Florida
Reminder, Effective October 1, 2021, fee-for-service 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). For more information related to the Florida Medicaid NCPDP D.0 Payer Specifications, please reference the D.0. Specs (Updated 07/07/2021) available on the Pharmacy Information page of the Web Portal.
Also in Florida, as part of Constitutional Amendment No. 2 passed by voters in the 2020 election, Florida’s minimum wage is set for a notable increase. Effective September 30, 2021 the state minimum wage will increase from $8.65 per hour to $10.00 per hour (a 13.5% increase). In accordance with the amendment, the minimum wage is set for annual increases on the path to a $15 minimum wage by September 30, 2026. The requirement applies to both public and private employers, regardless of size. In addition to increasing pay, Florida employers also face posting obligations to reflect the new amounts, posters that comply with the posting requirement can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
HB711, sponsored by Representative Gregory Harris (D), was signed by Governor JB Pritzker (D) on August 19, 2021. The measure will take effect on January 1, 2022 and applies to all managed care organizations and provides requirements concerning disclosure and review of prior authorization requirements, denial of claims or coverage by a utilization review program, and the implementation of prior authorization requirements or restrictions.
Also in Illinois, HB1745, sponsored by Representative Gregory Harris (D), was signed by Governor JB Pritzker (D) on August 19, 2021. The measure will take effect on January 1, 2023 and requires every health insurance carrier which provides coverage for prescription drugs to ensure that at least a certain percent of an individual’s healthcare plan must apply a flat-dollar copayment structure to their entire drug benefit.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
For the latest information and updates impacting Iowa’s enrolled vaccine providers, please visit the Iowa Dept. of Public Health (IDPH) COVID-19 Vaccine Providers web page, and click on the most recent version of the “ Vaccine Information Brief”. IDPH posted a NEW Vaccine Information Brief (9.27.2021). Note: changes to the document are highlighted in yellow. Also, for all Iowa-enrolled vaccine providers, a weekly listserv message will be sent to emails on record; this message will include the “Vaccine Information Brief”, as appropriate.
Also in Iowa, the Department of Human Services issued INFORMATIONAL LETTER NO. 2266-MC-FFS-CVD, containing information and updates regarding the authorization of an additional dose of COVID-19 vaccine following an initial 2-dose primary series of mRNA COVID-19 vaccine for certain immunocompromised individuals. See informational letter for details about billing and coding for administration fees.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
Both the Pharmacy Benefit Manager Advisory Council and the Prescription Drug Monitoring Program Advisory Committee will be holding their quarterly meetings in Baton Rouge on Wednesday, October 13.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
The Massachusetts Department of Public Health has issued a new COVID19 Bulletin dealing with booster vaccine rollout.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The Department of Social Services MO HealthNet issued a bulletin announcing the Medicaid prescription reimbursement will be increased on October 1, 2021. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Missouri Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.70. Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85.
Also in Missouri, effective September 1, 2021, MO HealthNet (Medicaid) started paying for transportation for Medicaid fee-for-service patients with an appointment at a pharmacy to receive vaccinations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
Effective October 1, all Medicaid beneficiaries will automatically receive full Medicaid benefits, including dental, vision and over-the-counter drugs as part of the Medicaid Expansion program. A new Medicaid card will not be needed for people who have current Medicaid coverage. Recall this change to the Medicaid Expansion program occurs as a result of the Department of Health and Human Services’ notice not to implement the Heritage Health Adult (HHS) demonstration that would have required engagement in wellness, personal responsibility and community engagement activities to quality for full Medicaid benefits.
Also in Nebraska, the Department of Health and Human Services (DHHS) announced the next weekly COVID-19 Medicaid Provider call will take place on October 6 at noon. Information to access the call has been posted on the DHHS website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The New York Health Commissioner approved the recommendations of the DUR Board developed at the July 2021 meeting. The meeting summary on the DOH website has been updated to include the Commissioner’s final determinations.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The North Carolina General Assembly has passed, and Governor Cooper has signed into law, legislation that authorizes qualified immunizing pharmacists to administer long-acting injectable medications to patients age 18 and older pursuant to prescription. This new authority becomes effective on October 1, 2021. Board staff has prepared a guidance document that summarizes the new authority and how pharmacists may exercise it.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Earlier this year, the Ohio Department of Medicaid (ODM) announced the selection of seven managed care organizations (MCOs) who will partner with the Department to provide Medicaid Services. The seven MCOs 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; and UnitedHealthcare Community Plan of Ohio, Inc. Providers who are interested in contracting with them are encouraged to contact them. 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.
Oklahoma
The Board of Pharmacy issued information regarding physician assistants (PA) prescribing Schedule II controlled substances prescriptions. For more information, contact pharmacy@pharmacy.ok.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Board of Pharmacy issued a notice requesting stakeholder fiscal impact information related to proposed requirements for “Proper Storage of Drugs”, “Remote Dispensing Site Pharmacies” and “Telework”. Note: The board reminds pharmacies that some information they may want to provide may be proprietary, and any information provided to the Board of Pharmacy becomes a public record. By October 6, please provide comments to pharmacy.rulemaking@bop.oregon.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
Gov. Wolf (D) has signed a bill that extends COVID-19 related pharmacy waivers due to expire on September 30 until March 31, 2022. It does not extend the waivers that were already terminated by the Department of State prior to September 30th. Since this was a blanket extension of the current waivers, the bill did not go further than the state waivers to fill in the gaps to match the PREP Act allowances. We will continue advocating for the passage of bills that match the PREP Act.
Also in Pennsylvania, NACDS reminds members that beginning October 1, the state will cover copays for Naloxone prescriptions for patients hesitant to pick up the prescription due to cost, regardless of the type of insurance coverage. Please refer to the submission specifications and program bulletin for more information.
Also in Pennsylvania, the Board of Pharmacy has published proposed regulations providing for pharmacy technician registration based on Act 140 of 2020. Keeping in mind that any substantive changes will require legislation, please send any comments you may have to Jill McCormack by October 11.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
NACDS provided comments encouraging the Board of Pharmacy (TSBP) to include in their FY 2023-2027 strategic plan statute and rule changes to permanently codify the scope of practice expansion authorized under the PREP Act for all pharmacy personnel, and to further modernize scope of practice for Texas pharmacists to allow for practices now authorized in other states. We also urged the Board to modernize their in-person counseling rules to permanently allow the option of telephonic counseling that has allowed pharmacies to deploy innovative workflow models to meet increased patient demand for pharmacy services.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
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.