Nebraska
The meeting materials for the next meeting of the Drug Utilization Review (DUR) Board on May 11, 2021, have been posted.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The Board of Pharmacy published a proposed rule to amend regulations under 21 NCAC 46 to require pharmacies to report information on compounded drugs to the National Association of Boards of Pharmacy’s e-Profile Connect system. The rule would implement the memorandum of understanding with the secretary of Health and Human Services on the distribution of compounded drug products. The rule also would update information on accessing U.S. Pharmacopeia compounding standards. A hearing is scheduled for June 15, 2021, via webcast and teleconference. Comments are due June 15, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Ohio Department of Medicaid (ODM) announced the selection of six health care organizations that will provide managed care services starting in 2022. Additional information about the MCO announcement can be found in this press release and supplemental briefing documents. Further information about the planned reforms to and administration of the managed care program can be found at:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
Senator Judy Ward, RN, (R) has introduced SB 511. The bill is a joint NACDS/PACDS initiative that would update the state’s Pharmacy Practice Act to allow trained pharmacists, interns, and technicians to immunize the full CDC schedule to a person aged 3 and above.
Also in Pennsylvania, the Department of Human Services published a bulletin announcing that the COVID vaccine reimbursement rate was increased to match the revised Medicare rate of $40 per dose, effective March 15.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
Big news at the Capitol this week is what to do about Medicaid expansion which will be part of the discussion as the House debates the state’s $246B budget proposal. President Biden’s action rescinding the 1115 Waiver authorized reimbursements to hospitals, nursing homes and mental health providers for patients without insurance came as quite a surprise to lawmakers. Texas has the highest number of uninsured in the nation. Among the several Medicaid expansion bills filed, none have been heard.
Also in Texas, the Health and Human Services Committee is seeking candidates to serve on the Value-Based Payment and Quality Improvement Advisory Committee. Anyone interested should review the linked application letter to find out who the committee is seeking as representatives and if you qualify; click on the application linked here to apply to be on the committee.
Also in Texas, the Senate Health and Human Services Committee held a hearing on April 21st on SB 2195 by the Chair Sen. Kolkhorst, legislation NACDS supports that protects patients who receive prescription drug benefits through a commercial health plan subject to Texas Department of Insurance (TDI) oversight. The bill also ensures patient choice, prevents self-dealing, and prohibits clawbacks. The Committee Substitute to SB 2195 was reported favorably by a 6-0 vote.
Lastly in Texas, NACDS launched two RxIMPACT alerts urging members to call members of the House Public Health Committee asking them to vote YES on HB 678 expanding access to immunizations and HB 2049 allowing pharmacists to furnish medications according to the result of a positive CLIA-waived test for acute conditions such as flu and strep throat.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Health Care Authority issued a final rule effective May 1, 2021, requiring providers to agree that all claims for Apple Health clients in fee-for-service and managed care are subject to 340B standards as part of participation in the 340B drug pricing program.
Also in Washington, the Office of the Insurance Commissioner extended two emergency orders until May 16, 2021, that are of interest to pharmacies.
- Notice extending the Emergency Order 20-01 requiring health insurers to waive copays and deductibles for coronavirus (Covid-19) testing. The order also requires insurers to allow a one-time early refill for prescription drugs; suspend 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.
- Notice extending Emergency Order 20-06 concerning insurance coverage for COVID-19 diagnostic testing prohibits all health carriers from balance billing for COVID-19 diagnostic testing processed by out-of-network laboratories, when determined to be medically necessary. The order also requests that insurers notify the agency if out-of-network laboratories submit claims but have not published a cash price or fail to accept such a price.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
Effective May 1, 2021, the COVID-19 related universal prior authorization (PA) number will no longer be accepted for pharmacy overrides related to the three-month maintenance supply program. The universal PA will continue to work for claims associated with COVID-19 in other allowances (other than the three-month maintenance supply program) as described in the March 17, 2020 ALERT which can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
On February 19, the Board of Pharmacy adopted regulation changes in Title 12, Chapter 52 of the Alaska Administrative Code. The final rule of the Board of Pharmacy refines the requirements for registration with the prescription drug monitoring program (PDMP) controlled substance prescription database, clarifies the requirements for registration by pharmacists before dispensing schedule II, III, or IV controlled substances under federal law, in particular clarifying the mechanism for out-of-state pharmacists to obtain a registration exemption and for those same pharmacists to meet registration requirements before dispensing controlled substances in this state and to clarify that a “prescriber” would be required to register within 30 days after initial licensure or registration with the DEA, whichever is later. These changes will be printed in Register 238, July 2021 of the Alaska Administrative Code. The rule is effective May 6, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
The Division of Pharmacy Services issued a final rule effective April 16 adding six opioid substances, four depressants, and two synthetic cathinones to Schedule I. The rule also adds three opioid analgesics to Schedule II, three mood-altering substances to Schedule IV, two substances to Schedule V and modifies Schedule VI removing FDA-approved cannabidiol substances from Schedule V.
For more information, contact NACDS’ Mary Staples at 817-442-1155.