Iowa
The Department of Human Services issued the following:
- INFORMATIONAL LETTER NO. 2243-MC-FFS updating the 340B Drug Pricing Program with billing information.
- INFORMATIONAL LETTER NO. 2245-MC-FFS updating the prospective safety edits for subsequent fills for opioids with information about point of sale (POS) billing and prior authorization (PA).
- INFORMATIONAL LETTER NO. 2254-MC-FFS reminding pharmacy providers to enroll with Iowa Medicaid so that they may prescribe naloxone or nicotine replacement therapy and order and administer vaccines in accordance with the Iowa Board of Pharmacy statewide protocols.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Board of Pharmacy is meeting all-day in-person on August 18th at the Baton Rouge Embassy Suites. http://www.pharmacy.la.gov/assets/docs/Board/2021-0818_01_AgendaBdMtg.pdf
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
In 2020 voters approved a state constitutional amendment mandating Medicaid expansion. Gov. Mike Parson's included funding in his budget proposal but the General Assembly refused to fund the expansion to cover 275,000 more low-income adults and hire 75 more employees to administer the expanded program. On August 10th the Circuit Court ruled that the Missouri Department of Social Services (DSS) should immediately begin enrolling people into the MO HealthNet program.
Also in Missouri, the Board of Pharmacy will be holding a virtual meeting on August 18th to discuss the newly formed Pharmacy Working Conditions Task Force members and meeting schedule, finalize draft legislation for 2022 session, and cover the following topics: https://pr.mo.gov/boards/pharmacy/meetings/future/2021-08-18%20OPEN%20Conf.%20Call.pdf.
Finally in Missouri, the Pharmacy Agent Corporation (PAC) along with the Missouri Pharmacy Association (MPA) and consultant, G.L.O. & Associates, secured an additional $5 million in funding for MO HealthNet to increase the net dispensing fee to $10.05 after all provider tax payments and expenses.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The DUR Board will meet on September 14. The following materials have been posted on the website: agenda, policy statements and July 13, 2021 draft meeting minutes.
Also in Nebraska, the Board of Pharmacy will conduct a conference call meeting on August 16. The agenda with information to access the conference call and a link to the draft regulations (172 NAC 134) related to "delegated dispensing permits" have been posted.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
State Attorney General Aaron Ford (D) recently issued an opinion that all pharmacists working in an out of state facility of any type must be licensed in Nevada. https://www.nacds.org/ceo/2021/0813/7-22-21-Practicing-Pharmacy-into-Nevada.pdf
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy announced a Technician Rules Advisory Committee meeting on August 25.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
At the August 3rd Board of Pharmacy, after a lengthy debate, the Board agreed to accept the proposed draft language of concern to chain pharmacies emergency refills of insulin and insulin supplies and new requirements on compounding non-sterile products including flavoring and simple mixture of creams and lotions. The Board will consider adopting final rules at their November 2nd meeting.
Also in Texas, pharmacies continue lobbying efforts to secure funding for the Prescription Monitoring Program (PMP) through the American Rescue Plan Act (ARPA) of 2021 to prevent any PMP usage interruptions. https://www.nacds.org/ceo/2021/0813/PMP-ARPA-Funding-Letter-8.11.2021.pdf
Also in Texas, Gov. Greg Abbott (R) announced that the temporary suspension of numerous COVID-19 rules listed on this link will terminate on September 1, 2021. The list includes discontinuing the telephonic counseling waiver in §291.33(c)(1)(B)(iii). https://www.pharmacy.texas.gov/coronavirus/temporary-rule-suspensions.asp
Finally in Texas, the Governor convened a second 30-day special session on August 7th, but the partisan stalemate continues. On August 10th, House Speaker Dade Phelan (R) signed civil arrest warrants for 52 House Democrats still missing from the state Capitol to regain a quorum needed so that the House of Representatives can begin moving legislation during the second special
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
Gov. Asa Hutchinson (R) convened a special session on August 4th to possibly amend a law passed earlier this year banning statewide mask mandates (Act 1002). Specifically, the Governor is asking the Legislature to create an exemption that will give public school boards flexibility to issue mask mandates to protect school children who are under 12 years old and are not eligible for a vaccine. Hutchinson reiterated that there will not be a statewide mask mandate. A second item added to the call was for the legislature to affirm the decision made by the Arkansas Department of Workforce Service to end the state’s participation in the Federal Pandemic Unemployment Compensation (FPUC), Pandemic Extended Unemployment Compensation (PEUC), and Pandemic Unemployment Assistance (PUA) programs that was paying unemployed workers $300 a week to stay home.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy published an updated list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California (MBC). This information is intended to prevent dispensing of controlled substances prescribed by restricted prescribers.
Also in California, the Department of Health Care Services (DHCS) published its Medi-Cal Rx Monthly Bulletin (August 1). This month's issue including information about the full Medi-Cal Rx implementation on January 1, 2022 moving the prescription drug benefit from Medi-Cal managed care to Medi-Cal fee-for-service, updates to the Contract Drug List (effective August 1) and changes to Provider Enrollment Division (PED) to include a new PED Online Inquiry Form.
Also in California, the DHSC issued ALL PLAN LETTER 20-022 (REVISED) to all Medi-Cal Managed Care Health Plans to provide updated information and guidance related to COVID-19 vaccine coverage and administration in the Medi-Cal program. The DHCS is following California's COVID-19 vaccination plan as approved by the state's Department of Public Health.
Finally in California, the DHCS distributed COVID-19 vaccine awareness materials developed by state's Department of Public Health. There are two versions of the cards with one "Top 5 FAQs for Parents" and the other "Top 5 FAQs".
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Florida Division of Disease Control intends to amend regulations under FAC 64D-3 to establish reporting requirements for all practitioners and enrolled coronavirus (Covid-19) vaccine providers administering such vaccines.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
The Department of Health (LDH) hosted a virtual pharmacy stakeholder meeting on August 2nd to discuss the scope of the Cost of Dispensing (COD) survey and their timeline for completion. Myers and Stauffer presented https://www.nacds.org/ceo/2021/0806/LA%20PPT%202021%20LDH%20COD%20stakeholder%20meeting.pdf
and fielded questions. They agreed to accept feedback on the survey instrument https://www.nacds.org/ceo/2021/0806/2021_LA_proposed_survey_tool.pdf and survey process through August 12th, and then collaborate with LDH to finalize the survey tool. Pharmacies should receive the survey by the end of August.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
The Mississippi Board of Pharmacy amended regulations under Title 30, Part 3001, Article XXXI, to clarify that a compounding certificate becomes inactive if a pharmacy fails to compound any prescription during a calendar year. The rule is effective Aug. 7, 2021.
Also in Mississippi, the Mississippi Board of Pharmacy amended regulations under Title 30, Part 3001, Article XXXI, to clarify requirements for initiation and/or modification of drug therapy under a protocol agreement. The rule is effective Aug. 7, 2021.
Finally, the Mississippi Board of Pharmacy adopted regulations under Title 30, Part 3002, Chapter 8, to establish requirements and procedures for background checks for applicants for a board license, registration, or permit. The final rule addresses petitions for determination, determination factors and disqualifying crimes, and the disqualifying determination notification. The rule is effective Aug. 8, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The state Supreme Court unanimously ruled that the Medicaid Expansion Amendment 2 approved by voters in August of 2020 is constitutional. Previously, Gov. Mike Parson’s (R) administration announced that it would not enroll the Expansion population because the Legislature’s did not provide additional funding. As a result of the court decision, Mo HealthNet (Medicaid) will move forward on Expansion.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
NC Medicaid has received reports of confusion in the field by providers and pharmacies when members do not present an ID card or when presented with a Medicaid member ID card that differs from the data shown in the NCTracks system. To mitigate any confusion associated with newly issued Medicaid Managed Care member ID cards, providers and pharmacies should always use NCTracks Recipient Eligibility Verification/Response to confirm eligibility and not rely solely on the information shown on a Member ID Card. Health plans are required to generate an identification card for each Member enrolled in their health plan that contains the Member’s North Carolina Medicaid or NC Health Choice Identification number. Some health plans also include their health plan member ID as well. However, member ID cards are not required to provide service, and this includes pharmacies as well. Therefore, members should not be turned away due to the lack of a Member ID card in their possession. For more information, please see the Medicaid bulletin Confirming Medicaid Coverage for Beneficiaries.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Board of Pharmacy will meet on August 11-12; meeting materials have been posted online.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Department of State (DOS) has issued a memo detailing the expiration dates of the professional waivers granted during the state of emergency that will expire on or before the Sept. 30 expiration of the state of emergency. Beginning August 17, the DOS will rescind waivers in several phases, starting with the waivers that have already served their purpose in pandemic response but have not been formally rescinded. Members can find a list of all the waivers and their expiration dates on the DOS website, which can also be searched by profession. NACDS is currently engaged with in-state partners, the Administration and General Assembly in recommending that critical pharmacy waivers be made permanent.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The 30-day special session Gov. Greg Abbott (R) convened in early July will end on Friday, August 6th without progress on any legislation because of the partisan standoff in the House of Representatives over the election integrity bill. The Governor vowed to call multiple special sessions until the elections bill passes.
Also in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) updated the Preferred Drug List.
Finally in Texas, since the Board of Pharmacy failed to secure funding from the Legislature to cover the cost of the electronic health record (EHR) to continue to be seamlessly integrated into the state’s Prescription Monitoring Program (PMP), access through the Appriss PMP Gateway and access to the NarxCare score will end on August 31, 2021. Free access to the PMP remains available at texas.pmpaware.net/login, but it is more cumbersome then the direct connect integration the state began paying for in 2020 when they mandated that both prescribers and dispensers check the system before prescribing opioids, benzodiazepines, barbiturates or carisoprodol. More information is available – News | PMP Changes (texas.gov)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Executive Director of the Pharmacy Quality Assurance Commission (PQAC), Lauren Lyles-Stolz, submitted her resignation at the July board meeting. As a result, the state's board, which is responsible for establishing policy for pharmacy practice, is looking for a new Executive Director to fill the position immediately. https://www.governmentjobs.com/jobs/3170061-0/executive-director-pharmacy-quality-assurance-commission-ems-doh5705
Also in Washington, the Health Care Authority (HCA) adopted regulations effective October 1, 2021, establishing standards for provider use of the qualified prescription drug monitoring program.
Finally in Washington, the Health Care Authority (HCA) is seeking provider input on their annual survey aimed at tracking progress toward our statewide goal of payments based on health outcomes rather than paying for each medical transaction. The survey is available until August 31st. More information is available at VBP website section.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Having accepted a Conflict Avoidance Plan, the Department of Health Care Services plans full Medi-Cal Rx implementation will begin January 1, 2022, meaning the prescription drug benefit in Medicaid managed care will move to Medicaid fee-for-service. The Conflict Avoidance Plan will be posted on the DHCS website.
Also in California, on July 1, the Department of Health Care Services updated its COVID-19 Vaccine Administration Provider FAQs.
Also in California, the Board of Pharmacy is offering a free six-hour online CE training program, "Prescription Drug Abuse and Diversion: What a Pharmacist Needs to Know," on August 11. Preregistration is required and space is limited. For questions about the event, email the Board.
Also in California, the Board of Pharmacy published a Notice of Proposed Action to amend section 1709 to Title 16 of the California Code of Regulations related to Ownership, Management and Control of Pharmacies and Other Business Entities. Written comments are due September 7.
Also in California, the California Pharmacy Law Update 2021 Edition, a free continuing education webinar from the Board of Pharmacy, is now available. The program includes recently enacted pharmacy laws, recently adopted regulations, an overview of the Board's organizational structure and activities and tips for navigating the Board's website.
Also in California, the director of the Department of Consumer Affairs issued several waiver extensions including one waiving license renewal requirements for individuals with active licenses between March 31, 2020, and September 30, 2021.
Also in California, the governor appointed Nicole D. Thibeau, a pharmacist, to the Board of Pharmacy. Since 2013, Dr. Thibeau has been Director of Pharmacy Services at the Los Angeles LGBT Center. She previously served as a pharmacist-in-charge at both Target and CVS pharmacies.
Finally in California, on July 27, Gov. Gavin Newsome (D) signed AB 133 (Chapter 143, Statutes of 2021) that includes language adding medication therapy management (MTM), provided by a pharmacist in conjunction with the dispensing of qualified specialty drugs, to the list of covered pharmacist services under the Medi-Cal program. It also makes an exception for MTM to the 85% Medi-Cal rate, requiring the Department of Health Care Services to implement an MTM reimbursement methodology.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
The Board of Pharmacy issued a response to Gov. Kim Reynold’s July 23, 2021, Proclamation of Disaster Emergency. Given there are no further suspensions of administration rules related to pharmacy licensure or registration, the board will no longer continue its enforcement discretion regarding pharmacy practice. As a reminder, the board’s responses to the governor’s various proclamations are available on the board’s website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
The Maryland Insurance Administration (MIA) issued a request for input on a report being prepared for the Legislature on the scope of the U.S. Supreme Court opinion in Rutledge v. Pharmaceutical Care Management Association and how to apply the decision to Title 15, Subtitle 16 of the Insurance Article. Comments are due to MIA on Sept. 10, 2021. NACDS intends to draft comments to send out for member review. If you have any comments, you’d like us to include, please send them to Jill McCormack by Aug. 31.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services (DHHS) released recent updates and information including the following:
- The Heritage Health pharmacy reference guide has recently been updated (August 2021).
- Because COVID-19 State of Emergency ended on June 30, those licensees, including pharmacy technicians, impacted by the original order (Executive Order 20-10) will be notified through a mailing that they need to renew their licenses before October 31.
- The 471-000-540 Nebraska Medicaid Practitioner Fee Schedule for Injectables was updated effective July 1.
- Provider Bulletin 21-13 includes changes to Preferred Drug List (effective July 15) and Hepatitis C (July 1) Criteria.
- DHHS announced that all Nebraskans eligible for Medicaid expansion will receive equal benefits coverage, including OTC medications, starting October 1.
- DHHS issued notice of public hearing on August 18 to receive comments on proposed changes to Nebraska Medicaid Managed Care (NAC Title 482, Chapters 2, 4 and 5). The proposed changes include removing language restricting managed care organizations from offering certain coverage, including over-the-counter drug coverage, as value-added services. Also, the proposed changes include removing language that excludes Basic benefit plan enrollees from certain services, including pharmacy services. These changes align the rules with the withdrawal of Nebraska's 1115 demonstration waiver and implementation of the Heritage Health Adult program.
Also in Nebraska, the draft July 13 minutes from the recent Medicaid DUR Board Meeting and the Board Policy Statements are now available.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Six NACDS members have been appointed to the 11-member Ohio Board of Pharmacy Workload Advisory Committee (PWAC), including representatives from CVS Health, Kroger, Rite Aid, Walgreen and Walmart. In April 2021, the Board of Pharmacy approved the formation of a the PWAC in response to the release of a July 2020 workload survey conducted by the Board. The purpose of the advisory committee is to promote patient safety and compliance with Ohio laws and rules by analyzing survey and other data and make recommendations to the Board to address pharmacist working conditions. PWAC recommendations may include changes to Board of Pharmacy rules as well as statutory changes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Oregon Health Authority revised regulations under OAR 333-047 and -049 regarding requirements for health care persons, entities and other enrolled providers that receive, store, administer or transfer coronavirus (COVID-19) vaccines, including reporting the amounts of doses administered and that are in inventory to the immunization registry, also known as the immunization information system. The rule was effective July 12, 2021.
The Oregon Health Authority, Public Health Division, temporarily adopted regulations under OAR 333-047 to prohibit health care providers and vaccine sites from requiring parental consent for coronavirus (COVID-19) vaccination for minors age 15 to 17 years, and from asking for a Social Security number. The temporary rule also requires persons or entities administering state-supplied COVID-19 vaccines to have a designated site coordinator, post signs with the site coordinator's contact information, provide information about when and where to get a second dose and provide a vaccine card as proof of vaccination. The rule, which replaces an earlier temporary rule on the same topic, is effective July 9, 2021, and expires November 22, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
NACDS has been asked to extend an invitation to our members from Governor Ralph Northam (D) and the Department of Health to exclusive online conversation with Dr. Anthony Fauci and other distinguished panelists on August 3 from 6:00 pm to 7:00 pm EDT. The online event is meant to help empower healthcare providers to encourage their patients to get vaccinated against COVID-19. All healthcare providers are invited.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.