District of Columbia
NACDS supported the efforts of members and in-state partners to amend B23-535. As originally introduced, the bill would have required warning labels on opioid prescriptions to be printed in a certain font and color scheme. The compromise amendment adopted during the Committee on Health markup removed the font and color mandate but still requires a warning label. The amended and engrossed version is expected to continue through the legislative process.
Also in the District of Columbia. B23-430, legislation allowing pharmacists to substitute interchangeable biologic products became effective on October 20 following the obligatory Congressional Review. Sponsored by Councilmember Mary Cheh (D) the law’s notification provisions are similar to those NACDS supported in other jurisdictions.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
The Board of Pharmacy published a final rule that amends regulations under FAC 64B16-27 to clarify requirements for pharmacist supervision of pharmacy technicians. The rule is effective on November 3, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Board of Pharmacy issued a response to Gov. Kim Reynolds’ (R) October 16 Proclamation of Disaster Emergency. All previous pharmacy regulatory relief provisions remain in place through November 15, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Michigan
In the wake of Gov. Gretchen Whitmer’s Executive Orders being rescinded with immediate effect by the State Supreme Court, legislation to authorize COVID-19 testing by pharmacists has cleared both the House and Senate. HB 6293 now heads to the Governor. NACDS and partners continue to work with SB 920 as a possible vehicle for restoring other rescinded regulatory relief.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Missouri
The Missouri COVID-19 Vaccinator Enrollment program is now open. Beginning Wednesday, October 28 at 8:00 a.m., providers will be required to utilize Missouri’s Immunization Information System, ShowMeVax, to complete the enrollment process. Tools and instruction can be found here, as is the Memorandum of Agreement form required for new providers. Questions about the enrollment process can be asked here.
Also in Missouri. Applications are now being accepted for the Rx Cares for Missouri Medication Destruction Program. Applications and a Program Guide can be found on the Board of Pharmacy website. Current program participants do not have to re-enroll. Enrollment is limited.
Also in Missouri. The Department of Health and Senior Services announced enhancements to ShowMeVax, Missouri’s web-based immunization information system. In early 2021, the current ShowMeVax daily data feeds into the enhanced ShowMeVax will cease. According to the Department, all providers wishing to continue exchanging vaccination data with the new system will need to register here. Questions about the transition can be addressed to the HL7 On-boarding team.
Lastly in Missouri. The Board of Pharmacy issued a proposed rule to adopt regulations under 20 CSR 2220-2 to establish licensing requirements and compliance standards for Class R remote dispensing site pharmacies. The rule would authorize the preparation, dispensing, and compounding of medication for patient dispensing without a pharmacist physically present at the Class R site to monitor and supervise pharmacy activities. The rule also would establish supervisory requirements. The proposal currently is in effect as an emergency rule. Comments are due November 14, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Ohio
The Ohio Department of Health and the Governor’s Pandemic Response and Recovery Leadership Team created a webinar on how to participate in the Ohio COVID-19 Vaccine Program. This webinar is now available on-demand and provides an overview of Ohio’s proposed vaccination strategy, as well as detailed instructions if you choose to become a provider of the COVID-19 vaccine when it becomes available. Please submit any questions you have to covidvaccine@ODH.ohio.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Dakota
The Department of Health and Social Services announced a new statewide standing order issued by Mary S. Carpenter, M.D., for Naloxone distribution from pharmacies. Per the standing order, Naloxone can now be requested and dispensed by pharmacists in South Dakota to any person who is an individual at risk of experiencing an opioid-related overdose and/or a family member, friend, or close third-party to a person at risk of experiencing an opioid-related overdose. Detailed information and supporting documents and forms regarding the standing order and Naloxone distribution can be found by accessing www.AvoidOpioidSD.com/pharmacy. For further questions, please contact the SD DSS, Division of Behavioral Health at avoidopioid@state.sd.us, or call 605-367-5236.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Wisconsin
The Governor’s Task Force on the Reducing Prescription Drug Prices, created per Gov. Tony Evers’ (D) Executive Order #39, issued its final report. Please recall NACDS submitted comments in August focusing on post-adjudication fees and drug importation. The primary recommendation from the Task Force is to advance 2019 AB 114/SB 100, PBM legislation introduced by the Pharmacy Society of Wisconsin among whose provisions include prohibiting post-adjudication fees.
Also in Wisconsin. Forward Health issued a bulletin with reminders about how pharmacies should bill for providing vaccinations.
Also in Wisconsin. The Department of Health Services is proposing to add coverage of vaccinations to the SeniorCare program, which serves approximately 93,000 individuals monthly. Comments are being accepted through November 2, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Arkansas
Gov. Asa Hutchison (R) appointed Rodney Richmond MS, PharmD, BCGP, FASCP to serve a six-year term on the eight-member Board of Pharmacy. Richmond is filling the seat previously held by Dr. Steve Bryant.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
After a lengthy discussion on October 20, the Board of Pharmacy’s Licensing Committee unanimously supported two motions to be considered by the full Board:
- order and administer CLIA-waived tests, and
- expand pharmacy technician duties to allow for the administration of immunizations.
These proposals will be considered at the full Board of Pharmacy teleconference meeting on October 27 & 28, 2020. The meeting agenda can be found here and additional meeting materials are available here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy released a proposed rule to repeal regulations under FAC 64B16-27 regarding ordering and evaluation of laboratory tests. Comments and hearing requests are due on October 28, 2020.
Also in Florida. The Board of Pharmacy released a final rule to adopt regulations under FAC 64B16-31 to establish standards for the collaborative practice certification and the test and treat certification. The rule addresses initial certification courses, agreement, and written protocol standards, formulary of medicinal drugs, patient records, follow-up care, and continuing education. The rule is effective on October 28, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
The Composite Medical Board released a proposed rule to amend regulations under GAC 360-34 that would remove the requirement for physicians to be in the same public health district as the pharmacists identified in a vaccine protocol agreement when entering into more than 10 agreements with pharmacists. A hearing is scheduled for November 5, 2020, via videoconference. Comments are due October 30, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The COVID-19 Vaccination Program Provider Agreement is now available online. According to the state, Iowa health care providers who intend to provide COVID-19 vaccines need to complete the COVID-19 Pandemic Vaccination Provider Agreement via a REDCap survey. Also please see the FAQ from the Department of Public Health. Questions regarding the COVID-19 Vaccine Provider Agreement can be directed to the IDPH Immunization Program at 1-800-831-6293 or COVID19Vaccines@idph.iowa.gov.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
Gov. John Bel Edwards (D) recently appointed three new members to serve on the 17-member Board of Pharmacy: Walgreens pharmacist Troy Menard, and independent pharmacists David Darcy and Anthony Mercantile. The Governor also reappointed five pharmacists: independent Allen Cassidy, health systems Ricky Indovina, independent Ricky Mannino, independent Doug Robichaux, and hospital Raymond Strong.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Department of Health issued MDH Issues Updated Guidance on Vaccines by Pharmacies and Immunet Reporting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The Michigan Department of Health and Human Services issued a bulletin indicating that pharmacists can receive reimbursement from Medicaid for flu vaccines retroactively beginning Oct. 1, 2020, for administering flu vaccines to individuals three years and older in accordance with the Public Readiness and Emergency Preparedness Act (PREP Act). Under this bulletin, the state will pay pharmacies the ingredient costs for vaccines and will allow for the billing, up to the state allowable cost, for administration fees.
Also in Michigan. The Michigan Pharmacists Association has appointed Mark Glasper as its next Chief Executive Officer (CEO) beginning in January 2021. Mark Glasper currently serves as CEO of the Kentucky Pharmacists Association.
Also in Michigan. Gov. Gretchen Whitmer (D) signed the state budget into law with pharmacy-related provisions taking effect on February 1, 2021. Of note, for pharmacies with seven or fewer outlets, Managed Medicaid reimbursement will follow fee-for-service reimbursement methodology. The State will also move to a single preferred drug list, create reporting requirements to improve transparency around pharmacy benefit managers (PBMs), and remove clawbacks from the Medicaid program.
Lastly in Michigan. The State Supreme Court struck down Gov. Gretchen Whitmer’s (D) executive orders (EO) related to COVID-19, effectively ruling that any EO signed after April 30 was null and void. NACDS and its in-state partners are working to legislate the business efficiencies covered in the rescinded EO’s. HB 6293, a bill authorizing pharmacists to provide COVID testing, is now headed to the Governor.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
North Carolina
Pharmacists who need to update their immunizer status with the Board of Pharmacy to administer vaccines may find instructions here.
Also in North Carolina. The Commission for Public Health issued an emergency rule to adopt regulations under 10A NCAC 41A to require all health care providers and clinical laboratories to report all coronavirus (COVID-19) diagnostic test results, both positive and negative. The rule includes requirements for how the reporting should occur and the timeframe for reporting positive and negative results. The rule because effective on September 25 and expires November 24, 2020.
Lastly in North Carolina. The Division of Medical Assistance is extending a temporary provider rate increases including pharmacy dispensing fees through the end of the federal COVID-19 public health emergency, which goes through January 21, 2021. This action will extend all COVID-19 rate increases currently in place. For more information, please click here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Department of Medicaid (ODM) is moving forward with the implementation of the tiered supplemental dispensing fee required by House Bill 166 of the 133rd General Assembly. After soliciting feedback from pharmacy association stakeholders, including NACDS, ODM has developed a methodology for allocating the funds as described in this FAQ document. They also created a dashboard that allows pharmacies to preview if they are eligible and the amount of funds they will receive by plugging in NPI numbers. Members can direct questions to medicaid_pharmacy@medicaid.ohio.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
A bill that includes several provisions related to pharmacy practice has passed the Senate unanimously and is in the House of Representatives for consideration. HB 770, sponsored by Rep. Tony DeLuca (D) originally requiring the registration of pharmacy technicians, was amended to include provisions:
- Waiving the state Clinical Laboratory Act lab employment requirement to allow pharmacists to order and administer COVID-19, strep, and influenza tests
- Allowing pharmacy technicians to perform remote data entry
NACDS will continue working with members and in-state partners over the next several weeks to overcome concerns raised by the medical community and Gov. Wolf (D). NACDS will be asking members to engage in advocacy communication efforts.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Dakota
The Board of Pharmacy shared an announcement that there is now a statewide standing order for naloxone distribution from pharmacies. Through a standing order issued by Mary S. Carpenter, MD, with the Departments of Health and Social Services, Naloxone can now be requested and dispensed by pharmacists in South Dakota to any person who is: an individual at risk of experiencing an opioid-related overdose; and/or a family member, friend, or close third party to a person at risk of experiencing an opioid-related overdose. Detailed information and supporting documents and forms regarding the standing order and Naloxone distribution can be found by accessing here.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Tennessee
The Department of Mental Health and Substance Abuse Services issued a final rule to repeal and readopt regulations under RRT 0940-06-01 to update standards on controlled substances. The rule includes the schedules of controlled substances and lists of certain non-narcotic substances, chemical preparations, prescription products, anabolic steroids, and cannabis products that are excluded from the schedules. The rule is effective on December 30, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
State Senator Dr. Dawn Buckingham (R) toured an HEB pharmacy in her district this week where she observed first-hand why the pharmacy technician ratio needs to be increased and witnessed how pharmacies are stepping up to fill gaps in health care by administering more immunizations. Dr. Buckingham expressed appreciation for NACDS’ support for her reelection campaign.
Also in Texas. The Health and Human Services Commission Department of State Health Care Services (DSHS) issued detailed guidance on how to become a COVD-19 Vaccinator in Texas. Pharmacists can register by visiting the following website. https://enrolltexasiz.dshs.texas.gov/eregister1.asp
Lastly in Texas. On Tuesday, November 3, 2020, at 9 am CST, the Board of Pharmacy will meet virtually to discuss the final adoption of proposed rules expanding pharmacy technician duties and increasing ratios. Please visit the links below for the agenda, live stream, and for information on how to provide oral comments during the meeting for which pre-registration must be completed by 5 pm CST October 31, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
In response to the potential expiration of several pharmacy efficiency executive orders that are set to expire on October 29, 2020, NACDS submitted comments to the Pharmacy Examining Board (PEB) in advance of its October 22 meeting urging the PEB to make several business efficiency waivers permanent rather than letting them expire. NACDS’ letter to the PEB can be found here.
Also in Wisconsin, the Department of Health Services is proposing to amend its SeniorCare waiver to include coverage of certain vaccinations. NACDS will support the proposal and encourages member companies operating in Wisconsin to submit similar support by the DHS deadline of November 2, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Alabama
The Department of Public Health issued a final rule amending regulations under AAC 420-7-2 to add tianeptine to the Schedule II list of controlled substances. The rule also removes Epidiolex® from the list of Schedule V controlled substances. The Department also issued a notice announcing the addition of the seizure medication Cenobamate to Schedule V of the Controlled Substances List attached to regulations under AAC 420-7-2.
Also in Alabama. The Board of Medical Examiners has issued a proposed rule adopting regulations under AAC 540-X-26 to establish requirements for collaborative pharmacy practice. The rule would set forth requirements for the collaborative drug therapy management agreement, eligibility, limitations, physician standards, reporting, and renewal. A hearing is scheduled for November 2, 2020, in Montgomery. The final date for written comments to the state is November 4, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
Concerned about confidentiality of the Maximum Allowable Ingredient Cost (MAIC) data collected on the quarterly surveys, NACDS and the California Retailers Association (CRA) sought reassurances from the Department of Health Care Services (DHCS) that all survey data will be kept confidential. DHCS provided the below response and requested that the following statement be shared with members.
All invoice information collected through this survey and subsequent surveys will remain confidential. Access to information collected is limited to Mercer employees working on the MAIC program. Mercer will not release or otherwise make public any information that names and/or discloses the business, financial, personnel, or other information provided by pharmacies in the course of completing this survey and subsequent surveys. Mercer will perform the following steps to secure the confidentiality of the information before sharing with either Magellan or DHCS:
- Mercer will store and evaluate all invoice information collected on a secure network path, where only Mercer employees working on the MAIC program will be able to access the information.
- Mercer will supply to Magellan the results of the statistical analysis, the MAIC rate for each drug grouping level (e.g. aripiprazole 10mg tablet) for Medi-Cal pharmacy claim processing. Mercer will not share survey data with Magellan outside of the MAIC rates calculated.
Also in California. On October 22, 2020, the Board of Pharmacy’s Licensing Committee will hold a virtual meeting that will focus primarily on pharmacy technician immunization administration and expanding the authority for pharmacists to order and administer CLIA-waived tests. NACDS and the California Retailers Association (CRA) submitted a joint letter in advance. Meeting materials can be found here. Members can also log on to the state website for observation and public comments.
Also in California. To encourage greater access to Medication-Assisted Treatment (MAT), the Board adopted a policy statement supporting pharmacists providing direct care and assisting medical providers in caring for patients with opioid addiction. The Board also developed a sample collaborative practice agreement for pharmacists to provide MAT to patients with opioid use disorder (OUD) in collaboration with a medical care provider. According to the Board, pharmacists can use the sample agreement to provide MAT in collaboration with a practitioner who has a DATA 2000 waiver authorizing the practitioner to prescribe medications used to wean patients from opioids.
Also in California. In an effort to prepare for the 2021 legislative session in priority states, NACDS held two separate conference calls with our in-state partners, the California Retailers Association (CRA) and the California Pharmacists Association (CPhA), to discuss NACDS’ policy priorities, identified by member surveys, for both the Reimbursement and Scope of Business Campaigns. Both CRA and CPhA expressed support for working with NACDS to achieve improved reimbursement policies for pharmacies operating in the state and expressed interest in learning more about our scope expansion ideas and business efficiencies. NACDS will continue collaborating with both partners as we move into the 2021 legislative session.
Lastly in California. The Division of Workers’ Compensation (DWC) scheduled its next public meeting of the Pharmacy and Therapeutics (P&T) Committee on October 21, 2020, at 12:30 PM via video/audio conference. The primary focus of this meeting will be to discuss the Medical Treatment Utilization Schedule (MTUS) drug formulary. Members can register for this meeting here. The meeting agenda and related materials can be found on the DWC P&T Committee webpage.
For more information, contact NACDS’ Mary Staples at 817-442-1155.