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Texas

Rep. Tom Oliverson (R) filed HB 4533, a Medicaid managed care organization rate floor bill for retail and specialty pharmacies.

Also in Texas, Rep. James Frank (R) filed HB 4051, a test-and-treat bill for flu, strep, COVID and minor, uncomplicated infections. The bill also includes provisions for doctor dispensing.

Also in Texas, last week, the Texas Pharmacy Association and the Texas Pharmacy Business Council testified in support of SB 1122 at the Senate Health and Human Services Committee. This legislation codifies Attorney General Ken Paxton’s February 5, 2025, opinion letter regarding the enforceability of existing laws against health benefit plans and PBMs administering the pharmacy benefits on behalf of an ERISA plan in certain circumstances that do not dictate plan choice or add requirements to a beneficiary’s status. The Texas Association of Business and the National Federation of Independent Business (NFIB) testified in opposition to SB 1122, falsely claiming that it would impose costs to employer-sponsored ERISA health plans of over $5 billion over the next decade. Since Texas is business-friendly, several Senators expressed concerns about rising costs to small businesses. The bill was left pending in the Senate Health and Human Services Committee.

Finally in Texas, Gov. Greg Abbott (R) notified state agencies to transition remote workers back to the office to ensure the efficient use of taxpayer dollars and that state agencies remain engaged and effective in serving the public.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2025-03-13T15:49:49-04:00March 13, 2025|Texas|

Virginia

NACDS issued a NACDS RxIMPACT action alert for SB 875 and HB 2610, and urges members with operations in the Commonwealth to contact Gov. Glenn Youngkin (R) to express how critical these bills are to patient access and pharmacy viability. Should he sign the bills, Virginia would join Ohio and Kentucky as the third state to reform PBM practices in Medicaid Managed Care under a single PBM. The bills had bipartisan support and overwhelmingly passed the General Assembly a few weeks ago.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2025-03-13T15:48:48-04:00March 13, 2025|Virginia|

Wisconsin

Senate President Mary Felzkowski (R) and Representative Todd Novak (R) introduced a new bill, Cole’s Act, aimed at reforming PBMs, a critical step toward ensuring fair drug pricing, increasing transparency for healthcare purchasers and alleviating workforce challenges in the healthcare sector. The bill is named in honor of Cole Schmidtknecht of Appleton who passed away from a severe asthma attack in 2024 after his inhaler was removed from his PBM’s formulary. A bill number is not publicly available yet, but NACDS will continue to advocate for PBM policy priorities throughout the state’s legislative session.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

2025-03-13T15:48:09-04:00March 13, 2025|Wisconsin|

Wyoming

Gov. Mark Gordon (R) signed HB 82 (Chapter Number 39), legislation that requires health insurance carriers to follow specific timelines regarding healthcare provider applications for credentialing and to reimbursement healthcare providers for services rendered and requires the Department of Insurance to promulgate rules providing for a uniform credentialing application for use throughout the state.

Also in Wyoming, Department of Health officials confirmed 30 pertussis cases in the state so far this year. This is an increase over 19 reported Wyoming cases in 2024, zero in 2023, and two in 2022. The increase started in late 2024 and continued into the current year.

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

2025-03-13T15:47:13-04:00March 13, 2025|Wyoming|

Arizona

The Arizona Pharmacy Association’s Board of Directors announced the appointment of Garet Turner as the association’s new Chief Executive Officer. Most recently, Mr. Turner was the interim executive director and vice president of strategic engagement for the Association of Air Medical Services and MedEvac Foundation International. Prior to that, he served as the Chief Development Officer for the American Society of Association Executives.

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

2024-12-06T09:18:32-05:00December 6, 2024|Arizona|

Arkansas

The Joint Senate and House Insurance and Commerce Committee is meeting December 16 to discuss Rule 128, which enforces existing law prohibiting below-cost reimbursement in the commercial market. Company testimony and support letters are crucial for the success of this meeting. Rule 128 is critical for fully enforcing Act 3 of 2018, helping to prevent unreasonable underpayments that threaten patient access and addressing excessive overpayments that drive up costs.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2024-12-06T09:17:36-05:00December 6, 2024|Arkansas|

California

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.

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:

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.

2024-12-06T09:16:59-05:00December 6, 2024|California|
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