The FDA has modified the Emergency Use Authorizations (EUAs) for Pfizer-BioNTech COVID-19 vaccine and Moderna COVID-19 vaccine to allow for administration of a third dose of an mRNA COVID-19 vaccine after an initial two-dose primary mRNA COVID-19 vaccine series for certain immunocompromised people.
Topics Related to Pharmacy Providers
Not required for medications administered at the provider’s office or outpatient hospital clinic settings and billed as part of the professional claim (Physician Administered Drug Program).
Providers and pharmacies should always use NCTracks to confirm eligibility.
Guidance to pharmacies on prior authorizations that transfer from a health plan to NC Medicaid Direct.
Changes have been made to the Clinical Pharmacy Practitioners (CPPs) fee schedule to more accurately reflect the types of services provided by a CPP certified by the NC Board of Pharmacy.
The five-year cost of dispensing (COD) survey has been completed for NC pharmacies.
The information in this bulletin is only for pharmacies administering vaccines outside of the CVS/Walgreens Long-Term Care program who have the means to handle the specific storage recommendations required of the COVID-19 vaccine and will be administering it.
This information is only for non-long-term care providers who have the means to handle the specific storage recommendations required of the Moderna COVID-19 vaccine and will be administering it.
Effective April 27, 2020, prescriptions for NC Medicaid and NC Health Choice beneficiaries are eligible for the addition of a mailing or delivery fee via the guidelines below. NC Medicaid encourages beneficiaries to request, and pharmacy providers to mail or deliver prescriptions to beneficiaries, during the COVID-19 pandemic to achieve better social distancing within their community.
The Outpatient Pharmacy point of sale (POS) adult and pediatric clinical edits for behavioral health medications will temporarily suspend effective March 23, 2020. These point of sale edits target dosages exceeding the FDA approved maximum limit and in class therapeutic duplication.