(CMS) released an evaluation design that explains how the Agency will conduct a meta-analysis on Medicaid section 1115 Substance Use Disorder (SUD) demonstrations, which will be complete in the spring of 2023.
Section 1115 SUD demonstrations require states to increase access to SUD treatment services; increase capacity to provide services; implement widely recognized patient placement criteria and provider standards, care coordination policies, other prevention/treatment strategies.
Texas HHS Vendor Drug Vendor Reminder: "Quantity Prescribed" Required for Schedule II Drugs Beginning Sept. 21
September 2, 2020
Beginning Sept. 21, 2020, VDP will require the "Quantity Prescribed" field (460–ET) on all pharmacy claims for Schedule II drugs.
CMS published a final rule on Jan. 24, 2020
‘‘Administrative Simplification: Modification of the Requirements for the Use of Health Insurance Portability and Accountability Act of 1996 National Council for Prescription Drug Programs D.0 Standard’’
Texas HHS Vendor Drug Program (VDP) will implement a uniform opioid policy for Medicaid (both fee-for-service and managed care) and CHIP to encourage appropriate use and reduce opioid over-prescribing effective 9/1/20. #DPPRtxtxvendordrug.com/about/news/202…
1) Recently, HHS Federal Register “more or less” in very “ambiguous language” advised that the Feds were passing the buck to the States, and that States were only “liable” to adhere to “minimum Federal standards” for participation in Medicaid (qualify
2) for eligibility for Federal funding for each State Medicaid program) in reference to opioid policy, and the States were more or less “free to create” more “stringent standards” at their pleasure, hence there were “Medicaid Drug Utilization Review” meetings held in Texas
CMS wants to introduce “..new Medicaid Drug Utilization Review (DUR) provisions designed to reduce opioid related fraud, misuse and abuse..” Docket Number: CMS-2482-P federalregister.gov/documents/2020…
H. Changes Related to the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act
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“These proposals include standards that would enhance a states’ ability to identify or limit inappropriate prescribing of opioids if a beneficiary is already receiving medication assisted treatment for substance use disorder (SUD).” cms.gov/newsroom/press…