Florida
The Department of Health proposed to amend regulations under FAC 64D-3 to add the coronavirus (COVID-19) to the list of reportable diseases and conditions. Comments and hearing requests are due July 21.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Department of Human Services issued a proposed rule that would amend regulations under 77 IAC 2070 to add dronabinol oral solution and capsules to the list of Schedule II controlled substances. Comments are due August 9.
Also in Illinois, the Department of Healthcare and Family Services has posted a new Provider Notice regarding Critical Access Pharmacy (CAP) Dispensing Fee Fiscal Year 2022 Attestation.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
The Department of Health (LDH) issued several new Medicaid bulletins for pharmacies:
- Louisiana Medicaid Pharmacy Point of Sale Diagnosis Code Requirements for Select Drugs – Effective July 1, 2021
- Louisiana Medicaid Pharmacy Point of Sale Quantity Limit for Dulaglutide (Trulicity®) – Effective July 1, 2021
- Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Criteria Updates for Select Drugs – Effective July 1, 2021
- Louisiana Medicaid Pharmacy Educational Alert for Opioid Prescriptions – Effective July 1, 2021
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Minnesota
Gov. Tim Walz (D) signed HF 33, the Health and Human Services omnibus budget bill on June 29. Notably, the final bill includes an increase in the Medicaid professional dispensing fee from $10.48 to $10.77, an expansion of the list of drugs permitted to be dispensed in a 90-day supply, an allowance for medication therapy management via telehealth and a requirement that Medicaid conduct a cost of dispensing study to determine a statewide dispensing fee for specialty drugs.
Also in Minnesota, the Board of Pharmacy posted an announcement and FAQs that they rescinded COVID operational variances due to Gov. Walz ending the state of emergency on July 1. The Board expects pharmacies to be compliance with current statute and rules by July 16. The announcement clarifies that the PREP Act and Declarations pre-empt state laws and remain in effect.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
NACDS submitted comments opposing the inclusion of discount cards and programs in the definition of Usual and Customary that could contribute to below-cost pharmacy reimbursement.
Also in Missouri, Gov. Mike Parson (R) signed into law legislation passed during the special session that extends the Federal Reimbursement Allowance (FRA) program, which is a provider tax on pharmacies, hospitals, nursing homes and other health-care providers that are critical to drawing down federal match to fund Missouri's Medicaid program to 2024. The FRA is currently set to expire September 30. (SB 1)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The next meeting of the Medicaid DUR Board Meeting will be held on July 13.
Also in Nebraska, given the expansion of testing availability throughout the state and decreased volume of specimens submitted to Test Nebraska, the Department of Health and Human Services announced that Test Nebraska will no longer be collecting COVID-19 specimens after July 18.
Finally in Nebraska, Gov. Pete Ricketts (R) announced the end of the coronavirus state of emergency at 11:59 p.m. on June 30. The Governor issued Executive Order (EO) 21-09 to rescind pandemic-related executive orders. With a few exceptions, the coronavirus executive orders will expire on July 30, which is thirty days after the state of emergency ends. NACDS researched and identified the following as impacting pharmacies, pharmacists, interns and/or technicians and expiring on July 30.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The Board of Pharmacy announces a notice to issue a temporary rule that would adopt regulations under 21 NCAC 46 to establish standards under which a pharmacist can administer long-acting injectable pharmaceuticals formulated to produce sustained release and gradual absorption. The rule also would establish recordkeeping requirements. A hearing is scheduled for August 2 by teleconference. Comments are due August 3.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
On June 30, Gov. Mike DeWine (R) signed HB 110, the biennial state budget bill. Included in the bill is a total of $15 million ($5,000,000 in Fiscal Year 2022 and $10,150,000 in Fiscal Year 2023) to continue funding for the Medicaid managed care pharmacy supplemental dispensing fees.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
REMINDER: The Board of Pharmacy cancelled all the COVID waivers effective July 1. If there is a need for a COVID waiver, then a request to reapply must be made to the board.
Also in Oklahoma, beginning July 1, the Board of Pharmacy transitioned to an online system where all new licenses and license renewals must be paid for through the Board's online store. The Board will only accept credit card payments (Mastercard or Visa) or Electronic Fund Transfers (EFT). For additional information, contact the Board.
Lastly in Oklahoma, the Board issued this reminder that the law on E-Scripts and OBNDD (Oklahoma Board of Narcotics and Dangerous Drugs) prescription pads does not apply to prescribers practicing in a federal facility, including Indian Health Services/Tribal pharmacies. The Board explained this is because prescribers can work there and be licensed in another state and not be licensed in Oklahoma. Furthermore, the Board stated the prescriptions from these federal facilities are legal and appropriate to fill if all other requirements are met.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The PACE program issued a Bulletin announcing it will reinstate the early refill edit that was temporarily lifted due to COVID-19 concerns. Additionally, the edit allowing a temporary override for quantities greater than 100 and a day’s supply greater than 30 will be removed when PACE is the primary payer. Both will be effective August 2. Questions may be directed to Provider Services at 1-800-835-4080.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
Gov. Greg Abbott (R) convened a 30-day special session of the Legislature on July 8 to address unfinished business, including election integrity, bail reform and several other issues.
Also in Texas, in advance of the August 3 quarterly board meeting, the Board of Pharmacy is seeking comments by July 27 on several proposed rules:
- Proposed rule updating the internship hours requirement to reflect the Accreditation Council for Pharmacy Education requirement.
- Proposed rule increasing the pharmacist initial license fee from $332 to $360 and the biennial renewal fee from $329 to $357.
- Proposed rule increasing the pharmacy technician initial registration fee from $83 to $84 and the biennial renewal fee from $80 to $81.
- Proposed rule increasing the pharmacy initial license fee from $507 to $538 and the biennial renewal fee from $504 to $535.
- Proposed rule allowing Class A or Class C pharmacies to provide remote pharmacy services using an automated disposing and delivery system.
Also in Texas, the Department of State Health Services (DSHS) is encouraging vaccine providers to participate in weekly webinars on Tuesdays from Noon-1:30 PM Central time. Preregister for the upcoming July 13 webinar here. Highlights from past webinars are available online COVID-19 Vaccine Providers Webinars page.
Finally in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) maintains a Specialty Drug List (SDL) for Medicaid Managed Care (MCO). Currently, HHSC reviews and adjusts the drug list quarterly. VDP is proposing changing the SDL publication schedule from quarterly to twice a year, giving MCOs more time to finalize contracts with pharmacies in their specialty networks. VDP is soliciting comments on this draft policy change by July 19 at 5:00 p.m. to the VDP Operations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
The Board of Pharmacy proposed amendments to regulations under 15 WVCSR 16 to reduce the biennial pharmacist license renewal fee to $50 for applicants aged 65 years or older. Comments are due July 15.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wyoming
Effective June 16, the Board of Pharmacy amended regulations under Chapter 16 adding vaccines approved by the US Food and Drug Administration for COVID-19 and allowing the administration of vaccines to children and healthy adults in accordance with current Centers for Disease Control and Prevention recommended vaccine schedules.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
On June 11, 2021, Gov. Gavin Newsom (D) signed Executive Order (EO) N-08-21, rolling back the provisions of numerous Executive Orders previously issued in response to the COVID-19 Public Health Emergency. Among these is the provision in paragraph 4 of EO N-55-20 that included the pharmacy waived delivery restriction that will expire June 30, 2021. Effective July 1, 2021, beneficiaries and clients, or their representatives, will need to sign for medications in person from their home or sign onsite at their provider location for all Department of Health Care Services programs.
Also in California, as a reminder, the Remote Processing (BPC section 4071.1(a)) limited waiver will expire on June 30, 2021. Note: although the waiver is expiring, persons or entities may request a site-specific waiver from the Board.
Also in California, on June 11, 2021, the Department of Health issued the State Public Health Officer Order of June 11, 2021, mandating various requirements as of June 15, 2021. The order replaces the previous pandemic public health orders with limited requirements related to face coverings, mega events and child and youth environments.
Also in California, NACDS and the California Retailers Association submitted a letter to the Senate Business, Professions & Economic Development Committee expressing opposition to AB 1533, the Board of Pharmacy sunset bill, unless it is amended to modify and clarify the provisions allowing the Board of Pharmacy to levy penalties of up to $1 million on chain pharmacies that would be excessive and disproportionate to the violations in question.
Also in California, the Office of Administrative Law has approved a proposal to add section 1747 to Title 16 of the Code of Regulations, regarding independent authority to furnish HIV Preexposure and Postexposure Prophylaxis and the order of adoption has been posted. The new regulation was effective June 8, 2021.
Also in California, the Office of Administrative Law has approved a proposal to add section 1717.5 in Article 2 of Division 17 of Title 16 of the Code of Regulations, regarding Automatic Refill Programs and the order of adoption has been posted. The new regulation is effective July 1, 2022.
Lastly in California, the California Privacy Protection Agency Board, created by Proposition 24, held its first board meeting on June 14, 2021. The meeting focused on how to staff the agency as they organize it to get up and running. All board members agreed that a monthly meeting was necessary; however, no specific meeting date was provided.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
An emergency rule of the Department of Health adopts regulations under FAC 64DER21-9 to require all health care practitioners and other enrolled coronavirus (COVID-19) vaccine providers to report to the online immunization information system within 72 hours the administration of any COVID-19 vaccine with an emergency use authorization from the FDA. The rule replaces a March 17, 2021, emergency rule on the same topic. The rule is effective June 11, 2021 and expires September 9, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
Gov. J.B. Pritzker (D) has signed SB 2017. Effective June 17, 2021, the legislation (page 549) allows for pharmacists to order and administer vaccines listed on the U.S. Centers for Disease Control and Prevention (CDC) Recommended Immunization Schedule, the CDC’s Health Information for International Travel or the U.S. Food and Drug Administration’s Vaccines Licensed and Authorized in the U.S. The legislation also authorizes that, when applicable, vaccines ordered and administered must be covered and reimbursed at no less than the rate that the vaccine is reimbursed when order by a physician.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
Effective July 1, 2021, community pharmacies in Iowa may begin to submit electronic claims for reimbursement of DisposeRx® (or other branded medication disposal solutions) dispensed to Iowa residents who may be at risk of an accidental opioid or other controlled substance misuse or overdose. Additional information, including the pharmacy electronic billing process, is available in the Disposal Kit Dispensing Program FAQ document on the Board of Pharmacy’s website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
As of June 29, 2021, pharmacies will not have to obtain identification for a patient person purchasing hypodermic syringes and needles or maintain a logbook for these purchases. The change is a result of the passage of HB 219 of 2021. The new law also details the conditions under which pharmacies may sell syringes without a prescription, including providing written or electronic materials on safe disposal and syringe exchange programs and offering the patient Naloxone. Lastly, the law clarifies that syringes sold under these provisions do not constitute drug paraphernalia.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
In response to a survey from the Louisiana Department of Health (LDH), NACDS submitted comments recommending ways LDH can improve the pharmacy benefit delivery models used by the state’s Medicaid managed care organizations. Specifically, NACDS suggested that they adopt policies to help ensure patient access to neighborhood pharmacies by promoting the ability for any willing pharmacy to participate in a managed care organization’s network provided that a pharmacy accepts the terms and conditions of that network. We also advocated that LDH carve out the prescription drug benefit from the Medicaid managed care program to the state’s fee-for-service program. Lastly, we recommended the adoption of a Medicaid managed care reimbursement methodology that seeks to ensure a pharmacy’s costs are covered, which aligns with methodology used under the state’s Medicaid fee-for-service program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
As a result of Gov. Larry Hogan’s (R) termination of the State of Emergency that will be effective July 1, 2021, the Department of Health’s Office of Pharmacy Services announced they will rescind the waiver allowing pharmacies to deliver without a receiver signature. Therefore, effective August 15, 2021, the Medicaid Fee-for-Service Program will require pharmacies to record signatures when delivering prescriptions.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
Now that the Massachusetts State of Emergency has been lifted, the Department of Public Health has issued several regulatory updates.
Therefore, effective June 30, 2021, the Board will return to the following pre-pandemic requirements:
- 12 hour workday maximum (247 CMR 6.02(9)(c))
- supervisory ratios (247 CMR 8.06(3))
- perpetual inventory every 10 days (247 CMR 9.01(14))
- compounding copies of commercially available drugs
- restocking emergency kits in long term care facilities within 48 hours (105 CMR 150.008(E))
- ID requirement for picking up a federally controlled substance or gabapentin prescription (105 CMR 700.012)
- NOTE: ID is not needed to pick up prescriptions for federally scheduled controlled substance in certain circumstances. However, the individual must print his or her name and address on the reverse side of the prescription and sign it. In the case of an electronic prescription, they must provide an electronic signature. Review the Data Submission Dispenser Guide for details.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
Gov. Mike Parson (R) convened a special session on June 23, 2021, to address extending Medicaid funding for the state because the Legislature adjourned last month prior to passing a renewal of the Federal Reimbursement Allowance (FRA), the tax on health care providers that draws down billions in federal matching dollars to fund the state's Medicaid budget. To prevent a $1.4B budget gap, lawmakers only have five days to pass legislation to extend the program as the deadline for a balanced state budget is set for July 1, 2021.
Also in Missouri, NACDS is preparing a comment letter objecting to an emergency proposed rule that would add this new definition of usual and customary ("U&C") for purposes of reimbursement for covered drugs under the state's Medicaid program. "U&C is defined as the provider's charge to the general public that reflects all advertised savings, discounts, special promotions, or other programs including membership-based discounts initiated to reduce prices for product costs available to the general public, a special population, or an inclusive category of customers."
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
Below are highlights from the June issue of the New Mexico Board of Pharmacy newsletter. See the newsletter for additional details and more information.
- As some prescribing practitioners are working to implement the electronic prescriptions for controlled substances requirement that was effective April 1, 2021, the Board issued an "Emergency Dispensing Declaration" from April 1, 2021, through June 30, 2021, and it does not intend to take action against a pharmacist who fills a nonelectronic controlled substance prescription not otherwise subject to the exceptions.
- Effective June 18, 2021, a healthcare provider may provide a prescription for medical aid in dying to a terminally ill adult who is mentally competent after meeting certain requirements pursuant to HB 47, the Elizabeth Whitefield End-of-Life Options Act
- REMINDER: Be Sure to submit Adverse Drug Event reports to the Board within 15 days as required by regulation.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
Gov. Andrew Cuomo (D) announced that the NYS COVID-19 Emergency Declaration expires after June 24, 2021. In response, NACDS sent a letter urging the Governor to recognize the authority of the federal PREP Act to insure a continuity of care for New Yorkers needing COVID vaccinations and tests. As a reminder, today pharmacists have the ability to give COVID-19 vaccines to those aged 12 years and older pursuant to NYSDOH guidance which recognizes this provision in the federal PREP Act. This guidance also speaks to vaccine reporting to NYSIIS/CIR and other related requirements.
In addition, NACDS wrote Gov. Cuomo a letter in support of SB 4807A, legislation which will authorize pharmacists to immunize patients 18 years of age and older for all CDC approved vaccines. The Governor has until December 31, 2021, to sign this proposal into law.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Dakota
Below are highlights from the June issue of the North Dakota Board of Pharmacy newsletter. See the newsletter for additional details and more information.
- Signed on March 22, 2021, by Gov. Doug Burgum (R), SB 2221 includes three key provisions including
- lowering the age for immunizations and vaccinations to at least three years of age upon an order from a prescriber or by written protocol with a physicians or nurse practitioner;
- permitting a pharmacist to bill for dispensing a one-time emergency refill of up to a 30-day supply of the prescribed medication under certain conditions and
- defining “public health issues” and establishing limited prescriptive authority through a statewide protocol for public health issues within the pharmacist’s scope of practice with the Board of Pharmacy adopting rules to establish standards of care.
- SB 2294, legislation increasing the retail sales quantity from 2 grams to 2.4 grams of ephedrine, pseudoephedrine, or phenylpropanolamine base, was signed by Gov. Doug Burgum (R) on March 23, 2021. This new law is effective August 1, 2021. The 30-day sales limit remains unchanged.
- SB 2279, permitting the Board of Pharmacy to adopt rules to establish requirements to allow a pharmacy technician to administer a drug under the immediate supervision of a pharmacist, was signed on March 25, 2021. The Board is preparing to initiate the rulemaking process to operationalize this for current registered technicians who have completed the requirements and meet the standards the Board outlines.
- Please note section on “Immunization and Medication Administration Guidance” that includes the two ways pharmacists and interns may update and maintain “administration authority” on their license.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.