NOTICE of PUBLIC SCOPING: Medicaid Pharmacy Services, Coverage and Reimbursement, including Professional Dispensing Fees and Pharmacist Rendered Professional Services.

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

7 AAC 105.610   – Recipient cost-sharing (Pharmacy–related)

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

7 AAC 110         – Provider requirements, Pharmacy–related professional services

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 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 coverage and reimbursement related to Medicaid Pharmacy Professional Dispensing Fees, pharmacist rendered professional services, covered outpatient drugs, and cost sharing.

The purpose of this notice is to engage Medicaid-enrolled providers, healthcare professional organizations, Medicaid recipients, and the general public in the process to solicit ideas and suggestions related to possible revisions to the regulations referenced. Handouts for the meeting will be available the day of the meeting on the division’s website at Health Care Services (alaska.gov). 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 Coverage and Reimbursement of Medicaid Pharmacy Services including Professional Dispensing Fees and Pharmacist Rendered Professional Services, 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 June 4th, 2021. Please send all submissions by email to jolene.withers@alaska.gov or by mail to Division of Health Care Services, Attention: Jolene Withers, 4601 Business Park Blvd., Building K, Anchorage, AK 99503-7167.

You may submit ideas and suggestions telephonically at a public scoping session to be held on May 24th, 2021 via teleconference/WebEx. The scoping session will begin at 1:00 p.m. AKST and will end at 2:00 p.m. AKST.

You can access the Webex at this link: https://stateofalaska.webex.com/stateofalaska/j.php?MTID=m0961687baec8769d4dc4f06bf37083e8

Meeting ID: 177 114 5926

WebEx audio will be disabled, so please call in via the conference line below.

If you wish to give your comments via telephone, please call 800.954.0591.  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 not later than May 20th, 2021 to ensure that any necessary accommodations can be provided.