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South Dakota

The Board of Pharmacy posted their October 2023 Newsletter including the following sections: 

  • South Dakota Board Welcomes Newly Registered Pharmacists and Pharmacies 
  • DSCSA (Drug Supply Chain Security Act) Interoperability Standards Delayed Until November 2024 
  • USP Compounding Chapters Update 
  • Does a Pharmacy Need to be Licensed to Ship Medications to Other States? 
  • The Board Has a New Website
  • The Board Will Propose a Bill to Increase License Fees in the 2024 Session 
  • DEA (Drug Enforcement Administration) Issues Multiple Guidance Documents in Recent Months 
  • PDMP (Prescription Drug Monitoring Program) Update 
  • Board Meeting Dates, Board of Pharmacy Members and Board of Pharmacy Staff Directory 

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

2023-10-20T12:10:19-04:00October 20, 2023|South Dakota|

Tennessee

To assist prescribers and providers, prior authorization (PA) requirements can be bypassed for certain medications when specific medical conditions exist. Those specific medications and diagnoses can be found here. Prescribers are encouraged to include the applicable diagnosis code on written prescriptions for inclusion on the electronic pharmacy claim. The submitted claim should include a Diagnosis Code Qualifier (Field # 492-WE) of “02,” indicating ICD-10, as well as the appropriate Diagnosis Code (Field # 424-DO).  

If you have any questions, contact the OptumRx Pharmacy Supports Center at 866-434-5520 or tnrxeducation@optum.com. 

Also in Tennessee, the October 31 Drug Utilization Committee (DUR) Board meeting will be held virtually via Microsoft Teams. Please Click Here or Phone number: +1 952-222-7450 Phone Conference ID: 857 579 147# 

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

2023-10-20T12:09:45-04:00October 20, 2023|Tennessee|

Texas

Gov. Greg Abbott (R) called lawmakers back to Austin this week for a third 30-day special session to advance border security measures, address school choice/vouchers and education savings accounts and tackle private employer COVID vaccine mandates.  

Also in Texas, prior to the third special session, State Comptroller of Public Accounts Glenn Hegar (R) announced a certification revenue estimate (CRE) for the Fiscal Year 2024-25 biennium projecting a Rainy-Day Fund balance of $23.77 billion. 

Also in Texas, the Health, and Human Services Commission (HHSC) Medicaid posted the September 2023 End of Continuous Medicaid Coverage Dashboard. 

Also in Texas, the next quarterly meeting of the Board of Pharmacy (TSBP) is on November 7 in Austin. This will be the first meeting with the new Executive Director/Secretary Danny Carroll, PharmD. 

Also in Texas, NACDS submitted comments to the State Board of Pharmacy (TSBP) on its strategic plan for fiscal years 2025-29, recommending statutory and regulatory changes to expand upon the temporary flexibilities under the federal PREP Act related to vaccinations and Test & Treat services. NACDS also urged TSBP to eliminate the ratio at a central fill Class A pharmacy and expand telepharmacy services beyond FQHCs (Federally Qualified Health Centers). 

Finally in Texas, the Health, and Humans Services Commission (HHSC) Vendor Drug Program (VDP) Medicaid announced several changes in Preferred Drug list status effective on October 16, 2023, needed because of the shortage of several preferred brand name medications. 

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

2023-10-20T12:09:16-04:00October 20, 2023|Texas|

Washington

The five-member Prescription Affordability Board (PDAB) held its first hybrid meeting on October 20.  

Also in Washington, the State Chief Science Officer Dr Tao Sheng Kwan-Gett signed an updated statewide standing order to dispense naloxone. 

Also in Washington, the Department of Health (DOH) Immunization Division is hosting a COVID-19 and RSV Vaccine Updates Webinar (online registration) on Tuesday, October 24 from 12:00 PM – 1:00 PM Pacific. Topics will include COVID-19 vaccine updates and RSV vaccine recommendations for older adults and pregnant persons, as well as recommendations for infants. The online seminar will be recorded. 

Finally in Washington, the Health Care Authority’s Health Care Cost Transparency Board met on October 18. 

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

2023-10-20T12:08:34-04:00October 20, 2023|Washington|

California

The Department of Health Care Services (DHCS) posted the following bulletins, notices, and alerts on the Medi-Cal Rx Web Portal.  

Also in California, Medi-Cal posted the following.  

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

2023-09-22T14:30:41-04:00September 22, 2023|California|

Florida

Gov. Ron DeSantis (R) and members of the Florida Cabinet approved rules to implement several provisions of the Prescription Drug Reform Act (SB 1550). The rules increase accountability among pharmaceutical middlemen known as pharmacy benefit managers (PBMs). As signed by the Governor earlier this year, SB 1550 institutes the most comprehensive reforms to Florida’s prescription drug market in state history. Additional information on the bill can be found here. 

Also in Florida, the Agency for Health Care Administration (Agency), along with its fiscal agent, Gainwell Technologies, is introducing enhancements implemented as part of the new NPI initiative. A new Taxonomy Master List (TML) Tip Sheet, an updated Provider Master List (PML) Tip Sheet and an updated Pending Provider List (PPL) Tip Sheet is now available. The updated PML and PPL test examples are now available. The release of the updated PML and PPL changes will occur on October 26, 2023.  After the release, a copy of the former version of the PML and PPL will remain archived on the Registration page of the Managed Care section of the Florida Medicaid Public Web Portal for reference. The release of the updated TML changes will occur on September 28, 2023.  The release will replace the current version of the TML on the Florida Medicaid Public Web Portal. To access a copy of the new TML Tip Sheet and the updated PML and PPL Tip Sheets, please visit the Florida Medicaid Public Web Portal at mymedicaid-florida.com, navigate to the Agency Initiatives tab, and select NPI Initiative. 

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

2023-09-22T14:29:59-04:00September 22, 2023|Florida|

Iowa

The Department of Health and Human Services, Iowa Medicaid posted the following:   

Also in Iowa, the Department of Health and Human Services (HHS) and the Iowa Department of Education received approval from the U.S. Department of Agriculture, Food and Nutrition Service to issue Summer 2023 Pandemic Electronic Benefits Transfer (P-EBT) for eligible school-age Iowa children.  This program provides $120 per eligible child, issued on new P-EBT cards to be received by October 4. Approximately 240,000 Iowa children are eligible for this benefit, totaling $28 million in food assistance.  

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

2023-09-22T14:29:23-04:00September 22, 2023|Iowa|

New York

Effective September 11, 2023, the New York State Department of Health that NYRx, the Medicaid Pharmacy Fee-For-Service program will provide reimbursement for qualified and enrolled pharmacies for COVID-19 vaccines and administration as approved by the FDA or authorized for emergency use.  Billing codes and other guidance provided in the annoucement. 

On September 12th, the New York State Education Department withdrew the proposed central fill pharmacy regulations. The Department and the New York Board of Pharmacy will convene stakeholders and restart the regulatory process. NACDS and members had been actively advocating for a change and delay in the proposed regulations, that amongst its provisions would have created a new central fill pharmacy registration class, prohibited central fill pharmacies from being open to the public, require that central fill pharmacies only prepare, and fill prescriptions sent from an originating pharmacy, prohibited direct-to-patient central fill models, and required the originating pharmacy to obtain consent from the patient in writing before a prescription may be prepared by a central fill pharmacy. A broad coalition of pharmacy interests are unified in opposition and pushed for support for delayed consideration. NACDS also previously submitted a letter during the public comment period. 

On September 20th, the New York State Department of Health held their monthly industry call for NYRx, the Medicaid fee-for-service program. The Education and Outreach team for NYRx holds virtual office hours on Tuesdays and Thursdays, 12-1pm eastern.   

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

2023-09-22T14:28:29-04:00September 22, 2023|New York|

South Carolina

Effective October 1, 2023, the Medicaid State Plan will be updated to allow South Carolina pharmacists to bill for hormonal contraception services in accordance with the Pharmacy Access Act and as described in this bulletin.

To be eligible for reimbursement for these services, pharmacists must complete a Healthy Connections Medicaid provider enrollment application. Pharmacists may apply on or after September 18, 2023. Interested pharmacists are encouraged to apply on the providers page of the Department of Health and Human Services’ (SCDHHS) website and enroll as an “individual pharmacist” under the provider type “other medical professional.” In addition to the standard enrollment information, pharmacists must provide information on the pharmacy or pharmacies where they will be providing this service. Training on completing this application and enrollment process is available on the SCDHHS website. 

Once enrolled, pharmacies will be able to bill dates of service on or after October 1, 2023, for Medicaid members. This includes members enrolled in the full-benefit Medicaid program and those enrolled in the Family Planning limited benefit program. Pharmacies will be reimbursed for the procedure and diagnosis codes listed below under the Healthy Connections Medicaid member’s medical benefit utilizing the CMS form 1500. These services will be reimbursed in parity with nurse practitioners and physician assistants at 80% of physician rates. The reimbursement rates for these services are available in the Base Physician Fee Schedule available on SCDHHS website. Covered services and billing guidance will be added to the Physicians Services provider manual by October 1, 2023. 

Also in South Carolina, the Joint Pharmacist Immunization Protocol has been updated to allow pharmacists to administer Respiratory Syncytial Virus (RSV) in certain populations without a patient-specific prescription.    

Pharmacists who administer vaccines under this Protocol shall maintain a current copy of this Protocol at each location at which a pharmacist administers a vaccine and an appropriate area for administering vaccines with the supplies and equipment.  

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

2023-09-22T14:27:46-04:00September 22, 2023|South Carolina|

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