Kentucky Medicaid Services Updates July 2020
Stay informed on recent updates from the Kentucky Department for Medicaid Services, including the Medicaid Oversight and Advisory Committee, Legend Drug Repository Program, Credentialing Verification Organization, Pharmacy Benefits Manager changes, and Ambulance Provider Tax Bill for 2020. Keep track of important developments and upcoming changes in the Medicaid system.
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Presentation Transcript
Medicaid Oversight and Advisory Committee Kentucky Department for Medicaid Services July 29, 2020
Legend Drug Repository Program DMS Actions: Reached out to CMS conference call scheduled for July 28, 2020 Polled other state Medicaid agencies: DE, IA, IN, LA, MD, MI, NV, OK, SD, VT, WY responded MN Medicaid excluded due to the various financing mechanism, including rebates, that would have a negative impact on the program and potential for misuse of Medicaid funds benefiting a non-Medicaid member MT stated Medicaid not addressed in rule and Medicaid agency does not track ND does not explicitly exclude Medicaid members from receiving drugs through repository programs and they do not track members who do OR concluded not enough savings to make the program worthwhile No known Medicaid agency is reimbursing for drugs through legend drug repository DPH would need a pharmacist in each local health department to receive, inspect, store, and dispense drugs 1
HB 69 (2018) Credentialing Verification Organization Credentialing Verification Organization: The Department developed and released Request for Proposal for single organization as a credentialing verification organization Awarded contract June 30, 2020 Award currently under protest 2
SB 50 (2020) Pharmacy Benefits Manager Anticipated contract date 01/01/2021 DMS will ensure proper communication is given to providers, members, and MCOs as we transition to single MCO PBM Subject to CMS approval Medicaid MCOs have received the clinical criteria for the Medicaid prescription single preferred drug list All MCOs and FFS Medicaid will be utilizing the same single preferred drug list on 1/1/2021 3
HB 8 (2020): Ambulance Provider Tax Bill Biweekly team planning sessions Provider revenue survey finalized Target implementation date is January 2021 Final design of program requires Approval of a State Plan Amendment by CMS Regulations 4
