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Notice of Public Scoping: Medicaid Pharmacy Covered Outpatient Drug Coverage and Reimbursement Methodology - In-State, Out-of-State, and Physician/Clinic Administered Medication Reimbursement Regulations

7 AAC 105.130 – Services requiring prior authorization (Pharmacy–related)

7 AAC 105.200 – Eligible Medicaid providers (Pharmacy–related)

7 AAC 120.100 – Provider requirements (Pharmacy–related)

7 AAC 120.110 – Covered outpatient drugs and home infusion therapy

7 AAC 120.112 – Non-covered drugs

7 AAC 120.120 – Drug use review

7 AAC 120.130 – Interim and final prior authorization medication lists and limitations on prescribed drugs

7 AAC 120.140 – Preferred drug list

7 AAC 145.400 – Covered outpatient drug payment rates and home infusion therapy drug rates

7 AAC 145.410 – Dispensing fee

7 AAC 160.900 – Requirements adopted by reference (Pharmacy–related)

The Department of Health and Social Services, Division of Health Care Services is reviewing current Medicaid Pharmacy Covered Outpatient Drug Coverage and Reimbursement Methodology -- In-State, Out-of-State, and Physician/Clinic Administered Medication Reimbursement regulations with the intent to revise and update coverage and reimbursement for covered outpatient drugs.

The purpose of this notice is to ask Medicaid-enrolled providers, healthcare professional organizations, Medicaid recipients, and the general public for ideas and suggestions for possible updates or revisions to these regulations. Ideas and suggestions can be as broad or as narrow, or as general or specific as a submitter may wish, but they should pertain only to Medicaid services and the Alaska Administrative Code chapters cited above.

If and when the Division of Health Care Services drafts new proposed regulations or amendments related to Medicaid Pharmacy Covered Outpatient Drug Coverage and Reimbursement Methodology -- In-State, Out-of-State, and Physician/Clinic Administered Medication Reimbursement, those proposed revisions will be noticed and made available for public review and comment under the Administrative Procedure Act AS 44.62.

Written suggestions, ideas, and other input will be accepted until 5:00 p.m. AKST on February 28th, 2020. Please send all submissions by email to jolene.withers@alaska.gov or by mail to Division of Health Care Services, Attention: Jolene Withers, 4501 Business Park Blvd., Building L, Anchorage, AK 99503-7167.

You may submit ideas and suggestions in person or telephonically at a public scoping session to be held on February 21st, 2020 at the Frontier Building, 3601 C Street, Suite 880, Anchorage, AK 99503. The scoping session will begin at 12:30 p.m. AKST and will end at 2:00 p.m. AKST. If you wish to give your comments via telephone, please call 800.678.2887. The facilitator may limit each participant’s length of comments to allow enough time for all those who have called in or signed up and timely registered to participate.

If you are a person with a disability who needs a special accommodation in order to participate in this process, please contact Jolene Withers at jolene.withers@alaska.gov or at 907.334.2446 not later than February 14th, 2020 to ensure that any necessary accommodations can be provided. 

Attachments, History, Details

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Revision History

Created 2/5/2020 1:52:03 PM by smdunkin

Details

Department: Health and Social Services
Category: Regulations
Sub-Category: Pre-notice public input
Location(s): Statewide
Project/Regulation #:
 
Publish Date: 2/5/2020
Archive Date: 2/29/2020
 
Events/Deadlines: