New York

On April 27, 2023, Governor Hochul announced an budget agreement with the legislature that held off all efforts to repeal the NYRx, the Medicaid prescription benefit carve out for fee-for-service. As of April 1, 2023, all Medicaid members enrolled in Mainstream Managed Care now receive their prescription drugs through the program. 

On April 24, 2023, NACDS participated in a pharmacy lobby day in Albany, in collaboration with the Community Pharmacy Association of New York and the Pharmacist State Society of New York. Members and pharmacists lobbied in support of S3467: CLIA-waived testing, S6337: expanding the Long Acting Injectables law, and for final signature of A 1060: pharmacists administered contraceptives.  

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

2023-04-28T12:00:19-04:00April 28, 2023|New York|

North Dakota

On April 5, Gov. Doug Burgum (R) signed SB 2378, legislation related to clinician-administered drugs. The new law includes language that prohibits a PBM from requiring “a patient, as a condition of payment of reimbursement, to purchase pharmacist services, including prescriptions drugs, exclusively through a mail-order pharmacy or a pharmacy benefit manager affiliate, or a combination of both.”

Also in North Dakota, on April 10, Gov. Doug Burgum (R) signed HB 1095, legislation including comprehensive medication management services in health benefit plans.  

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

2023-04-28T11:59:36-04:00April 28, 2023|North Dakota|

Oklahoma

Insurance Commissioner Glen Mulready (R) recently filed an administrative action against CVS citing a violation of state law prohibiting patient steering. The administrative hearing is scheduled on May 25, 2023. 

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

2023-04-28T11:59:02-04:00April 28, 2023|Oklahoma|

Oregon

The Department of Human Services began issuing $170 million in Pandemic EBT (P-EBT) food benefits to 434,000 students and young children in late March through May. These additional food benefits are part of the Pandemic EBT (P-EBT) program, a temporary COVID-19 response program meant to provide additional food support for children whose access to food provided through school programs may have been impacted by COVID-19. A P-EBT card containing $391 in food benefits, which is different from a regular electronic benefit transfer (EBT) card, will be sent by mail to each eligible child. 

Also in Oregon, the Oregon Health Authority published a final rule effective April 1, amending Prior Authorization Approval Criteria Guide & Preferred Drug List DUR/P&T Actions. (OAR 410-121-0030, OAR 410-121-0040) 

Also in Oregon, the Board of Pharmacy published a final rule effective April 4, amending Committee Member Compensation. (OAR 855-010-0016) 

Also in Oregon, the Board of Pharmacy posted the following: 

  • Interns Workgroup – May 3 at 1:00 p.m. – Agenda 
  • Collaborative Drug Therapy Management / Clinical Pharmacy Agreements Workgroup – May 4 at 1:00 p.m. — Agenda and Meeting Materials 

Also in Oregon, the Board of Pharmacy is proposing to adopt the following rules and announced a May 23 public hearing. Written comments may be sent to pharmacy.rulemaking@bop.oregon.gov no later than 4:30 p.m. on May 23.  

Finally in Oregon, the Board of Pharmacy adopted the following Temporary Rule, effective May 5: Division 045 – related to USP <795> and USP <797> Adopted Standards by Reference 

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

2023-04-28T11:58:27-04:00April 28, 2023|Oregon|

Texas

HB 1105 by Rep. Four Price (R), legislation that lowers the age to 3-years old and up for pharmacists, pharmacist interns and certified pharmacy technicians to administer all vaccines and immunizations without a patient specific prescription or medical order was voted favorably out of the House Public Health Committee on April 26th by a 7-4 vote. 

Also in Texas, on April 25th, the House Human Services Committee held a hearing on HB 1293, Rep. Toni Rose’s (D) Medicaid rate floor bill that all pharmacy groups support, would require PBMs’ pharmacy reimbursement to at least cover the pharmacy costs. Committee members questioned Priscilla Parrilla with the Health and Humans Services Commission’s Vendor Drug Program about the concerning fiscal note, and requested VDP (Vendor Drug Program) provide the committee with more information on how that was calculated. The bill was left pending in the committee. 

Also in Texas, on April 26th, the Senate Health and Human Services held a hearing on SB 1619 by Sen. Charles Perry (R), legislation supported by all pharmacy groups that would prohibit the Health and Human Services Commission’s Vendor Drug Program from including any discount price offered for the prescription drug, including a discount offered through a third-party discount card when defining the price of a prescription drug for purposes of determining the Usual and Customary (U&C) reimbursement rate for Medicaid. The bill was left pending in the committee. 

The Senate Health and Human Services also took testimony on SB 1137 by Sen. Charles Schwertner (R), PBM ERISA (Employee Retirement Income Security Act) reform legislation being led by the Texas Pharmacy Association and the Texas Pharmacy Business Council that is supported by all pharmacy groups. The companion bill by Rep. Tom Oliverson (R), HB 2021, was heard in the House Insurance Committee on March 21st. Both bills were left pending in committee. 

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

2023-04-28T12:15:55-04:00April 28, 2023|Texas|

Wyoming

The Wyoming Attorney General (Commissioner of Drugs and Substances Control) issued a proposed rules to additional substances to Schedule I and Schedule IV in the Wyoming Controlled Substances Act of 1971. Comments may be emailed to melissa.rexius@wyo.gov; the comment period ends on June 1, 2023.  

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

2023-04-28T11:55:16-04:00April 28, 2023|Wyoming|

Alabama

The Alabama Medicaid Agency (Medicaid) is announcing the final extension of the COVID-19 public health emergency (PHE). The new expiration date is May 11, 2023, which correlates with the expiration date of the national emergency. A Provider ALERT will be forthcoming from Medicaid to communicate changes to services related to the COVID-19 PHE.  

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. Providers should include appropriate COVID-19 diagnosis code(s) on claims submitted to help with tracking of COVID-19. 

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

2023-03-31T09:47:07-04:00March 31, 2023|Alabama|

Arkansas

Janet Mann is the new Medicaid Director with the Department of Human Services. Mann has over 20 years of experience in health care and finance, including working in Mississippi Medicaid.

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

2023-03-31T09:46:43-04:00March 31, 2023|Arkansas|

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