Pharmacy Reimbursement changes will be implemented retrospectively upon CMS State Plan Amendment (SPA) approval
On February 1, 2016, the Centers for Medicare and Medicaid Services (CMS) published 42 CFR, Part 447: Medicaid Program Covered Outpatient Drugs with final comments (CMS-2345-FC). This rule addresses regulations pertaining to reimbursement for covered outpatient drugs in the Medicaid program. In accordance with this rule, all states must submit an amendment to its State Plan by June 30, 2017, to CMS with an effective date of no later than April 1, 2017, to be in compliance with the new reimbursement requirements.
The Mississippi Division of Medicaid (DOM) submitted State Plan Amendment (SPA) 17-0002 Pharmacy Reimbursement to the Centers for Medicare and Medicaid Services (CMS) on March 15, 2017.
Reimbursement changes will be implemented retrospectively upon CMS approval. Pharmacy POS claims with a date of service on or after April 1, 2017, will be mass adjusted according to the CMS’ approved reimbursement methodology. Pharmacy providers will be notified when CMS approves SPA 17-0002.
Deadline extended for 340B Covered Entity Attestation Enrollment Form
The deadline for 340B covered entities to complete the Initial 340B Covered Entity Attestation Enrollment Form and submit to Conduent has been extended to May 1, 2017.
Billing requirements defined in the cover letter and instructions of the Initial 340B Covered Entity Attestation Enrollment Form for providers who have elected to opt-in, will be effective on July 1, 2017.
Additional information about the 340B program may be found at the Medicaid website: https://medicaid.ms.gov/providers/pharmacy/340b-program/