The Department of Vermont Health Access has published updates to the Preferred Drug List (PDL) effective January 1, 2023.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Vermont Health Access (DVHA) is implementing changes to its prescription drug benefits programs to ensure Medicaid patients continue to have access to the medications they need for conditions related to COVID-19. The changes center around copayments, prescription instructions, and approved medication treatments. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Vermont Office of Boards, Commissions & Public Service announced that there was a vacancy on the Board of Pharmacy. If a Vermont pharmacist is interested in filling the vacant spot the application for filling the new position can be found here. The next Board of Pharmacy meeting is April 27.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Department of Vermont Health Access recently released its March 2022 Pharmacy Newsletter. It contains information on: 

• Pharmacy Benefit Provider Satisfaction Survey 
• Hypertension Management Initiative  
• Team Care Program 
• Important Changes to Administration Fees for Vaccines  
• Update on Pharmacy COVID-19 Antigen Test Coverage  
• Preferred Drug List (PDL) 
• New DURB Board Member 
• Drug Utilization Review Board (DURB) Meeting 
• Website Updates 

Also in Vermont, the Department of Vermont Health Access issued a communication that Synagis® prophylaxis is of unproven value when administered outside of the RSV season as defined by the CDC surveillance reports. Therefore, no further shipments will be authorized after March 11. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On January 1, 2022, the Medicaid pharmacy administration fee for vaccines changed from $13.97 to $13.87. This is to align with changes to the physician fee schedule and does not apply to COVID-19 administration fees. There is further guidance around POS submission, administration fees added to adult ACIP (Advisory Committee on Immunization Practices) recommended vaccines, and enrollment in the Vermont Child Vaccine Program (VCVP). 

Also in Vermont, the Department of Vermont Health Access (DVHA) contracts with Change Healthcare to support Vermont’s publicly funded pharmacy benefit programs. The Change Healthcare help desk supports all pharmacies and prescribers enrolled in Vermont’s pharmacy benefit programs. It is the first point of contact for pharmacy and medical providers for drug prior authorization requests, drug claims processing issues, and other drug-related questions, concerns, and complaints.  

Change Healthcare is conducting a provider satisfaction survey of pharmacies and prescribers and your participation in this survey is particularly important to DVHA as responses from this survey will be used for quality improvement efforts. The entire survey should take less than 5 minutes to complete. Comments are dure by March 15.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Vermont Department of Financial Regulations has issued draft guidance for commercial insurance coverage of COVID-19 at-home rapid antigen testing. The Department contemplates requiring commercial health insurers to cover at-home rapid antigen testing listed as “preferred” by Vermont Medicaid without member cost sharing. Under the draft emergency rule, the tests would be fully covered when prescribed, in which case the claim would process exactly like any other prescription medication, or if the member submits a claim form. This guidance, once finalized, will be effective December 1, 2021.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Effective 10/14/21, pharmacies may submit claims for administration of a booster dose of the Pfizer-BioNTech COVID-19 vaccine for dates of service on or after September 10, 2021. The Department of Vermont Health Access issued an updated guidance reminds pharmacies for any additional questions please contact the Healthcare Pharmacy Help Desk at 1-844-679-5362.

Also in Vermont, Governor Scott (R) signed a proclamation recognizing October as Pharmacists’ Month.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Effective October 1, 2021, Continuous Glucose Monitoring (CGM) systems and supplies will be available ONLY through retail pharmacy channels and will no longer be accepted via DME provider channels. Prior authorization requirements that had been waived temporarily because of the COVID-19 Public Health Emergency will be reinstated. Prescribers may send prescriptions electronically to the pharmacy or hand write prescriptions for patients. Claims will adjudicate in “real time” through the Pharmacy Point of Sale (POS) system which will allow for faster and easier access for patients. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Vermont Office of Professional Regulation has provided updated guidelines that allows Pharmacy Technicians and Interns to administer to 19 years of age and older.  It also extends the PREP Act authorization and associated liability coverage to October 2024.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.