Stakeholder feedback for the audit plan will be accepted until 5:00 PM CST on August 6th.
Stakeholder feedback for the audit plan will be accepted until 5:00 PM CST on August 6th.
Recommendations from the California report touched on pharmacy topics and access to care.
The meeting discussed issues that could affect pharmacy reimbursement, statutory provider definitions, and medical accessibility reporting.
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.
While progress continues, the guideline updates are delayed due to quorum issues, and the hospital fee schedule is still in early planning stages.
A remote hearing will be held on May 28th, with comments accepted through June 5th. If enacted, changes will take effect July 1st.
Three in-progress bills impact medical reimbursement and fee schedules, prescription drug authorizations, and medical necessity evaluations.
The committee issued new recommendations related to 300 mg ibuprofen, gabapentin and pregabalin, cyclobenzaprine, and tizanidine.
Matters discussed included physician dispensing, missed appointment fees, passive therapy utilization, and interpreter bill denials.
The April 15th hybrid meeting will take place from 12:30 PM to 2:30 PM PST, covering a wide variety of pharmacy topics.
The state’s definition of “compounded prescription drug” would be updated to fall in line with federal standards.
One bill proposes the use of the ODG guidelines, while another bill would establish a fee schedule similar to neighboring states.
