This week, Sen. Scott Weiner (D) introduced two bills in what he calls “the prescription drug affordability package, or PDA,” aimed at reducing the cost of prescription drugs for Californians.

• SB 40: Would cap monthly insulin co-pays at $35 a month for most private health plans.
• SB 41: Would
• Require PBMs to be licensed by the Department of Insurance by January 1, 2027.
• Impose duties and reporting requirements on PBMs, with violations subject to civil penalties.
• Prohibit a contract between a PBM and a health care service plan or insurer that is executed, amended or renewed on or after January 1, 2026, from authorizing spread pricing.
• Prohibit a health care service plan contract or health insurance policy issued, amended or renewed on or after January 1, 2026, from calculating an enrollee’s or insured’s cost sharing at an amount exceeding the actual rate paid for the drug and require the contract or policy to include cost-sharing provisions.

Also in California, the Department of Health Care Services posted the following alerts, weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal.  Please note the maximum allowable ingredient cost notice with rates effective January 1, 2025. Also, on January 31, 2025, the Transition Policy will be retired and reinstatement of prior authorization (PA) requirements and other claim utilization management (UM) edits for members 21 years of age and younger will apply to both new start and continuation of therapy claims.

• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice
• Medical Supplies: Updates of the List of Contracted Pen Needles, Effective January 1, 2025
• Updates to the List of Contracted Enteral Nutrition Products, Effective January 1, 2025
• Diabetic Supplies: Updates to the Contracted Disposable Insulin Delivery Devices, Effective January 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Diabetic Testing Supplies, Effective January 1, 2025, and March 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Continuous Glucose Monitoring (CGM) Systems, Effective January 1, 2025
• Updates to the List of Contracted COVID-19 Tests, Effective January 1, 2025
• Medi-Cal Rx Monthly Bulletin for December
• Changes to the Medi-Cal Rx Contract Drugs List
• Updates to the Medi-Cal Rx Provider Manual
• 60-Day Countdown: Pediatric Integration of Members 21 Years of Age and Younger
• Mass Adjustment for TPOXX Drug Reimbursement for Impacted Claims with a Date of Service August 20, 2022, through October 1, 2024
• Mass Adjustment for Mpox Vaccine Reimbursement for Impacted Claims with a Date of Service August 17, 2022, through October 11, 2024
• Medi-Cal Rx Weekly Wrap-up for November 15-21

Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy distributes a list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. This information is available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers.

Questions or comments about the prescribers listed should be directed to the Medical Board of California.

Finally in California, the Board of Pharmacy issued a reminder. Starting January 1, 2025, licenses that are eligible for renewal will be processed online. Those who are eligible include:

• Pharmacist
• Advanced Practice Pharmacist
• Pharmacy Technician
• Designated Representative – Wholesaler
• Designated Representative – Veterinary Food-Animal Drug Retailer
• Designated Representative – 3PL (Third-Party Logistics)
• Designated Representative – Reverse Distributor

The Board of Pharmacy (Board) will no longer mail out a paper renewal application for the above licensees. In its place, a postcard reminder will be sent approximately six weeks prior to the license expiration date and the licensee will renew by going to www.pharmacy.ca.gov. The postcard is only a reminder, if the licensee does not receive a postcard, they are still required to submit their payment on-time to avoid a delinquency fee and possible cancellation of the license.

Renewal payment transactions must be completed prior to 5:00 pm Pacific Time on the date the license expires to avoid the delinquency fee. The Board recommends printing the payment confirmation at the end of this transaction for recordkeeping. Once the online payment is submitted, please allow two business days for processing.

The Board must be notified of any change in address within 30 days. Change of address may take between 7-10 business days to update in the system. If the correct address is not in the system at the time of renewal, the process may be delayed. Address changes can be made on-line or in writing to the board.

Fees are changing on January 1, 2025. The updated fee schedule with the new fees has been posted on the website.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.