On December 5, Belmont University will host a free, live webinar providing a one-hour Board of Pharmacy update from 6:30-7:30 pm CT. All pharmacists and pharmacy technicians in Tennessee are welcome to register.
Also in Tennessee, TennCare recently released a notice regarding changes to the TennCare pharmacy program, specifically to the morphine milligram equivalent (MME), which will become effective January 1, 2024.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
TennCare’s updated dispensing fees took effect on November 1. TPA (Tennessee Pharmacists Association) is interested in collecting feedback on whether your pharmacy is receiving the updated dispensing fees from TennCare and other obligated payors. Please reach out to olivia@tnpharm.org with any feedback or questions
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Effective November 1, BD is the sole preferred manufacturer of insulin syringes and pen needles. Please refer to the OTC list for a list of covered NDCs. The updated OTC list, including covered NDCs, was posted to the Optum Rx TennCare website on November 1, 2023. Please refer to the November Provider Notice and contact TNRxEducation@optum.com with any questions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
To assist prescribers and providers, prior authorization (PA) requirements can be bypassed for certain medications when specific medical conditions exist. Those specific medications and diagnoses can be found here. Prescribers are encouraged to include the applicable diagnosis code on written prescriptions for inclusion on the electronic pharmacy claim. The submitted claim should include a Diagnosis Code Qualifier (Field # 492-WE) of “02,” indicating ICD-10, as well as the appropriate Diagnosis Code (Field # 424-DO).
If you have any questions, contact the OptumRx Pharmacy Supports Center at 866-434-5520 or tnrxeducation@optum.com.
Also in Tennessee, the October 31 Drug Utilization Committee (DUR) Board meeting will be held virtually via Microsoft Teams. Please Click Here or Phone number: +1 952-222-7450 Phone Conference ID: 857 579 147#
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
To assist prescribers and providers, prior authorization (PA) requirements can be bypassed for certain medications when specific medical conditions exist. Those specific medications and diagnoses can be found here. Prescribers are encouraged to include the applicable diagnosis code on written prescriptions for inclusion on the electronic pharmacy claim. The submitted claim should include a Diagnosis Code Qualifier (Field # 492-WE) of “02,” indicating ICD-10, as well as the appropriate Diagnosis Code (Field # 424-DO). If you have any questions, contact the OptumRx Pharmacy Supports Center at 866-434-5520 or tnrxeducation@optum.com
Also in Tennessee, TennCare held a webinar on the results of the recent Cost of Dispensing survey. During this event, TennCare disclosed the increased, updated professional dispensing fees (PDFs) applicable to all pharmacies within the TennCare Pharmacy network. Also, beginning November 1, 2023, pharmacies that have not responded to three or more TennCare surveys in the past will have their PDF set at $5.00. Based on the findings, the dispensing fees will be as follows:
Ambulatory
Specialty
Other
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Please see the webinar invitation for TennCare Pharmacies, during which OptumRx will unveil the findings from the Pharmacy TennCare Cost of Dispensing Survey. During this event, OptumRx will also disclose the updated professional fees applicable to all pharmacies within the TennCare Pharmacy Network. Please do not hesitate to reach out to your Provider Liaison Pharmacist with questions or concerns at TNRxEducation@optum.com.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gov. Bill Lee (R), Department of Economic and Community Development Commissioner Stuart C. McWhorter, and The Kroger Company officials announced that Kroger will be constructing its fifth U.S. Central Fill facility in Cleveland, TN. Rep. Kevin Raper (R-Cleveland) stated, “…This endeavor will create 140 jobs and provide state-of-the-art care through the utilization of automated technology to fulfill prescriptions. We are honored to be the site for this project, and highly anticipate the positive impact it will have on our economy and community.”
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Gov. Bill Lee (R), Department of Economic and Community Development Commissioner Stuart C. McWhorte, and The Kroger Company officials announced that Kroger will be constructing its fifth U.S. Central Fill facility in Cleveland, TN. Rep. Kevin Raper (R-Cleveland) stated, “…This endeavor will create 140 jobs and provide state-of-the-art care through the utilization of automated technology to fulfill prescriptions. We are honored to be the site for this project, and highly anticipate the positive impact it will have on our economy and community.”
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The new rule from Tennessee Department of Commerce and Insurance, 0780-01-95 – Pharmacy Benefits Managers, became effective June 27, 2023.
Also in Tennessee, beginning August 1, 2023, prior authorization requirements will be removed for the following preferred medications: Advair Diskus, Advair HFA, Dulera, Symbicort, aripiprazole, Diclegis, ezetimibe, fenofibrate and Xarelto. We encourage you to read this notice thoroughly and contact OptumRx’s Pharmacy Support Center (866-434-5520) should you have additional questions.
Finally, TennCare is continuing the process of reviewing all covered drug classes. Changes to the PDL [Preferred Drug List] may occur as new classes are reviewed, and previously reviewed classes are revisited. As a result of these changes, some medications your patients are now taking may be considered non-preferred agents in the future. Please inform your patients who are on these medications that switching to preferred products will decrease delays in receiving their medications. We encourage you to read this notice thoroughly and contact OptumRx’s Pharmacy Support Center (866-434-5520) or tnrxeducation@optum.com should you have additional questions. For more details on Clinical Criteria, please visit https://www.optumrx.com/oe_tenncare/landing.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.