New York

On February 21, the State Department of Health held an online seminar to update interested parties on the latest information regarding the Medicaid Pharmacy Benefit Transition from Managed Care to NYRx effective April 1. The next presentation and meeting will be March 21 at 1:00 p.m. 

Also in New York, the Department of Financial Services (Department) Pharmacy Benefits Bureau (“PBB”) announced a final request for public engagement as the Department looks to develop nation-leading regulatory standards for Pharmacy Benefit Managers (PBMs).  

This request asks for information on PBM audits of pharmacies, which are meant to eliminate or reduce fraud, waste, and abuse, but often are overly burdensome and costly without meeting this intended goal. Instead, pharmacy owners are taken away from providing healthcare, requiring them to review and defend claims from years in the past at the sole direction of PBMs without justification. The information collected will inform the scope of regulations necessary to ensure audits follow a clear and transparent process and have guardrails in place to meet the goal of preventing fraud, misuse, and waste. The Department is in the process of developing a series of PBM regulations that together will form the most comprehensive regulatory framework in the country. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

2023-03-03T10:07:08-05:00March 3, 2023|New York|

North Dakota

Engrossed HB 1095,legislation to include comprehensive medication management services in health benefit plans, unanimously passed the House and was sent to the Senate where it was referred to the Human Services Committee. A hearing has been scheduled for March 7 at 9:00 a.m.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-03-03T10:06:40-05:00March 3, 2023|North Dakota|

Oregon

Dana Hittle has been appointed as the permanent Medicaid director and will oversee Oregon’s Medicaid program, including the Oregon Health Plan. Hittle previously served as interim state Medicaid director for the last two years and, before that, was deputy Medicaid director.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-03-03T10:06:03-05:00March 3, 2023|Oregon|

South Dakota

HB 1135, legislation related to PBMs, passed both the House and the Senate, and will be sent to the Gov. Kristi Noem (R) for her signature. This legislation includes requirements for PBM licensure, prohibits retroactive fees except in certain situations and the collection of renumeration fees and adds criteria for drugs to be placed on the MAC list.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-03-03T10:05:19-05:00March 3, 2023|South Dakota|

Tennessee

TennCare is now in Phase II of its plan to unwind from the Public Health Emergency. They have created a communications toolkit and offered several other resources that healthcare providers, including pharmacies, can use to share more information with TennCare patients to ensure their coverage does not fall through. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

2023-03-03T10:04:35-05:00March 3, 2023|Tennessee|

Texas

Rep. Dr. Tom Oliverson (R), chair of the House Insurance Committee, filed HB 2021, legislation that applies existing law intended to protect patients and pharmacies to all PBMs operating in Texas. The PBMs and Health plans are orchestrating opposition leveraging the Texas Association of Business and the Texas State Chamber of Commerce, mounting an aggressive campaign saying that preempting ERISA hurts employer’s ability to offer quality, affordable health care and prescription options that best fit the needs of their employees. 

Also in Texas, NACDS and Texas Federation of Drug Stores (TFDS) pharmacists and interns from HEB and Walgreens spent time at the Capitol meeting with new members and staff to educate them on pharmacy’s priority issues: Medicaid reimbursement rate floor and making the PREP Act flexibilities permanent by lowering the age to 3 years for pharmacists and pharmacy technicians to administer vaccinations without a prescription.  

Finally, the House Public Health Committee convened an organizational meeting on February 27 to discuss an organizational meeting and will be taking invited testimony from the Texas State Board of Pharmacy (TSBP), the Texas Department of State Health Services, and the Texas Health and Human Services Commission. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2023-03-03T10:13:14-05:00March 3, 2023|Texas|

Virginia

Pharmacy made tremendous advances in the Commonwealth in the 2023 Regular Legislative Session that will dramatically improve patient care and advance practice. HB 2274, allowing pharmacists to test and treat for flu, COVID, strep and UTIs (urinary tract infections) under a statewide Board of Pharmacy protocol, is on Governor’s desk for signing, along with its companion, SB 948. The bills are the final piece in updating Virginia’s law to match the PREP Act. Notably, the Legislature also passed SB 1538 to clarify that Medicaid must reimburse for all the pharmacy-based services currently authorized in the Commonwealth. The bill applies to both Fee-for–Service and Managed Care. NACDS thanks the Virginia Association of Chain Drug Stores (VACDS), the Virginia Pharmacists Association (VPhA) and members for their tremendous efforts on the ground during this short session. NACDS will continue to update members as the bill signing process unfolds.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2023-03-03T10:03:10-05:00March 3, 2023|Virginia|

Washington

NACDS sponsored the Washington State Pharmacy Association’s successful Pharmacy Days at the Capitol on January 25 and February 13. More than 120 students and pharmacists participated in 60 appointments with legislators advocating for PBM reform and, in general, for the profession of pharmacy, promoting convenient access to healthcare services. Pharmacist James Lin from Kroger-QFC met with Sen. Javier Valdez (D).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2023-03-03T10:02:41-05:00March 3, 2023|Washington|

West Virginia

Our priority bills continue to advance in the Legislature. HB 2754, that would make the pharmacy immunization allowances from the federal PREP Act permanent in state law, was approved by the Senate Health and Human Resources Committee and is now on the Senate Floor for a final vote. The Senate passed an omnibus Rules package, SB 361, that authorizes the Board of Pharmacy to promulgate a rule increasing the pharmacy technician ratio from 1:4 to 1:6. The same bill also includes a final rule modernizing collaborative practice agreements to allow for population-based care. Notably, the collaborative practice rule is currently effective as an emergency rule. The package now awaits action in the House Judiciary Committee, as does Committee Substitute SB 345, a bill that would provide legislative approval of the PBM rule pursuant to the passage of HB 2263 of 2021.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2023-03-03T10:02:09-05:00March 3, 2023|West Virginia|

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