Kentucky
MedImpact, the state Single PBM, issued a communication clarifying that the prohibition on automatic refills does not include 90-day fills.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On December 6, the Board of Pharmacy published new regulations relative to pharmacy licensing and the Continuous Quality Improvement Program.
Created six new license categories for certain types of pharmacy practice:
- sterile compounding,
- complex sterile compounding,
- institutional sterile compounding,
- non-resident drug stores,
- non-resident sterile compounding,
- non-resident complex non-sterile compounding.
The proposed changes explain which license types are needed for which activities, set forth the eligibility requirements and procedures for obtaining each type of license, and set forth grounds for denial of licensure due to lack of suitability. The proposed changes update requirements related to the change of a pharmacy’s manager of record, location or ownership, pharmacy renovations and the closure of a pharmacy. The proposed changes remove practice standards from this section in order that all such practice standards may be aggregated at 247 CMR 9.00.
Requires pharmacies to establish and implement a “Continuous Quality Improvement Program,” meaning a system for identifying and documenting prescription dispensing errors; notifying affected patients, and health care providers as necessary; analyzing the error to identify causes and contributing factors; and using the information to improve pharmacy systems and workflow.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Nebraska
The Medicaid Drug Utilization Review (DUR) Board posted the January 14 meeting agenda.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Hampshire
On December 18, the Board of Pharmacy will be holding its next regular meeting. The meeting agenda includes proposed rules updates to pharmacy rules 100, 200 and 300. Meetings are held at 9:00 am at 7 Eagle Square, Concord NH 03301. Zoom options are available.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New Jersey
On December 9, the Assembly Committee on Financial Institutions and Insurance held a second hearing on A4953, Patient and Provider Protection Act, legislation that includes PBM reforms. NACDS submitted a letter to the Committee Chair Roy Freiman (D) who also sponsored the bill. The bill was amended and recommitted within the committee.
Also in New Jersey, on December 9, the Senate Committee on Health, Human Services, and Senior Citizens held a hearing on A1899 and S1981, companion bills that would expand vaccine and pharmacy technician authority. The bills were approved by the committee and expect action on the Senate floor on December 19. NACDS will continue to advocate for expedited passage of this bill.
Finally in New Jersey, on December 11, the Board of Pharmacy held its regular scheduled meeting. The next meeting is scheduled for January 22, 2025.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Oregon
The Division of Financial Regulation recently announced permanent rulemaking repealing 836-053-0025, the regulation of the insulin co-pay amount for health benefit plans for the state, as a result of SB 1508 (2024) effective January 1, 2025.
Also in Oregon, the Division of Financial Regulation recently announced permanent rulemaking amending 836-052-1000, establishing and updating the list of prosthetic and orthotic devices; prohibiting internal or separate limits or caps on prosthetic and orthotic devices, other than the lifetime policy maximum, when permitted by law; and defining when coverage for prosthetic and orthotic device is provided through a managed care organization effective January 1, 2025.
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted an agenda and meeting materials for its December 18 meeting. You must register in advance to participate.
Finally in Oregon, the Oregon Prescription Drug Affordability Board has posted to the website the UPL report for the Oregon Legislature pursuant to ORS 646A.685.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The Department of Health and Human Services (SCDHHS) will operate on an updated schedule for Healthy Connections Medicaid claims submission and payments to accommodate the December 2024 and January 2025 holidays. Due to observance of the Christmas holiday, December 19 at 5:00 pm is the deadline to submit claims for payment date December 27. Electronic remittance advice will be available December 24. Payments will be dated December 27, as usual. Due to observance of the New Year’s holiday, December 27 at 5:00 pm is the deadline to submit claims for payment date January 3. Electronic remittance advice will be available December 31. Payments will be dated January 3rd, as usual. The schedule will return to the normal payment cycle on January 3, 2025.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare released a document summarizing the temporary changes in counties impacted by Hurricane Helene, aligning with Gov. Bill Lee’s (R) Executive Order No. 105. These changes aim to provide relief to victims of severe weather and flooding and will remain in effect until December 25, 2024.
Also in Tennessee, all pharmacies participating with TennCare and OptumRx are encouraged to contact their provider liaison for any processing issues or questions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alabama
Pharmacist registrations with Board of Pharmacy expire December 31, 2024. The Board of Pharmacy is accepting pharmacist license renewals online only. As a reminder, the Board transitioned to a new database last month. The new system and renewal process look different, and the changes will require individuals to create a new account to renew licenses. Pharmacies and facilities will not need to create a new account. Instead, each pharmacy will be linked to the supervising pharmacist, and each facility will be linked to the designated representative. For information, watch the tutorial videos on the ALBOP YouTube channel.
Also in Alabama, effective January 1, 2025, the Alabama Medicaid Agency’s Durable Medical Equipment (DME) Program will cover E2298, PWR SEAT ELEVATION SYS (Power Seat Elevation System), for adults 21 years of age and older. Prior authorization (PA) will be required. E2298 will continue to be covered for children under 21 years of age with a PA. The limit will be one (1) per two (2) calendar years for both adults and children. Policy questions concerning this provider notice should be directed to the DME Program at (334) 242-5050.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.