NOTICE OF PROPOSED CHANGES IN THE REGULATIONS OF THE
DEPARTMENT OF HEALTH AND SOCIAL SERVICES
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BRIEF DESCRIPTION
The Department of Health and Social Services proposes to require that pharmacies distribute a pamphlet to recipients that have a claim rejected because the prescription requires prior authorization.
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The Department of Health and Social Services proposes to adopt regulation changes in Title 7, Chapters 120 and 160, of the Alaska Administrative Code, dealing with Medicaid pharmacy claims that are rejected due to the need for prior authorization, including the following:
- 7 AAC 120.130, Interim and final prior authorization medication lists and limitations on prescribed drugs, is proposed to be amended to require pharmacies to distribute an informational pamphlet to recipients that have a prescription claim rejected because it requires prior authorization.
- 7 AAC 160.900, Requirements adopted by reference, is proposed to be
amended to adopt by reference a pamphlet for recipients that explains their rights
and options for dealing with a rejected claim due to prior authorization being
required.
You may comment on these proposed regulation changes, including the potential costs to private persons of complying with the proposed changes, by submitting written comments to Chad Hope, Medicaid Pharmacy Program Manager, Department of Health and Social Services, Division of Health Care Services, 4501 Business Park Blvd., Suite 24, Anchorage, AK 99524-0249; E-mail: chad.hope@alaska.gov
The comments must be received no later than 4:00 p.m. on July 31, 2014.
If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Chad Hope at the address above or by phone at (907) 334-2654 no later than July 24, 2014 to ensure that any necessary accommodations can be provided.
For a copy of the proposed regulation changes, contact Chad Hope at the address, phone number, or E-mail address above, or go to the Alaska Online Public Notice System website at: http://aws.state.ak.us/OnlinePublicNotices/ and click on the attachment at the bottom of the page for this public notice.
After the public comment period ends, the Department of Health and Social Services will either adopt these or other provisions dealing with the same subject, without further notice, or decide to take no action on them. The language of the final regulations may be different from that of the proposed regulations. You should comment during the time allowed if your interests could be affected.
Statutory Authority: AS 47.05.010, AS 47.05.012, AS 47.07.030, AS 47.07.040.
Statutes Being Implemented, Interpreted, or Made Specific: AS 47.05.010,
AS 47.05.012, AS 47.07.030, AS 47.07.040.
Fiscal Information: The proposed regulation changes are not expected to require an increased appropriation.
Date: 6/25/2014
/s/William J. Streur, Commissioner
Department of Health and Social Services
ADDITIONAL REGULATIONS NOTICE INFORMATION
(AS 44.62.190(d))
1. Adopting agency: Department of Health and Social Services
2. General subject of regulation: Pharmacy benefits and prior authorization.
3. Citation of regulation (may be grouped): 7 AAC 120 and 160.
4. Reason for the proposed action:
( ) compliance with federal law
( ) compliance with new or changed state statute
(X) compliance with court order
(X) development of program standards
( ) other: (please list)
5. RDU/component affected: Division of Health Care Services
6. Cost of implementation to the state agency and available funding (in thousands of dollars):
Initial Year Subsequent
FY 15 Years
Operating Cost $0 $0
Capital Cost $0________ $0_______
Federal receipts $0 $0
General fund match $0 $0
General fund $0________ $0________
General fund/
program receipts $0 $0________
General fund/
mental health $0________ $0________
Other funds (specify) $0________ $0________
7. The name of the contact person for the regulations:
Chad Hope Medicaid Pharmacy Program Manager
Division of Health Care Services
4501 Business Park Blvd., Suite 24
Anchorage, AK 99524-0249
E-mail: chad.hope@alaska.gov
8. The origin of the proposed action:
__X__ staff of state agency
_____ federal government
_____ general public
_____ petition for regulation change
__X__ other (please list)_____legal settlement_________
9. Date:6/25/2014
Prepared by: Kurt D. West, Project Coordinator