TPA attended the Vendor Drug Program’s (VDP) quarterly meeting for pharmacy stakeholders this week. Topics of discussion included Medicaid’s response to the opioid crisis, prescriber enrollment, outstanding balances and the specialty drug list.
Regarding the opioid crisis, VDP shared they are currently discussing the implementation of safety prior authorizations for opioid medications and increasing access to Naloxone/Narcan. On prescriber enrollment, see article below “Process for Claims That Deny When Prescriber Not Enrolled.”
As for outstanding balances, VDP has recently identified pharmacies with outstanding balances and are in the beginning phases of addressing these outstanding balances. VDP did make sure to note that many of these outstanding balances are the result of the limited number of patients still being serviced under fee-for-service. If your payments from VDP are up to-date, no need to worry; however, if they are not, VDP will be working with you to bring your account back into balance. As this moves forward , VDP will be providing TPA and the other pharmacy organizations additional information to help you work through the problem.
Lastly, VDP discussed the recent changes to the specialty drug list that has resulted in numerous questions and concerns from pharmacy. VDP is committed to working with TPA and pharmacy to address these questions and concerns.
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