Washington
The Health Care Authority’s (HCA) Apple Health (Medicaid) announced that they are implementing changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program on November 1, 2021.
Also in Washington, HCA is publishing quarterly updates to billing guides starting on October 1, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The Wisconsin Department of Health Services (DHS) and Pharmacy Society of Wisconsin (PSW) currently are engaged in logistical planning for how assisted living facilities (ALF) will access COVID-19 booster doses.
DHS and PSW are asking pharmacy partners to please fill out a short survey to guide Wisconsin’s strategy around booster dose planning for this critical population. Fill out the survey here.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alabama
At the onset of the COVID-19 pandemic, the Alabama Medicaid Agency (Medicaid) temporarily ceased revalidation for providers. Medicaid has now resumed revalidation for providers. Affected providers may contact the Gainwell Provider Enrollment Unit at 1-888-223-3630 and speak to a Provider Enrollment Specialist. To learn more about the revalidation process please visit www.medicaid.alabama.gov, select the ‘Providers’ tab, then click on ‘Provider Enrollment‘ to view details. If a provider does not revalidate their enrollment, it will result in the provider enrollment being closed which can cause patients to not receive medications.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
As a result of federal funding available to the Division of Corporations, Business and Professional Licensing (CBPL) to offset certain administrative costs of running the Prescription Drug Monitoring Program (PDMP), the Division is recommending decreasing the PDMP fee to zero. Written comments must be received not later than 4:30 p.m. on October 22, 2021, NACDS will not be commenting on this issue. Comments must be addressed to CBPL Regulations Specialist, PO Box 110806, Juneau, AK 99811 or regulationsandpubliccomment@alaska.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arizona
NACDS submitted comments to the Board of Pharmacy stating support for the proposed rules allowing pharmacists to delegate additional nondiscretionary tasks to pharmacy technicians, including the technical act of administering vaccines and performing other tasks that a pharmacy technician is trained to perform.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
Arkansas lawmakers will return to the Capitol on September 29th to finalize the redistricting maps and conclude the regular session. Gov. Asa Hutchinson is waiting on legislators to reach a consensus on tax reform before calling a special session.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
NACDS submitted a comment letter (View comment letter here) to the Board of Pharmacy recommending they maintain the existing Prescription Drug Monitoring Program rule language requiring reporting of dispensing transaction data "no later than the outlet's next regular business day."
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Delaware
The Delaware Department of Health and Social Services and the Delaware Emergency Management Agency issued an Emergency Order effective immediately recognizing qualified pharmacy technicians’ authority to immunize 19 and older adults for the flu.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Iowa
The Board of Pharmacy issued guidance related to monoclonal antibody administration by pharmacists, including a reminder of recordkeeping and requirements to order and administer COVID-19 therapeutics.
Also in Iowa, the Board of Pharmacy alerted licensees and registrants about recent phishing scams by individuals posting as Board employees.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Massachusetts
MassHealth is adopting new policies for the prescribing and dispensing of ivermectin. MassHealth is imposing new quantity limits of 20 ivermectin tablets per 90 days. This edition of Pharmacy Facts details of those updates in policy.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The Department of Commerce and Insurance (DCI) is hosting a webinar on October 8th aimed at helping pharmacists identify and prevent fraud, waste, and abuse in the MO HealthNet pharmacy program. Pre-registration is required – (Click here to register).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Board of Pharmacy held a full board conference call meeting on September 2 to discuss issuing an emergency rule to address pharmacy staffing shortages related to COVID-19 and flu vaccinations. As a result, the Board of Pharmacy adopted temporary emergency rules, effective September 14, 2021, and expiring on January 11, 2022, including the following:
- Rule I: Temporary emergency suspension of pharmacist to pharmacy technician ratio for purposes of vaccine activities and COVID-19 testing.
- Rule II: Temporary emergency expansion of personnel who may work in a pharmacy or under the supervision of a pharmacist.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services issued a Health Alert Network Update notifying healthcare providers and facilities that COVID-19 monoclonal antibody (mAb) therapy has a new indication for post-exposure prophylaxis via emergency use authorization. As of September 13, the US Government began allocating mAb therapy; infusion sites will no longer order mAb therapy directly from distributors.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Department of Health has issued two requests to pharmacies. The first asks that pharmacies review its list of participating vaccination providers and make changes if needed. The list is being shared with businesses to encourage them to contact a participating local provider to conduct onsite vaccination clinics. ODH is also asking pharmacies to fill out a survey related to children's COVID vaccines to gauge vaccine provider availability. Survey participants also have the option to, and are encouraged to share with ODH, any barriers they might face to providing those vaccination opportunities to younger children, as well as any supports that could make vaccinating younger children more feasible.
Also in Ohio, earlier this year, ODM announced the selection of seven managed care organizations (MCOs) who will partner with the Department to evolve the delivery of managed care services for its more than 3 million members and thousands of medical providers. The seven MCOs selected for the next generation managed care program are:
- AmeriHealth Caritas Ohio, Inc.
- Anthem Blue Cross and Blue Shield
- Buckeye Community Health Plan
- CareSource Ohio, Inc.
- Humana Health Plan of Ohio, Inc.
- Molina Healthcare of Ohio, Inc.
- UnitedHealthcare Community Plan of Ohio, Inc.
Providers who are interested in contracting with Ohio Medicaid's next generation MCOs are encouraged to contact the MCOs. Contact information for the MCOs can be found on the Resources for Providers webpage of the next generation website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The state has announced a new program that will reimburse pharmacies for Naloxone copays when the pharmacist believes the patient will be hesitant to pick up the prescription due to cost. The Naloxone Copay Assistance Program is funded through federal grants and will begin October 1, 2021. The program will run on the PACE platform; however, the program will reimburse a pharmacy up to $75 per claim for any patient regardless of their insurance plan. There are adjudication testing opportunities available prior to Oct 1. Should you wish to run test claims, please contact NACDS’ Jill McCormack. For more detail, see the program bulletin and detailed adjudication specifications. NACDS thanks Governor Wolf, the Governor’s Opioid Command Center, PACE, and our members that helped advocate for this important lifesaving program over the last few years.
Also in Pennsylvania, Acting Secretary of Health Alison Beam signed an order this week with guidance on administering COVID-19 booster shots once they are available. It requires vaccine providers, as possible, to:
- provide online scheduling for vaccination appointments,
- provide a telephone number, with prompts to a live agent during normal business hours, to assist in scheduling appointments,
- offer walk-in appointments, and
- work with local Area Agencies on Aging (AAA) and Medical Assistance Managed Care Organizations (MCO) to help schedule eligible adults and people who cannot leave their homes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
Public Chapter 569 went into effect on July 1, 2021. To assist with the implementation process, especially regarding the filing of PBM complaints with the Tennessee Department of Commerce and Insurance (TDCI), the Tennessee Pharmacy Association has worked with TDCI to troubleshoot the complaint process and has been working to develop materials to guide pharmacies as they submit formal PBM complaints. TPA will be conducting several 30-minute open-forum webinars to share the latest news and information related to implementation of Public Chapter 569. These webinars will allow members to hear from TPA staff and other stakeholders, as well as serve as an opportunity to hear from you about the resources you still need.
Also in Tennessee, the Tennessee Board of Pharmacy, at the September meeting, determined that, for purposes of pharmacist-to-technician waivers, certified technicians could be those trained by an ACPE-approved program outlined in a PREP Amendment. The BOP will discuss USP standards at its November 16-17 meeting.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Texas Department of State Health Services (DSHS) has updated the Texas COVID-19 Vaccine Program Provider Manual (Click her for manual)
Also in Texas, the Legislature returned to the Capitol on September 20th for a third 30-day special session to tackle several issues including redistricting, property tax reform, and allocating the $16B in federal COVID relief funds. (Link to special session)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
Effective October 1, 2021, Continuous Glucose Monitoring (CGM) systems and supplies will be available ONLY through retail pharmacy channels and will no longer be accepted via DME provider channels. Prior authorization requirements that had been waived temporarily because of the COVID-19 Public Health Emergency will be reinstated. Prescribers may send prescriptions electronically to the pharmacy or hand write prescriptions for patients. Claims will adjudicate in "real time" through the Pharmacy Point of Sale (POS) system which will allow for faster and easier access for patients.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Washington
The Pharmacy & Therapeutics Committee and Drug Utilization Review Board are meeting virtually on October 20th at 9 AM to review drug classes for the Apple Health (Medicaid) PDL. To preregister and access the meeting materials, go to WA P&T Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
The Insurance Commissioner recently released the Insurance Bulletin No. 21-07 regarding how recent legislation impacts the state's network adequacy requirements. Of note, the bulletin emphasizes that any sub-networks for specialty drugs that consist of only mail order pharmacies violates the state's network adequacy standards.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Alabama Pharmacy Association has partnered with the Tennessee Pharmacists Research and Education Foundation to offer live OSHA training. If you are a pharmacist providing immunizations or CLIA-waived testing services, or a pharmacy technician or other health care professional assisting with these services, you must have live OSHA training on bloodborne pathogens every year. The Tennessee Pharmacists Research and Education Foundation (TPREF) is offering a webinar that meets all of OSHA’s training requirements, including the live component. This webinar will provide attendees with one (1.0) contact hour of live ACPE Continuing Education. More information and registration can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
NACDS and the California Retailers Association (CRA) submitted the following letters to Gov. Gavin Newsom (D):
- a joint letter urging the governor to sign into law AB 1064, legislation authorizing a pharmacist to independently initiate and administer any vaccine that has been approved or authorized by the FDA and received an ACIP individual vaccine recommendation published by the CDC for persons 3 years of age and older,
- a joint letter urging the governor to sign into law SB 409, the Board of Pharmacy’s legislation permanently authorizing pharmacists to perform CLIA-waived testing services, including COVID-19 and flu tests and
- a joint letter expressing significant concerns with specific provisions AB 1533, the Board of Pharmacy sunset legislation. These provisions would allow the Board of Pharmacy to levy penalties of up to $150,000 on chain community pharmacies that would be excessive and disproportionate to the violations in question, which may jeopardize access to critical healthcare services.
Also in California, NACDS submitted a joint letter with the California Retailers Association to the Board of Pharmacy on an issue pertaining to the state’s electronic prescribing mandate that will go into effect in 2022. Specifically, chain pharmacy encouraged the Board to clarify compliance requirements for the transfer of unfilled electronic controlled substances between pharmacies considering the federal DEA requirements and existing NCPDP standards for Electronic Prescribing of Controlled Substances that constrain what pharmacies can currently do.
Also in California, SB 362, legislation sponsored by the United Food and Commercial Workers and the California Pharmacists Association, that prohibits chain community pharmacies (75 or more stores under one ownership in California) from establishing pharmacy quotas as defined in the bill with certain exceptions, passed both chambers and was sent to the governor for signature. Capitol Advocacy, on behalf of NACDS and CRA, advocated for amendments refining the definition of “quota” and creating exceptions related to measurement and evaluation of performance, competence or quality of care provided to patients by a pharmacist or pharmacy technician.
Finally in California, Both the agenda and meeting materials for the Board of Pharmacy meeting on September 23 are posted. Note: Agenda Item VI. Strategic Planning Session will include the results of the 2021 Environmental Scan conducted earlier this year.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
The Department of Healthcare Finance will hold its virtual Quarterly Pharmacy Provider Forum on September 21 from 10-12am and September 22 from 1-3pm. The content for both is the same. To RSVP and receive meeting link, contact Allison Williams.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Effective October 1, 2021, fee-for-service (FFS) pharmacy claims must identify prescribers by their National Provider Identifier (NPI) and the prescribers must be actively enrolled with Florida Medicaid or the claims will be denied at the point of sale. Prescribers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b). This requirement does not pertain to pharmacists, state-authorized pharmacy interns, and qualified pharmacy technicians who administer pediatric and COVID-19 immunizations under the Public Readiness and Emergency Preparedness (PREP) Act. Pharmacy claims must continue to identify the administering pharmacist by Florida pharmacist license number (i.e., PSXXXXXXX), submitted as the prescriber ID in the National Council for Prescription Drug Programs (NCPDP) field 411-DB for the following vaccines and immunizations covered under the PREP Act, in accordance with or identified by the Advisor Committee on Immunization Practices (ACIP CDC vaccines). More information can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Department of Healthcare and Family Services has posted a new Provider Notice regarding Prior Approval Requests for Synagis Continued through September 30, 2021. You may view the new Notice at the following link:
Also in Illinois, the Department of Healthcare and Family Services has posted an Updated Preferred Drug List Illinois Medicaid October 1, 2021. You may view the Updated List at the following link.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.