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.

Gov. Wolf (D) has signed a bill that extends COVID-19 related pharmacy waivers due to expire on September 30 until March 31, 2022. It does not extend the waivers that were already terminated by the Department of State prior to September 30th. Since this was a blanket extension of the current waivers, the bill did not go further than the state waivers to fill in the gaps to match the PREP Act allowances. We will continue advocating for the passage of bills that match the PREP Act.

 Also in Pennsylvania, NACDS reminds members that beginning October 1, the state will cover copays for Naloxone prescriptions for patients hesitant to pick up the prescription due to cost, regardless of the type of insurance coverage. Please refer to the submission specifications and program bulletin for more information.

Also in Pennsylvania, the Board of Pharmacy has published proposed regulations providing for pharmacy technician registration based on Act 140 of 2020. Keeping in mind that any substantive changes will require legislation, please send any comments you may have to Jill McCormack by October 11.

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

The state has announced a new program 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 will begin October 1, 2021. The program will run on the PACE platform; however, the program will reimburse a pharmacy up to $75 per claim for any patient regardless of their insurance plan. There are adjudication testing opportunities available prior to Oct 1. Should you wish to run test claims, please contact NACDS’ Jill McCormack. For more detail, see the program bulletin and detailed adjudication specifications. NACDS thanks Governor Wolf, the Governor’s Opioid Command Center, PACE, and our members that helped advocate for this important lifesaving program over the last few years. 

Also in Pennsylvania, Acting Secretary of Health Alison Beam signed an order this week with guidance on administering COVID-19 booster shots once they are available. It requires vaccine providers, as possible, to: 

• provide online scheduling for vaccination appointments, 
• provide a telephone number, with prompts to a live agent during normal business hours, to assist in scheduling appointments, 
• offer walk-in appointments, and 
• work with local Area Agencies on Aging (AAA) and Medical Assistance Managed Care Organizations (MCO) to help schedule eligible adults and people who cannot leave their homes. 

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

The Governor’s Opioid Command Center in conjunction with the Department of Drug and Alcohol Programs have announced their intent to implement the Naloxone Copay Assistance Program on Oct. 1, 2021. Any PACE provider may submit claims to the new Naloxone Copay Assistance Program for up to $75 per claim for any Commonwealth resident (does not have to be a PACE beneficiary) through the existing PACE adjudication system. Additional program details will be provided in the next 2 weeks. The program is a result of a partnership between the state and NACDS and Pennsylvania Association of Chain Drug Stores (PACDS). We are currently working with members and the PACE program to develop the patient criteria and operationalize the program. 

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

The House Professional Licensure Committee will hold an informational meeting on Monday, September 20, 2021, at 10:00 a.m. to discuss the pharmacy-related regulatory waivers and suspensions issued by the Department of State during the COVID-19 pandemic and brief the members of the committee. NACDS plans to testify in favor of making the PREP Act permanent in state statute in coordination with the Pennsylvania Association of Chain Drug Stores (PACDS), the Pennsylvania Pharmacy Association (PPA) and other partners. 

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

The Department of Health issued a press release and FAQ to provide guidance to vaccinators regarding administering an additional dose of the COVID-19 vaccine to immunocompromised individuals.  

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

The Department of State (DOS) has issued a memo detailing the expiration dates of the professional waivers granted during the state of emergency that will expire on or before the Sept. 30 expiration of the state of emergency.  Beginning August 17, the DOS will rescind waivers in several phases, starting with the waivers that have already served their purpose in pandemic response but have not been formally rescinded. Members can find a list of all the waivers and their expiration dates on the DOS website, which can also be searched by profession. NACDS is currently engaged with in-state partners, the Administration and General Assembly in recommending that critical pharmacy waivers be made permanent. 

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