Impacted items would include pharmacy and topical reimbursement, home health, prior authorization, and more.
Impacted items would include pharmacy and topical reimbursement, home health, prior authorization, and more.
Stakeholder feedback for the audit plan will be accepted until 5:00 PM CST on August 6th.
The meeting discussed issues that could affect pharmacy reimbursement, statutory provider definitions, and medical accessibility reporting.
Topics covered include a new AI innovation office, a remote interpreters program, and updates for rulemaking and audits.
The August 20th webinar will discuss the impact of PBM legislation on workers' compensation systems.
A public hearing will be held on September 14th. with written comments accepted until October 5th.
The Committee is focused on high-cost and high-utilization medications, including GLP-1s, PPIs, anticonvulsants, topical agents, and biologics.
Commenters asked the DWC to clarify the scope of pharmacy and pharmacist definitions and prior authorization requirements.
The Fourth Edition of the AMA Guidelines have been in use since 2000 and would be updated to the Six Edition, published 2025.
The hearing will take place on July 15th, allowing interested stakeholders to attend virtually.
As part of proposed updates to the Healthcare Service rules and the state fee schedule, additional changes are up for debate.
The proposed rules would align with the February 2026 ruling on physician dispensing in Publix Super Markets, Inc. v. Department of Financial Services.
Targets for consideration include pharmacy rules, physical therapy, DME, and ancillary services.
A remote hearing will be held on May 28th, with comments accepted through June 5th. If enacted, changes will take effect July 1st.
The DWC will work with system participants to develop the audit plan, including timeframe, size, and case selection.
