Florida
The Board of Pharmacy issued a notice announcing Emergency Order DOH No. 20-014 that allows licensed pharmacists and registered pharmacy interns to order and administer vaccinations approved by the FDA and in accordance with the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) immunization schedules to adults and children under 18 years, in response to the coronavirus (COVID-19) outbreak. The order also specifies that pharmacists are required to report all patient vaccination details to Florida SHOTS.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
Despite efforts by NACDS, the Louisiana Alliance of Retail Pharmacy (LARP), chain pharmacy lobbyists, and quick responses from our Louisiana pharmacists via the RxIMPACT Alerts, SB 51 failed to garner 20 votes after it was amended on the Senate floor to apply only to COVID vaccines. SB 51, sponsored by Senator Regina Ashford Barrow (D), would have lowered the age for pharmacists to provide childhood vaccinations without prescription order to 3 and order. NACDS will continue to work on this issue in the upcoming legislative session in efforts to align with the authority granted under the HHS PREP Act declaration.
Also in Louisiana. SB 63, also sponsored by Sen. Barrow, encountered strong opposition from the medical community at the Senate Health and Welfare Committee. SB 63 would have allowed pharmacies that do screenings using CLIA-waived tests to provide treatment based on positive test results. The bill would have provided treatment or therapy for HIV, which includes an HIV Pre-Exposure Prophylaxis, also known as PrEP, or an HIV Post-Exposure Prophylaxis, also known as PEP. Due to such strong opposition, the bill was pulled, and discussions focused on convening a study committee to work out differences in the interim.
Also in Louisiana. The Board of Pharmacy announced changes to several proposed rules. A public hearing will be held and comments on the following rules are due by October 26, 2020.
- Notice – a proposed rule that would amend regulations under LAC 46:LIII, Chapter 12, to revise automated medication system registration eligibility criteria and add detention and correctional facilities operated by state or local governments as locations. The rule also would revise credentialing procedures, modify pharmacist-in-charge responsibilities, and require the retrospective review of medications removed from a non-profile driven system. In addition, the rule would adopt documentation requirements. The changes will also revise the requirements for stocking and restocking and specify that a pharmacy with an automated medication system on-site does not need to register the system. A hearing is scheduled for October 26, 2020, in Baton Rouge.
- Notice – a proposed rule that would amend regulations under LAC 46:LIII, Chapter 29, to add several drugs to the definition of “drugs of concern.” The rule also would add recordkeeping requirements for prescription transactions and revise provisions on authorized access privileges, access registration procedures, and methods of access. In addition, the rule would extend the automatic registration procedures to include dispensers. The changes would also remove seven of nine drugs originally proposed and retain the drugs promethazine when present in oral liquid formulations and gabapentin.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
The Division of Medicaid posted a final rule that would amend regulations under Title 23, Part 214, Chapter 2, to update the participation and enrollment requirement for pharmacists providing disease management services. The file rule is effective on November 1, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
NABP/AACP
On October 13 NACDS participated in the NABP/AACP virtual District 6, 7, & 8 meeting, which included participants from Alaska, Arizona, Arkansas, California, Colorado, Hawaii, Idaho, Kansas, Louisiana, Missouri, Montana, Nevada, New Mexico, Oklahoma, Oregon, Texas, Utah, Washington, and Wyoming. Of note, the meeting heard resolutions from Districts 6 & District 7. District 6 requested NABP to convene a “Workplace Safety and Well-Being Task Force” to develop suggested guidelines and objective tools that may be used by Boards of Pharmacy in their “oversight endeavors.” District 7 requested NABP to establish a Task Force to encourage and support member boards to transition to a “just culture” regulatory approach to errors through a systematic approach. Lastly, NABP recommended the Executive Committee to convene a committee to inventory all waivered provisions enacted during the public health emergency and advise which waivers could safely remain in effect and be incorporated into the NABP Model Act and Rules.
Nevada
As a result of efforts by NACDS, the Retail Association of Nevada (RAN), and our chain pharmacy members, permanent rules passed by the Board of Pharmacy allowing pharmacy technicians to administer vaccinations last month were fast-tracked and received administrative approval in weeks rather than months. More information on the rules can be found here.
Also in Nevada. The Department of Health and Human Services, Board of Pharmacy, and Immunize Nevada will be hosting a teleconference regarding COVID-19 Vaccines on October 22, 2020, at 2 PM PT. The aforementioned state entities have stated that they appreciate the commitment of pharmacists to play a vital role in administering COVID immunizations, when available and that the goal of the meeting is to initiate a dialogue between the Nevada Department of Health and Human Services and pharmacists by providing an update on vaccine preparations and answering common questions the state has received regarding the vaccine.
To join this meeting via phone – 1-888 475 4499 US Meeting ID: 852 2988 4465 Passcode: 396451
To join this via the internet – https://us02web.zoom.us/j/85229884465?pwd=L24xR1FIOEQ4OVhyTWVkWWxKU1Z2QT09
Meeting ID: 852 2988 4465 Passcode: 396451
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
The Office of the Superintendent of Insurance issued a notice regarding coverage for coronavirus diagnostic testing and treatment, which requires issuers to remove cost barriers to testing and treatment and waive any cost-sharing, including co-pays, deductibles, and coinsurance. The bulletin specifies that carriers are prohibited from balance billing for COVID-19 diagnostic testing when determined to be medically necessary.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Tennessee
The Department of Finance and Administration, Division of TennCare published a recent notice announcing its intentions to revise the Medicaid State Plan to include in the TennCare benefits package buprenorphine-enhanced supportive medication-assisted recovery and treatment, known as “BE-SMART,” for beneficiaries needing treatment for opioid use disorder, effective January 1, 2021. The Department intends to submit the amendment CMS as a revision to the Medicaid state plan. Comments are requested, but a due date is not specified.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Prescription Monitoring Program Advisory Committee will hold its virtual quarterly meeting at 9 AM on October 20, 2020. The meeting agenda can be found here. More information about the PMP is available here.
Also in Texas. The Board of Pharmacy requested comments be submitted by October 31, 2020, on sixteen proposed rules, including the expansion of pharmacy technician duties and expanding ratios. NACDS strongly urges members to submit letters of support and participate in the November 3, 2020 Board of Pharmacy zoom meeting. Links to the proposed rules and brief summaries are below.
- Proposed rule amending regulations under 22 TAC 283 to clarify course work requirements for reciprocity applicants retaking the state pharmacy jurisprudence exam.
- Proposed rule amending regulations under 22 TAC 283 to remove an outdated reference to pharmacist intern-trainees.
- Proposed rule amending regulations under 22 TAC 283 to remove the ratio of pharmacists to pharmacist-interns.
- Proposed rule amending regulations under 22 TAC 283 to remove an outdated reference to a change of name fee.
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include receiving and transferring prescriptions for dangerous drugs. The rule also would remove the ratio of on-site pharmacists to pharmacy technicians.
- Proposed rule amending regulations under 22 TAC 291 to update the definition of “original prescription.”
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include receiving, transferring, or contacting a prescriber regarding prescriptions for dangerous drugs.
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include receiving, transferring, or contacting a prescriber regarding prescriptions for dangerous drugs. The rule also would increase the ratio of pharmacists to pharmacy technicians and pharmacy technician trainees to 1:6.
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include the transfer of prescriptions for dangerous drugs and documentation of consultation.
- Proposed rule amending regulations under 22 TAC 291 to require non-pharmacist individual owners or managing officers of a Class A pharmacy license applicant to attend a pharmacy ownership training course.
- Proposed rule amending regulations under 22 TAC 291 to require non-pharmacist individual owners or managing officers of Class A pharmacies to take ownership training within 90 days of notifying the board of a change of managing officer. The rule also would revise the change of ownership notification requirements.
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include receipt of oral prescription drug orders for dangerous drugs.
- Proposed rule amending regulations under 22 TAC 291 to expand the nonjudgmental duties that may be performed by pharmacy technicians to include receiving and transferring prescriptions for dangerous drugs. The rule also would remove the ratio of pharmacists to pharmacy technicians and pharmacy technician trainees.
- Proposed rule of the State Board of Pharmacy would amend regulations under 22 TAC 315 to clarify when a controlled substance prescription is not required to be issued electronically. The rule also would add procedures for requesting a waiver of the electronic prescribing requirement.
- Proposed rule amending regulations under 22 TAC 309 to update the definition of “original prescription.”
- Proposed rule amending regulations under 22 TAC 309 to update provisions on oral prescriptions to allow for expanded pharmacy technician duties.
Lastly in Texas. The Department of State Health Services’ (DSHS) Immunization Program is urging pharmacies and other health care providers interested in administering the COVID-19 vaccines once they are available to enroll as vaccine providers at EnrollTexasIZ.dshs.texas.gov. For more information on the DSHS Immunization Program, visit EnrollTexasIZ.dshs.texas.gov.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Department of Health has issued a VA COVID-19 Vaccine Provider Intent form. Pharmacies who wish to receive COVID vaccine allocations from VDH are required to fill out the form. Questions regarding the COVID-19 Vaccine Provider Intent Form can be directed to COVIDVaccineInfo@vdh.virginia.gov
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
California
As California prepares for the start of the implementation of SB 212, which requires the pharmaceutical industry to form a stewardship organization and fund a drug take-back program, the California Product Stewardship Council (CPSC) provided stakeholders with an update on the safe disposal drug take-back bin (med bin) “infrastructure” that they have been building since they were awarded the grant in 2018. To find a med bin near you, visit www.takebackdrugs.org.
Also in California. Beginning on January 1, 2021, Medi-Cal pharmacy benefits will be transitioned to and administered through the fee-for-service delivery system for all Medi-Cal beneficiaries (generally referred to as “Medi-Cal Rx”). The Department of Health Care Services (DHCS) has partnered with Magellan Medicaid Administration, Inc. (Magellan) to provide a wide variety of administrative services and supports for Medi-Cal Rx. DHCS is providing critical information regarding the prescriber and pharmacy registration for the secure Medi-Cal Rx Provider Web Portal. This portal will be used to provide regular transitional monitoring supports to help ensure submitting providers and other interested entities will have all necessary information to support efforts related to a smooth and effective transition, including communications, training, and other pertinent resources. DHCS continues to make significant progress towards a successful transition of pharmacy services on January 1, 2021, to Medi-Cal Rx. Medi-Cal Rx transitioning pharmacy services from Medi-Cal managed care to fee-for-service will, among other things:
- Standardize the Medi-Cal pharmacy benefit statewide, under one delivery system.
- Improve access to pharmacy services with a pharmacy network that includes the vast majority of the state’s pharmacies and is generally more expansive than individual Medi-Cal managed care plan pharmacy networks.
- Apply statewide utilization management protocols to all outpatient drugs, as appropriate.
- Strengthen California’s ability to negotiate state supplemental drug rebates with drug manufacturers as the largest Medicaid program in the country with over 13 million beneficiaries. More information on the Medi-Cal Rx transition and the Provider Portal can be found here.
DHCS/Magellan has also launched the training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies. For detailed registration and training instructions, access the Medi-Cal Rx Web Portal and Training Registration or visit https://medi-calrx.dhcs.ca.gov/provider/ and click Register in the upper right-hand corner.
Also in California. A Medi-Cal Rx subscription service is now available, so pharmacies are encouraged to sign up and receive Medi-Cal Rx updates by email.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Department of Health Care Policy & Financing (HCPF) is hosting training sessions focusing on the upcoming residential and inpatient substance use disorder (SUD) service benefit on October 22 and 29, 2020. The program will cover topics including an overview of the SUD benefit expansion, enrollment with Health First Colorado as a residential/inpatient SUD treatment provider, billing procedures for the new services, ASAM Criteria documentation of medical necessity, utilization management, provider licensure requirements, and content provided by the Regional Accountable Entities (RAEs) and Managed Service Organizations (MSOs) for treatment providers. Members may register for the training and can visit the Ensuring a Full Continuum of SUD Benefits website (for additional information).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy has issued a notice announcing a change to a July 27 proposed rule that would amend regulations under FAC 64B16-27 to clarify standards for the supervision of pharmacy technicians, including supervising pharmacist responsibilities and requirements for delegation. The change clarifies language regarding the prohibition on interfering with the supervising pharmacist’s independent professional judgment.
Also in Florida. The Board of Pharmacy has issued a proposed rule that would adopt regulations under FAC 64B16-31 to clarify standards for collaborative practice and test and treat certifications. The rule would specify that licensees are not required to complete the three-hour continuing education related to minor, nonchronic health conditions if the initial certificate was issued fewer than 12 months before the expiration date of the license. Comments and hearing requests are due on October 14, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
On October 7, The DEA in coordination with HHS, held a virtual webinar titled, “Supporting Healthcare Professionals during the Pandemic.” Topics discussed included drugs of abuse and trends, COVID 19 guidance, telemedicine, updates on fraud and robberies, and an overview of DEA requirements regarding the handling of controlled substances according to Federal regulations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
Health Commissioner Dr. Kristine Box has issued a Standing Order allowing pharmacists and interns to administer vaccines as recommended by the Advisory Committee on Immunization Practices (ACIP) to patients age 11 and older. The Standing Order recognizes HHS’ recent declaration permitting pharmacists to order and administer (and interns to administer) vaccines for children ages 3-18 and notes that for these immunizations ordered or administered under HHS’ declaration, the declaration requirements should be followed. Commissioner Box also signed immunization protocols for the administration or dispensing of vaccines to individuals 11 and older, which is the current age range under the state statute.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Iowa
The Iowa Medicaid Enterprise issued an informational letter announcing changes to the Preferred Drug List effective October 1. Among other policy changes included in the Informational Letter, prior authorization is now needed for 90 morphine equivalent units (MME), reduced from 120 MME.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Kentucky
Representative Bentley, Pharm.D. (R) has pre-filed BR 328, which would require commercial insurance plans to reimburse pharmacists for claims submitted for services within their scope of practice, as well as require the insurer to credential pharmacists for these services.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Legislature convened a 30-day special session on Monday, September 28, focused primarily on budget and COVID issues. Seizing on the opportunity to pursue an NACDS initiative to make waivers permanent, NACDS and the Louisiana Alliance of Retail Pharmacy (LARP) persuaded Senator Regina Ashford Barrow (D) to file an immunization bill lowering the age for pharmacists to vaccinate without a prescription order to three and older to align with the federal PREP Act declaration. The current arbitrary age limits set in the statute are 7 years or older for influenza and all other vaccines, 17 years or older.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Board of Pharmacy Rules Committee Work Group met on October 7 to discuss the Controlled Substance Rule. The meeting agenda can be found here. The full Board will meet on October 14, 2020. The meeting agenda and Zoom meeting access information can be found here.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Missouri
Governor Mike Parson (R) issued a waiver authorizing pharmacists to order and administer COVID vaccinations per the HHS guidance issued under current the PREP Act declaration. For more information, please visit the above link.
Also in Missouri. The Board of Pharmacy issued a reminder that all amendments to existing immunization protocols that add additional childhood vaccines, revise age limits, or add the COVID-19 vaccination must be signed and dated by all pharmacists participating in the protocol in addition to the physician.
Also in Missouri. The Missouri Pharmacy Association (MPA) has shared information that Diabetes Self-Management Education and Support (DSMES) grant funding is available to help pharmacies become accredited sites for diabetes classes and education and bill for these services. For more information, please contact MPA’s Annie Eisenbeis.
Also in Missouri. The Board of Pharmacy filed an emergency rule to implement Class R Remote Dispensing sites per 2019 HB 1682 effective August 28 and published a guidance statement. Questions about Class R licensure can be emailed to the Board. For more information, please visit the above links.
Lastly in Missouri. The Board of Pharmacy will meet on October 8, 2020. Among the many agenda items, the Board has proposed rule language on prescription and medication order transfers. For more information please visit the above link.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nebraska
Medicaid expansion took effective October 1. To date, 10,288 eligible residents have signed up, but state officials expect enrollment to reach 90,000 within a few years. For more information please visit the above link.
Also in Nebraska. The Department of Health and Human Services held a public hearing on October 8, 2020, to address amendments to regulations on wholesale drug distributors and delegated dispensing permits. For more information please visit the above links
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
North Carolina
The Commission for Public Health announced a notice of intention to issue a temporary rule that would adopt regulations under 10A NCAC 41A to require all health care providers and clinical laboratories to report allCOVID-19 diagnostic test results, both positive and negative. The rule would include requirements for how the reporting should occur and the timeframe for reporting positive and negative results. The rule currently is in effect as an emergency rule. A hearing is scheduled for October 9 by teleconference. Comments are due October 16, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
Medicaid issued an update with a reminder that pharmacies bill vaccinations through the medical benefit with traditional Medicaid billed to the State and expanded Medicaid billed to Sanford Health. For more information please visit the above link.
Also in North Dakota. With changes to the State Health Officer position, the North Dakota Pharmacists Association has shared the new immunization protocol, which can be found here.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Ohio
On Sept. 30 the Ohio Department of Medicaid (ODM) released a Request for Applications (RFA) inviting managed care organizations to submit proposals for Ohio’s managed care program. The RFA is a major part of ODM’s plans to streamline and modernize the Medicaid Managed Care program. For more information click here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
On October 7, The DEA in coordination with HHS, held a virtual webinar titled, “Supporting Healthcare Professionals during the Pandemic.” Topics discussed included drugs of abuse and trends, COVID 19 guidance, telemedicine, updates on fraud and robberies, and an overview of DEA requirements regarding the handling of controlled substances according to Federal regulations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
SB 1210, sponsored by Sen. Judy Ward (R), which originally allowed pharmacists to order and administer COVID point-of-care tests by exempting them from the PA Lab Act’s lab experience requirement, was amended and reported out of the Senate Health Committee. The amendment, drafted by NACDS, would expand the bill to include all CLIA-waived tests. The amendment passed 7-4 on a party line vote, but the bill as amended was adopted unanimously. Further action is expected the week of October 19, 2020, when the Senate returns to session. The Department of Health opposed the bill, which drove the party-line vote on the amendment. NACDS has been working jointly with PACDS on the ground in Harrisburg to pass this bill before the Legislature adjourns Sine Die sometime in November.
Also in PA. Legislation that would require pharmacy technicians to register in Pennsylvania is advancing, after previous versions of the bill failed to make it past the finish line in previous years. HB 770 passed the House in May of 2019, but just last week passed the Senate Consumer Protection and Licensure Committee and received first consideration in the Senate. The bill is viewed by many as a necessary precursor for any future consideration of advanced duties for technicians. The bill is supported by PACDS.
Also in PA. The Department of Human Services issued a Medicaid Bulletin providing notice that the Department will pay pharmacies for the collection of specimens by pharmacists for COVID-19 testing effective October 1.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.