Medicaid Oversight and Advisory Committee Kentucky Department for

Medicaid Oversight and Advisory Committee Kentucky Department for Medicaid Services July 29, 2020

Legend Drug Repository Program DMS Actions: • Reached out to CMS – conference call scheduled for July 28, 2020 • Polled other state Medicaid agencies: DE, IA, IN, LA, MD, MI, NV, OK, SD, VT, WY responded – MN Medicaid excluded due to the various financing mechanism, including rebates, that would have a negative impact on the program and potential for misuse of Medicaid funds benefiting a non-Medicaid member – MT stated Medicaid not addressed in rule and Medicaid agency does not track – ND does not explicitly exclude Medicaid members from receiving drugs through repository programs and they do not track members who do – OR concluded not enough savings to make the program worthwhile • No known Medicaid agency is reimbursing for drugs through legend drug repository • DPH would need a pharmacist in each local health department to receive, inspect, store, and dispense drugs 1

HB 69 (2018) Credentialing Verification Organization: • The Department developed and released Request for Proposal for single organization as a credentialing verification organization • Awarded contract June 30, 2020 • Award currently under protest 2

SB 50 (2020) Pharmacy Benefits Manager • Anticipated contract date 01/01/2021 • DMS will ensure proper communication is given to providers, members, and MCOs as we transition to single MCO PBM • Subject to CMS approval • Medicaid MCOs have received the clinical criteria for the Medicaid prescription single preferred drug list • All MCOs and FFS Medicaid will be utilizing the same single preferred drug list on 1/1/2021 3

HB 8 (2020): Ambulance Provider Tax Bill Biweekly team planning sessions Provider revenue survey finalized Target implementation date is January 2021 Final design of program requires • • – Approval of a State Plan Amendment by CMS – Regulations 4