Erica Joyner – Page 41 – In The States

Missouri

Gov. Mike Parson (R) signed SB 63 into law, which makes it the 50^th state to create a statewide prescription drug monitoring program. The bill establishes the Joint Oversight Task Force of Prescription Drug Monitoring, responsible for collecting and maintaining the prescription and dispensation of prescribed controlled substances to patients within the state. It also extends the expiration date of the RX Cares for Missouri Program to August 28, 2026.

Also in Missouri, the Department of Social Services, MO HealthNet Division, issued two new proposed rules requesting comments by July 1, 2021. Both are currently in effect as emergency rules expiring February 24, 2022.

Proposed rule removes obsolete provisions and references new provisions establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid.
Proposed rule establishes the payment methodology for covered entities under the 340B drug pricing program that chooses to carve in Medicaid.

Also in Missouri, the Board of Pharmacy issued a final rule effective June 30, 2021, removing the limit on the number of intern pharmacist practice hours that may be earned per week.

Also in Missouri, the Department of Commerce and Insurance issued a proposed rule to establish the license application process and a $1,000 application fee for pharmacy benefit managers. The rule replaces a September 15, 2020, proposed rule. Comments are due on June 16^th, and a public hearing will be held on June 17, 2021.

Also in Missouri, the Board of Pharmacy is soliciting comments on two proposed rules:

Proposed rule rescinds regulations regarding pharmacy operating procedures during declared disasters. A concurrent proposed rule would readopt the provisions to address both disasters and state/federal emergencies. Comments are due June 16, 2021.
Proposed rule adopts regulations establishing guidelines for temporary pharmacy operations during an emergency or declared disaster. The rule would replace pharmacy disaster operation procedures that are proposed for repeal concurrently.

Also in Missouri, the Board of Pharmacy recently approved two final rules 20 CSR 2150-5.025 and 20 CSR 2220-6.050 which allows pharmacy technicians to administer vaccines under the supervision of a state-licensed pharmacist according to a written protocol with a licensed physician who is actively engaged in the practice of medicine. The rule is issued in response to the COVID-19 pandemic effective July 30, 2021.

Lastly in Missouri, the Department of Social Services, MO HealthNet Division issued three final rules effective July 30, 2021.

Final rule adds an exception to the 31-day supply maximum restriction on medications reimbursed by the division on behalf of participants eligible for the fee-for-service programs, and an exception to allow for a 90-day supply requirement for select medications established in a concurrent rule. The rule also replaces references to “recipient” and “patient” with “participant.”
Final rule adopts a 90-day supply requirement per dispensing on select medications reimbursed by the division on behalf of participants eligible for Medicaid fee-for-service programs.
Final rule revises the amount of the professional dispensing fee reimbursable for MO HealthNet covered prescriptions by pharmacy providers.

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

Erica Joyner2021-06-11T15:09:45-04:00June 11, 2021|Missouri|

Montana

SB 395 Chapter Number: 501, establishing licensure, reporting, marketing, and advertising, network adequacy requirements, and 340B related provisions for PBMs, was signed by Gov. Greg Gianforte (R) on May 12, 2021.

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

Erica Joyner2021-06-11T15:09:28-04:00June 11, 2021|Montana|

Nebraska

Effective July 1, 2021, the METAVIR fibrosis score required for coverage by Nebraska Medicaid will be changed to F0. The current prior authorization criteria require a METAVIR fibrosis score of at least F2. These changes mean that patients with a METAVIR fibrosis score of F0 may have their prescribed antiviral medications to treat hepatitis C be covered by Nebraska Medicaid. Prior authorization for Hepatitis C antiviral medications will continue to be in place. See Provider Bulletin 21-11 for additional details.

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

Erica Joyner2021-06-11T15:09:16-04:00June 11, 2021|Nebraska|

Ohio

This week the full Senate passed their budget bill by a party-line vote. The passed version appropriates $5 million for Fiscal Year 2022 and $10.15 million for Fiscal Year 2023, plus Federal Medical Assistance Percentages to fund the Managed Care Supplemental Dispensing Fee. NACDS worked in partnership with the Ohio Council of Retail Merchants to advocate that funding for this program continue. It is not included in the competing versions of the budget as proposed by the Governor and the House. We will continue to champion this line item as budget negotiations continue over the next two weeks.

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

Erica Joyner2021-06-11T15:09:02-04:00June 11, 2021|Ohio|

Oklahoma

HB 2677, amending the audits and administrative appeals procedures, was signed by Gov. Kevin Stitt (R) on May 4, 2021.

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

Erica Joyner2021-06-11T15:08:51-04:00June 11, 2021|Oklahoma|

South Carolina

The Board issued several emergency orders to allow for the safe and effective care of patients during an unprecedented pandemic. The Board has continually reviewed these orders and made adjustments as necessary. Effective July 1, 2021, all Board-issued emergency orders are scheduled to be rescinded. Please begin planning now. Those orders pertain to Safe Harbor regarding the reuse of personal protective equipment, pickup kiosks, and remote order entry outside of a licensed facility. Those orders can be here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2021-06-11T15:08:35-04:00June 11, 2021|South Carolina|

Texas

NACDS sent a letter to Gov. Greg Abbott (R) urging him to sign HB 1919 into law, legislation that would help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and pharmacy benefit managers from “steering” patients to use any particular in-network pharmacy provider over another. In addition, we have been urging member companies to also contact the Governor’s office.

Also in Texas, the Board of Pharmacy hired a new Executive Director/Secretary Tim Tucker, Pharm.D., replacing Allison Benz who announced earlier this year that she would be retiring on August 31, 2021. The Texas press release can be found here.

Also in Texas, the Board of Pharmacy adopted several rules that became effective June 9, 2021.

Final rule extends the time that Schedule II prescriptions are valid to 30 days to conform to federal standards and removes a reference to the effective date of the pharmacy responsibility provisions.
Final rule allows pharmacists to electronically sign the data entry attestation statement. The rule also updates references to the DEA 222 order form requirements for distributing Schedule II controlled substances.
Final rule extends the time that Schedule II prescriptions are valid to 30 days to conform to federal standards.
Final rule corrects statutory and regulatory cross-references in the requirements on pharmacy operation.

Also in Texas, the Health and Human Services Commission has several COVID-related upcoming weekly seminars now open for registration.

Webinar Tuesdays: Actively Administering & Advanced VAOS Users: For COVID-19 vaccine coordinators and providers who have received an order of the COVID-19 vaccine and are actively administering the vaccines. The state will share important news updates, clinical considerations, and advanced user tips on the systems and processes to support you.
- June 15, 12:00PM-1:30PM CT – Register here
- June 22, 12:00PM-1:30PM CT – Register here
- June 29, 12:00PM-1:30PM CT – Register here
Webinar Thursdays: Basics & Beginners: For providers who are new to the COVID-19 vaccine management program and/or have not yet received an order of the vaccine. We discuss important news updates, how to access VAOS, and how to get started with placing orders.
June 17, 12:00PM-1:30PM CT – Register here
June 24, 12:00PM-1:30PM CT – Register here

Lastly in Texas, the Health and Human Services Commission (HHSC) will resume publication of the quarterly Specialty Drug List in July. Please see the stakeholder notice.pdf for more information

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

Erica Joyner2021-06-11T15:08:19-04:00June 11, 2021|Texas|

Washington

The Health Care Authority issued a final rule changing the time frame in which manufacturers must report new drugs marketed in the state and incorporate the prescription drug pricing transparency program’s nondisclosure agreement.

Also in Washington, effective July 1, 2021, Apple Health (Medicaid) which is administered by the Health Care Authority (agency) will implement changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program. Please view the MAC memo for more details. Additionally, the full SMAC list can be found on the agency’s Provider billing guides and fee schedules website under the Prescription Drug Program and applies to claims billed FFS.

Also in Washington, effective for claims with dates of service on and after July 1, 2021, Apple Health (Medicaid) updated the pharmacy Expedited Authorization (EA) List. On the Provider Billing Guides and Fee Schedules Page, scroll to Prescription Drug Program Billing Guides to access.

Also in Washington, the Office of the Insurance Commissioner issued a notice extending the Emergency Order 20-01 requiring health insurers to waive copays and deductibles for COVID-19 testing. The order also requires insurers to allow a one-time early refill for prescription drugs, suspends any prior authorization requirement for treatment or testing of COVID-19, and allows enrollees to be treated by out-of-network providers within a reasonable distance at no additional cost when the insurer does not have enough in-network medical providers.

Lastly in Washington, the Department of Health issued a final rule effective June 18, clarifying dispensers must submit information to the prescription monitoring program as soon as possible, but no later than one business day. The rule also removes the requirement that a facility or entity be a trading partner with the state’s health information exchange to have access to the prescription monitoring program.

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

Erica Joyner2021-06-11T15:08:06-04:00June 11, 2021|Washington|

California

For veterinary prescriptions that may not be refilled between May 1, and June 30, 2021 (due to the one-year time limitation on prescriptions), the director of the Department of Consumer Affairs extends an order waiving the California Code of Regulations, title 16, section 2032.1, subdivision (c) to the extent it prohibits a veterinarian from prescribing a drug for a duration longer than one year from the date the veterinarian examined the animal and prescribed the drug, subject to the condition that any such prescription may be refilled for a total period not to exceed 18 months from the date the veterinarian last examined the animal and prescribed the drug.

Also in California, recent Medi-Cal Rx News updates include the following:
• The Pharmacy Provider Self-Attestation Process has been extended through May 9, 2021, and has a new web address. If your company already submitted your self-attestation and received a confirmation email from CODSurvey@mercer.com, please disregard April 30, 2021, notice.
• Changes to the Contract Drugs List have been made effective May 1, 2021.
• Changes to the Contract Drugs List – Authorized Drug Manufacturer Labeler Codes have also been made effective May 1.

Lastly in California, the Medi-Cal Update Bulletin 990 – April 2021 includes the following items of interest. See bulletin for additional information.
• A new DUR Educational Article titled “Drug Safety Communication: Potential Increased Arrhythmia Risk from Lamotrigine (PDF)” is available on the DUR: Educational Articles page of the Medi-Cal website.
• Updates to the List of Enteral Nutrition Products effective for dates of service on or after March 1 have been made available.
• The MAPC per Unit of Measure for HCPCS code A4657 in The Medical Supplies Billing Codes, Units, and Quantity Limits spreadsheet has been corrected to ‘By Report”.

For more information, contact NACDS’ Sandra Guckian at 703-837-4195.

Erica Joyner2021-05-07T11:54:47-04:00May 7, 2021|California|

About Erica Joyner