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Maryland

Gov. Hogan (R) has issued an Executive Order that provides for staffing flexibility to pharmacies as they engage in COVID-19 vaccinations and testing. 

Also in Maryland, the Department of Health has published an Advisory regarding Epidolex prescriptions due to a conflict between the federal and state scheduling process. 

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

January 28, 2022|Maryland|

Missouri

The Board of Pharmacy filed a revised emergency rule effective February 4, 2021, that will allow Missouri licensed interns and technicians located in other states to perform remote data entry.  

Also in Missouri, due to system limitation, MO HealthNet will reimburse pharmacy providers $0.01 for the full course of the therapeutic and the full dispensing fee. Pharmacy providers must submit a cost to MO HealthNet in excess of the Professional Dispensing Fee (PDF) to receive full reimbursement of the PDF. MO HealthNet will also cover home tests currently payable at $12 per test plus the PDF. 

Finally in Missouri, MO HealthNet in partnership with Missouri Board of Pharmacy's Rx Cares for Missouri Program and the Missouri Department of Health & Senior Services (DHSS), kicked off the "Safe At Home" Patient Safety Opioid Initiative. It allows MO HealthNet to reimburse pharmacy providers who dispense at-home medication disposal packets to eligible MO HealthNet participants who are at risk of experiencing an opiate-related overdose. MO HealthNet has selected DisposeRx® packets as the preferred medication disposal packet. These convenient at-home medication disposal packets will allow MO HealthNet participants to dispose of unused opioids safely and easily, preventing accidental overdoses.  

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

January 28, 2022|Missouri|

Nebraska

The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on February 2 at noon (Central).   

Also in Nebraska, the Department of Health and Human Services made available the new COVID-19 Ad Hoc Fee Schedule (1.1.2022), including adjustments to payments for administration of COVID-19 vaccines. 

Also in Nebraska, the Department of Health and Human Service posted the revised fee schedule for injectables effective January 1, 2022 REVISED. 

Also in Nebraska, the Department of Health and Human Services issued Provider Bulletin 22-05A to notify providers that effective January 15, 2022, OTC COVID at-home tests will be covered by Medicaid. The reimbursement policy is up to $12.00 for a kit containing one test or up to $24.00 for a kit containing two tests is allowed.  

Finally, the Department of Health and Human Services issued Provider Bulletin 22-06 announcing changes to the Tobacco Cessation Program. Effective December 26, 2021, enrollment in the Nebraska Tobacco Free Quitline is no longer required to be able to receive tobacco cessation products; enrollment is still encouraged. 

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

January 28, 2022|Nebraska|

Nevada

Effective January 1, 2022, all controlled substance prescriptions MUST be transmitted to a pharmacy by electronic prescribing, except for the following prescriptions: 

  1. a) Issued by a veterinarian;
    b) Issued under circumstances where:
    Electronic transmission is unavailable due to technologic or electronic failure; or
         2. The drug will be dispensed at a pharmacy located outside of this State;
    c) Issued by a practitioner who will also dispense the drug;
    d) For which electronic prescribing is prohibited by federal law;
    e) Issued pursuant to a protocol for research; or
    f) Issued under circumstances in which the practitioner determines that:
         1. The patient is unable to obtain the drug in a timely manner if the prescription is given by electronic transmission; and
         2. Delay will adversely affect the patient's medical condition. 

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

January 28, 2022|Nevada|

New Hampshire

Medicaid is ready to process at home COVID antigen tests. The necessary changes to be able to process the tests were completed last Friday (1/21/22), the pharmacy fax blast was sent out Friday afternoon as planned and is also posted online. Medicaid has issued a notice along with a standing order from DHHS for the at home tests that pharmacies may use. Dr. Ballard’s NPI number is on the order.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

January 28, 2022|New Hampshire|

North Carolina

Dr. Betsey Tilson, State Health Director, rescinded the following Statewide Standing Orders due to the high prevalence of the Omicron variant of SARS-CoV-2 virus in North Carolina for which these therapies are not an effective treatment:  

  • Statewide Standing Order for Subcutaneous Administration of Casirivimab/ Imdevimab (REGEN-COV) Monoclonal Antibodies
  • Statewide Standing Order for Intravenous Administration of Casirivimab/ Imdevimab (REGEN-COV) Monoclonal Antibodies
  • Statewide Standing Order for Intravenous Administration of Bamlanivimab/ Etesevimab Monoclonal Antibodies  

The recission orders can be accessed here: https://covid19.ncdhhs.gov/guidance#vaccination-info-for-providers  

These Statewide Standing Orders may be reactivated in the future depending on the effectiveness of the therapies on circulating variants.  

Also in North Carolina, reminder effective Jan. 10, 2022, NC Medicaid-enrolled pharmacies may bill for FDA approved over the counter (OTC) COVID-19 tests dispensed for use by NC Medicaid beneficiaries in a home setting, with or without a prescription issued by an NC Medicaid-enrolled provider. NC Medicaid Direct beneficiary implementation date is Jan. 10, 2022. Refer to beneficiaries' managed care plan for guidance on the specific plan's implementation date.  

Finally, NC Medicaid will cover one kit per claim per date of service, with a maximum of four test kits every 30 days. Covered test kits are listed below. Please note that some kits will include two tests.  

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

January 28, 2022|North Carolina|

Oklahoma

The National Association of Insurance Commissioners (NAIC) announced that Oklahoma Insurance Commissioner Glen Mulready would serve as chair of the NAIC Health Insurance and Managed Care (B) Committee for the 2022 term.

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

January 28, 2022|Oklahoma|

Oregon

The Board of Pharmacy posted the agenda and meeting materials for the February 9-11, Board Meeting. 

Also in Oregon, the Board of Pharmacy issued a notice requesting fiscal impact for Pharmacy Prescription Lockers (PPL) from stakeholders. Note: any information provided to the Board becomes a public record. 

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

January 28, 2022|Oregon|

Pennsylvania

The state has reissued billing guidance for the Pharmacy Naloxone Copay Assistance Program, because of claims – otherwise eligible- but rejected due solely to coding errors. The claims are eligible for correction for payment. NACDS reminds members that naloxone claims from any patient, regardless of type of insurance coverage, are eligible for the copay to be reimbursed to the pharmacy. The program, which NACDS and PACDS helped the Governor's Opioid Taskforce develop with member input, is funded through federal grants and meant to incentivize greater naloxone access to all Pennsylvanians. It is run on the PACE program system merely to streamline the adjudication process for pharmacies. 

Also in Pennsylvania, The Department of Human Services published a Bulletin for COVID Oral Antiviral Treatments billing procedures and codes for pharmacies. 

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

January 28, 2022|Pennsylvania|

Virginia

The Board of Pharmacy issued the following clarification regarding pharmacy technicians' authority to administer vaccines:  

As part of his COVID Action Plan, Governor Glenn Youngkin signed Executive Order 11, to give flexibility and support to healthcare providers, hospitals and other healthcare facilities. Paragraph 13 of Executive Order 11 increases the number of persons performing the duties of a pharmacy technician that a pharmacist may supervise to five (5) and exempts pharmacy technicians performing COVID-19 administrative tasks from being counted in the ratio. Please be advised that the administration of a CLIA-waived test or vaccine does not constitute an administrative task.  Additionally, the decision regarding the number of pharmacy technicians a pharmacist will supervise, and whether any other duty constitutes a COVID-19 administrative task, is a decision that must be made by the Pharmacist-in-Charge or pharmacist on duty, pursuant to 18VAC110-20-112(A) and 18VAC110-20-110(C).  The Executive Order shall remain in effect until February 21, 2022, unless sooner amended or rescinded by further executive order or directive.  

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

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

January 28, 2022|Virginia|

Washington

Apple Health (Medicaid) covers over–the–counter (OTC) COVID-19 tests with or without a prescription for clients. An adjudicated pharmacy claim is required for reimbursement. Pharmacies may not bill for test administration of an OTC COVID-19 test as these tests should be used by the patient in the home setting.

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

January 28, 2022|Washington|

California

On January 10, Gov. Gavin Newsom (D) released his proposed 2022-23 State Budget. Both the Governor's Budget Summary (See page 109+ for Health and Human Services) and Proposed Budget Detail have been posted. Of interest in the Health and Human Services section include: 

  • Savings related to Medi-Cal Rx Implementation ($327 Million)
  • Savings related to Pharmacy Recoupment (See bottom of page 10.) ($100 Million)  

Legislative hearings and negotiations will begin and February and continue through May. The Governor will release a revised budget in May. 

 Also in California, the Department of Health Care Services published the following alerts: 

Also in California, the Board of Pharmacy sent a notice about reissued pharmacy law waivers in response to Gov. Gavin Newsom's (D) declaration of emergency and the nation declaration of emergency. 

Also in California, the Board of Pharmacy issued a Notice of Meeting and Agenda for the Teleconference Medication Error Reduction and Workforce Committee Meeting on January 27. Meeting materials will be posted on the website in advance.  

Finally in California, the Board of Pharmacy published a Notice of Meeting and Agenda for the Teleconference Public Board Meeting scheduled to be held January 27-28. Meeting materials will be posted on the website in advance.

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

January 20, 2022|California|

Florida

Effective January 1, 2022, the UnitedHealthcare of Florida, Inc., and UnitedHealthcare Insurance Company Dual-Eligible Special Needs Plans (D-SNP) changed their names to Care Improvement Plus South-Central Insurance Company d/b/a UnitedHealthcare Dual Complete. All member benefits, provider networks, and plan telephone numbers remain the same. United Healthcare continues to be responsible for the services provided to members of United Healthcare Dual Complete Plan including Medicare and Medicaid services. The website will remain www.UHCCommunityPlan.com  

Contact numbers: Member and Provider Services: 1-844-560-4944  

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

January 20, 2022|Florida|

Georgia

Immunization Delivery Training for Pharmacy Technicians. A 6.0 hour CE program consisting of both home-study and live training. Under HHS authorization (PREP Act 10.20.20) trained pharmacy technicians can administer certain vaccines under the supervision and authorization of a pharmacist. GPhA is offering live training on 

 Saturday, February 19, 2022 
9:00 am – 12:00 pm
Georgia Pharmacy Association Classroom  

GPhA's Immunization Delivery Training program for Pharmacy Technicians is recognized as an education provider for the Pharmacy Technician Certification Board's (PTCB) Immunization Administration Assessment-Based Certificate. CLICK HERE for more information and to register! 

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

January 20, 2022|Georgia|

Illinois

The Illinois Department of Healthcare and Family Services has posted the October 21, 2021 D & T Advisory Board Meeting Minutes at the following link. 

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

January 20, 2022|Illinois|

Kentucky

SB 25 passed the General Assembly last week and extended COVID executive orders until 4/4/22. Of interest to pharmacy, this bill continues emergency dispensing, remote work for pharmacists, and the ordering and administering vaccinations and COVID-19 testing.  

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

January 20, 2022|Kentucky|

Maryland

The Maryland Insurance Administration (MIA) has released its report on the impact of Rutledge v. PCMA court decision and the subsequent Webhi decision on Maryland law and the MIA's ability to regulate Pharmacy Benefits Managers (PBMs) relationships with pharmacies in Maryland. The report was mandated by the passage of HB 601 of 2021. It concluded that, should the legislature pass legislation regulating PBMs when providing services to an ERISA plan, ERISA would not preempt the MIA's enforcement of those laws. The report also provides a summary of previously passed laws related to PBMs in Maryland and MIA's current methods of enforcing them. The report cites comments jointly submitted from NACDS and the Maryland Association of Chain Drug Stores last fall, which highlighted examples of pro-pharmacy laws that align with the Rutledge decision. 

Also in Maryland: On December 15, the Department of Health (MDH) issued an updated Vaccination Matters Order and guidance.  

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

January 20, 2022|Maryland|

Minnesota

The Division of Insurance of the Department of Commerce’s Final Rule on PBM Licensure and Regulation was adopted with the revisions, published in the register, and became effective Jan 18. For further detail and background or to read stakeholder comments, including those filed by NACDS, go to the Department’s rulemaking page.

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

January 20, 2022|Minnesota|

Montana

The Board of Pharmacy reminds pharmacies that the temporary emergency rule (MAR 24-174-77) expired on January 11, 2022; this temporary rule included the removal of the pharmacist to pharmacy technician ratio for purposes of vaccine and testing administration and allowed other healthcare providers authorized to administer vaccines to assist pharmacists with vaccine administration. Since these provisions are no longer in effect, the pharmacist to pharmacy technician ratio is 1:4 per ARM 24.174.711. 

Also in Montana, the Board of Pharmacy issued a Notice of Public Hearing on Proposed Amendment in MAR 24-174-78. This proposed amendment removes the pharmacist to pharmacy technician ratio, provides for certain pharmacist-in-charge oversight in staffing and allows for other healthcare providers authorized to administer vaccines to assist pharmacists with vaccine administration. The Public Hearing will be held via remote conferencing on February 4. Written comments must be received no later than 5:00 p.m. on February 11. 

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

January 20, 2022|Montana|
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