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Click on the black accordion bars below to see more information about important news topics.

  • Michigan Medicaid's Medication Therapy Management Program
  • Changes to Nurse Practitioner CII Prescriptive Authority
  • Cumulative Opioid Edits Begin to Take Effect
  • Update on Identifying Victims of Human Trafficking Education Requirements
  • Business and Professional Liability Insurance Needs

NPI, CHAMPS and MTM CE - April 6, 2017

To participate in Medicaid's new MTM program, pharmacies and pharmacists must take several steps to ensure they are ready and eligible to provide services to patients. 

The Pharmacy must 
  • Be enrolled in the Community Health Automated Medicaid Processing System (CHAMPS)
  • Have a private or semi-private space separate from commercial business for patient consultation
Individual pharmacists performing MTM must
  • Have successfully completed an MTM continuing education program approved by ACPE
  • Have an Individual (Type 1) National Provider Identifier (NPI)
  • Be enrolled in CHAMPS as an individual
    • Enrollment in CHAMPS is now live for individual pharmacists. The MTM CE program referenced above also contains information about enrolling in CHAMPS. Registration for CHAMPS occurs through Michigan's single sign on portal available at https://milogin.michigan.gov.
  • Be affiliated with a providing pharmacy, Federally Qualified Health Center, Tribal Health Center or Rural Health Clinic registered with CHAMPS

Michigan Medicaid Updates - April 4, 2017

We have been alerted by the Michigan Department of Health & Human Services (MDHHS) that many pharmacies have not adjusted their dispensing fee from $2.75 to the maximum $10.80 that is allowed by the new reimbursement schedule for the Medicaid Fee-for-service program. Pharmacies are advised to look at their claims submission processes to make sure the appropriate dispensing fee has been submitted.

Additionally, we have heard concerns regarding potential errors in the accuracy of NADAC reimbursement rates for Michigan Medicaid claims. We have reached out to MDHHS regarding this issue and they are looking into the concerns.

Lastly, MPA met with the Office of the Inspector General (OIG) Friday, Mar. 31, 2017 to discuss concerns expressed by pharmacies and open a dialogue about current auditing practices. The OIG offered some insights into their auditing mechanism, clarification about the criteria they use to initiate audits and suggestions for pharmacies as to how to be better prepare for these audits. More information related to this will be made available in the near future.

If you have any questions, please contact us at Info@PSI.solutions.

Michigan Medicaid's Medication Therapy Management Program

On Friday, Feb. 24, 2017, Michigan Medicaid released a bulletin outlining a new Medication Therapy Management (MTM) service that pharmacists will be able to provide for many Medicaid patients beginning April 1, 2017. Click here to see a full copy of the bulletin (which also includes information about the new Medicaid reimbursement and dispensing fees). It outlines the requirements for pharmacist eligibility to provide the MTM services along with the patient eligibility, documentation and billing standards that must be followed.

PSI believes this is a great opportunity for community pharmacists to have a big impact on Medicaid patients, and we have a solution to help make the process of completing MTM sessions for these patients easier. We are building a community pharmacy network and will be offering tools to support you in clinical endeavors such as this MTM program. If you are interested in learning about our network, please complete the form here. To respect the confidentiality of our partners, we must request each interested pharmacy sign a non-disclosure agreement. Once we have a signed agreement, we will be able to share additional information. By completing this form, you are providing us with contact information to allow us to send you the non-disclosure agreement for your review. You will have an opportunity to review the non-disclosure agreement without any further obligation before proceeding.

Changes to Nurse Practitioner CII Prescriptive Authority

New rules from the Michigan Board of Medicine have been filed with the state and are effective as of Dec. 6, 2016. One of the rules now permits nurse practitioners (NPs) to prescribe up to a 30-day supply of schedule two (CII) controlled substances. Previous restrictions that limited NPs to prescribing a seven-day supply of a CII upon discharge have been lifted, but only for NPs practicing under the delegated authority of a Medical Doctor (MD). Analogous rule changes from the Board of Osteopathic Medicine and Surgery (BOMS) are in the process of promulgation, but these rules have not been filed with the state and are thereby not yet effective. It is expected that the corresponding BOMS rules will be filed by the end of the year. Pharmacy Services Inc. (PSI) and Michigan Pharmacists Association (MPA) will continue to keep you apprised of changes as they occur. The language of the new rule governing NP prescribing under delegated authority can be found below. If you have any questions, please contact us at Info@PSI.solutions.


Rule 338.2411 Delegation of prescribing controlled substances to nurse practitioner or nurse midwife; limitation.

Rule 111. (1) A physician may delegate the prescription of controlled substances listed in schedules 2 to 5 to a registered nurse who holds a specialty certification under section 17210 of the code, MCL 333.17210, with the exception of a nurse anesthetist, if the supervising physician establishes a written authorization that contains all of the following information:

·         The name, license number, and signature of the supervising physician.

·         The name, license number, and signature of the nurse practitioner or nurse midwife.

·         The limitations or exceptions to the delegation.

·         The effective date of the delegation.

(2) The supervising physician shall review and update a written authorization on an annual basis from the original date or the date of amendment, if amended. The supervising physician shall note the review date on the written authorization.

(3) The supervising physician shall maintain a written authorization at the supervising physician’s primary place of practice.

(4) The supervising physician shall provide a copy of the signed, written authorization to the nurse practitioner or nurse midwife.

(5) The supervising physician shall ensure that an amendment to the written authorization is in compliance with subrules (1), (2), (3), and (4) of this rule.

(6) A supervising physician shall not authorize a nurse practitioner or a nurse midwife to issue a prescription for a schedule 2 controlled substance with a quantity greater than a 30-day supply.

(7) A supervising physician shall not delegate the prescription of a drug or device individually, in combination, or in succession for a woman known to be pregnant with the intention of causing either a miscarriage or fetal death.

Cumulative Opioid Edits Begin to Take Effect

Pharmacy Services Inc. and Michigan Pharmacists Association (MPA) recently became aware that some Medicaid plans have already implemented restrictions on opioid dosing based on Morphine Equivalent Dosing (MED).  These dose limitations are in alignment with policy changes recently proposed and/or implemented at state and federal levels. Most healthcare payers are expected to soon follow suit and implement their own restrictions.

Beginning Jan. 1, 2017, all Medicare plans will be required by CMS to implement a cumulative opioid safety edit for many Schedule II narcotics, including hydrocodone, tramadol, codeine and oxycodone containing products. Claims submitted that exceed 250 mg MED for patients will reject with messaging indicating that prior authorization is required. Note that this calculation considers all opioid containing products that a patient is currently taking. MPA strongly advises against dispensing quantities exceeding this daily threshold as cash transactions. Dispensing these medications via cash transactions for current patients may violate the terms and conditions in the pharmacy’s contract with the health payer and expose the pharmacy to potentially increased liability.

Pharmacists are encouraged to notify patients and prescribers about this change and to work collaboratively to ensure that the patient’s pain is managed appropriately given these new parameters. Pharmacists may also want to consider utilizing MED charts or calculators such as the one provided by the NYC Department of Health and Mental Hygiene (Apple app or Android app) to anticipate problems as new opioid prescriptions are received.

If you have any questions regarding this, or other payer-related issues, please contact us at Info@PSI.solutions.

Update on Identifying Victims of Human Trafficking Education Requirements

Have you taken the necessary steps to meet the human trafficking education requirements for health professionals?

Effective Jan. 14, 2015, a new law amending the Michigan Public Health Code (MCL 333.16148) was put in place that requires all licensed health professionals in the state of Michigan to complete training related to identifying victims of human trafficking. This law was passed recognizing that health professionals, including pharmacists and pharmacy technicians, may be more likely to encounter a potential victim of human trafficking while delivering patient care than the average worker or citizen of the state. This requirement applies to all license or registration renewals beginning with the first renewal cycle after the rules are promulgated by the Board of Pharmacy and for an initial license or registration issued five or more years after the rules are promulgated.  The rules approved by the Board of Pharmacy state that the training must cover all of the following topics:

  • Understanding the types and venues of human trafficking in the United States
  • Identifying victims of human trafficking in health care settings
  • Identifying the warning signs of human trafficking in health care settings for adults and minors
  • Resources for reporting the suspected victims of human trafficking   

Additionally, acceptable providers or methods of training include:

  • Training offered by a nationally-recognized or state-recognized, health-related organization.
  • Training offered by, or in conjunction with, a state or federal agency.
  • Training obtained in an educational program that has been approved by the Board of Pharmacy for initial licensure or by a college or university.
  • Reading an article related to the identification of victims of human trafficking that meets the requirements of the law and is published in a peer review journal, health care journal, or professional or scientific journal.  


In order for a licensee to prove they have completed the appropriate training, he or she must produce a proof of completion certificate issued by the training provider, or complete a qualified self-certification as recognized by the state.  PSI’s training module, “Identifying Victims of Human Trafficking,” meets all of the requirements set forth by the law and the administrative rules.  The training provides a low-cost pathway to compliance for both pharmacists and pharmacy technicians.

For institutions interested in licensing content that meets the state's requirements, visit PSI's Products page.

For individuals interested in obtaining continuing education credit in addition to meeting the licensure requirement, please visit Michigan Pharmacists Association's Identifying Victims of Human Trafficking continuing education page to register.

Business & Professional Liability Insurance Needs

Do you have all the coverage that a pharmacist needs for your non-medical activities?

As a pharmacist, you not only provide direct patient care in the pharmacy but also likely use your skills and knowledge in other settings. Many pharmacists speak at seminars, conduct training programs, serve as expert witnesses, teach in an academic institution or perform consulting services in addition to--or instead of--direct patient care.

Depending on the exact nature of your activities, even your personal professional liability insurance policy may not provide enough coverage. For example, consulting activities carry unique legal risks and may increase your exposure to the risk of a lawsuit. Do you know if you are fully protected today?

Through the PSI Insurance Agency, HPSO offers a Consulting Services Liability Endorsement that can be added to HPSO's professional liability policy for only $25 a year. This endorsement will provide additional protection for lawsuits resulting from advice, testimony or consulting services a pharmacist provides as a licensed medical professional. (This coverage is not currently available to pharmacy technicians.) HPSO also provides a Case Management endorsement for pharmacists who are managing a patient's total care—developing, assessing and coordinating treatment plans; or conducting utilization reviews. These endorsements are available to pharmacists whether they are working full-time, part-time, employed or self-employed. 

To add one or both of these endorsement policies to your HPSO professional liability insurance policy, contact the PSI Insurance Agency today at (517) 484-1467. If you don’t have an individual liability insurance policy, call one of the knowledgeable agents at PSI Insurance Agency today to learn why you need this protection even if you think your employer is covering you!

Interested in learning more about your risks as a healthcare professional? Read the HPSO report, “2013 Pharmacists Liability: A Ten-Year Analysis.”