cannot bill for vaccines covered under the VFC program. 

Also in Pennsylvania: The Pennsylvania Prescription Drug Monitoring Program (PDMP) will be transitioning PDMP system vendors.  This change will bring new enhancements to the PDMP that are based on feedback from PDMP users, including a single platform for pharmacists to search patients, and upload and edit data. Starting on January 10, 2022, PDMP users will need to transfer their accounts to create new login credentials and establish their SFTP credentials (if applicable) within the LogiCoy PDMP platform. Pharmacies using a third party for data submission must ensure their vendor also transfers their accounts. Transitioning accounts takes an average user less than two minutes, as registration has been streamlined to pre-populate information based on the user’s license information. The transfer account period begins on January 10. During this time all PDMP users must, by February 14: 

1. Visit https://pdmp.health.pa.gov/  

1. Click “Transfer Account or Register” 

1. Follow the prompts and enter their information 

1. Ensure the information is correct and submit  

Pharmacists (or their data submission vendor) will be able to test their data submission during this time. Please note, before February 14, PDMP users will continue to use PMP Aware to search patients and PMP Clearinghouse to upload data. On February 14, PDMP users will begin using the LogiCoy PDMP to search patients and upload data. Users who search patients through their organization’s pharmacy management system will not need to change how they search patients and will not experience any changes to their pharmacy management system’s connection to the PDMP. For more information about the PDMP, please visit: www.doh.pa.gov/pdmp. For assistance with account transfer, please contact LogiCoy technical support at 844-939-0999 or email papdmp@logicoy.com.  

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

The Office of Medical Assistance Programs (OMAP) has issued a Bulletin with updates to the Statewide Preferred Drug List clarifying when an MCO can require prior authorization for certain drugs. The PACE Prescription Drug Program has also issued a Bulletin clarifying the claims submission code for “other coverage” claims. The Bulletin applies to all prescription programs administered by PACE.

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

NACDS reminds members that a new program is available that will reimburse pharmacies for naloxone copays when the pharmacist believes the patient will be hesitant to pick up the prescription due to cost. The Naloxone Copay Assistance Program is funded through federal grants and began October 1, 2021. The program runs on the existing PACE adjudication platform and will reimburse a pharmacy up to $75 per claim for any patient regardless of their insurance plan. In the interest of making the program as seamless as possible for pharmacies to increase access to naloxone, there is no ID patient card or patient criteria to meet. For more details, see the program bulletin and detailed adjudication specifications. It is our understanding that only a handful of claims were submitted in October; if you are experiencing any barriers to utilizing the program or have suggestions to increase uptake, please contact NACDS’ Jill McCormack at 717-525-8962 or jmccormack@nacds.org.

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