Programs
Regulatory Updates
Total of 165 Records Returned
State: Michigan
Michigan Pharmacy Benefits Managers
Date Proposed : 02/24/2021
Date Effective : 01/1/2024
Date Adopted : 02/23/2022
Program: Pharmacy
(4) Except as otherwise provided in a contract between a mail-order pharmacy or specialty pharmacy and a carrier, health plan, or pharmacy benefit manager, the carrier, health plan, or pharmacy benefit manager shall not require pharmacist or pharmacy accreditation standards or recertification requirements inconsistent with, more stringent than, or in addition to federal and state requirements to obtain reimbursement for a covered drug.
Read MoreState: Kentucky
Kentucky Renal Dialysis
Date Proposed : 05/14/2021
Program: Renal Dialysis
This administrative regulation establishes the requirements for dialysis technician training programs. KY 24273 2021
Read MoreState: Colorado
Hospice Inpatient Unit – Specialized Prescription Drug Outlet
Date Proposed : 02/17/2022
Date Effective : 08/10/2022
Date Adopted : 06/8/2022
Program: Hospice, Pharmacy
(b) A pharmacy located in a hospice inpatient unit may register as a specialized prescription drug outlet if the pharmacy compounds drugs and devices and dispenses and delivers the drugs and devices, or provides pharmacist care services, to residents of the hospice inpatient unit.
Read MoreState: All
Surgical Dressings – Medicare Requirements
Date Posted : 02/24/2022
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
Medicare covers primary or secondary surgical dressings:
- Used to protect or treat a wound
- If needed after debridement of a wound
State: All
DME – CMS expands access to home oxygen services
Date Posted : 02/10/2022
Date Effective : 09/27/2021
Program: Durable Medical Equipment, Prosthetics, Orthotics, and Supplies
The guidance, Change Request 12607, makes the following changes effective for claims with a date of service starting Sept. 27, 2021:
- Expansion of oxygen coverage for acute and chronic conditions (when hypoxemia exhibited).
- Expansion of oxygen coverage for short and long-term need (when hypoxemia exhibited).
- DME MACs may determine whether ordered oxygen and oxygen equipment are reasonable and necessary.
- Removal of Home Oxygen Use for Cluster Headache (240.2.2) and allowing DME MACs to make coverage determinations for patients with cluster headaches.
State: Oklahoma
OK – Private Duty Nursing
Date Proposed : 12/1/2021
Program: Private Duty
Amends rules to update how assessments for private duty nursing (PDN) services are conducted. Additional revisions will clarify who can sign the PDN treatment plan. Finally, revisions will update grammatical and formatting errors, as well as reorganization of the policy for better clarity and understanding. OK 20553 2022
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Accreditation Commission for Health Care, Inc.