Missouri
The Department of Commerce and Insurance (DCI) is hosting a webinar on October 8th aimed at helping pharmacists identify and prevent fraud, waste, and abuse in the MO HealthNet pharmacy program. Pre-registration is required – (Click here to register).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Board of Pharmacy held a full board conference call meeting on September 2 to discuss issuing an emergency rule to address pharmacy staffing shortages related to COVID-19 and flu vaccinations. As a result, the Board of Pharmacy adopted temporary emergency rules, effective September 14, 2021, and expiring on January 11, 2022, including the following:
- Rule I: Temporary emergency suspension of pharmacist to pharmacy technician ratio for purposes of vaccine activities and COVID-19 testing.
- Rule II: Temporary emergency expansion of personnel who may work in a pharmacy or under the supervision of a pharmacist.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services issued a Health Alert Network Update notifying healthcare providers and facilities that COVID-19 monoclonal antibody (mAb) therapy has a new indication for post-exposure prophylaxis via emergency use authorization. As of September 13, the US Government began allocating mAb therapy; infusion sites will no longer order mAb therapy directly from distributors.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Department of Health has issued two requests to pharmacies. The first asks that pharmacies review its list of participating vaccination providers and make changes if needed. The list is being shared with businesses to encourage them to contact a participating local provider to conduct onsite vaccination clinics. ODH is also asking pharmacies to fill out a survey related to children's COVID vaccines to gauge vaccine provider availability. Survey participants also have the option to, and are encouraged to share with ODH, any barriers they might face to providing those vaccination opportunities to younger children, as well as any supports that could make vaccinating younger children more feasible.
Also in Ohio, earlier this year, ODM announced the selection of seven managed care organizations (MCOs) who will partner with the Department to evolve the delivery of managed care services for its more than 3 million members and thousands of medical providers. The seven MCOs selected for the next generation managed care program are:
- AmeriHealth Caritas Ohio, Inc.
- Anthem Blue Cross and Blue Shield
- Buckeye Community Health Plan
- CareSource Ohio, Inc.
- Humana Health Plan of Ohio, Inc.
- Molina Healthcare of Ohio, Inc.
- UnitedHealthcare Community Plan of Ohio, Inc.
Providers who are interested in contracting with Ohio Medicaid's next generation MCOs are encouraged to contact the MCOs. Contact information for the MCOs can be found on the Resources for Providers webpage of the next generation website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The state has announced a new program that will reimburse pharmacies for Naloxone copays when the pharmacist believes the patient will be hesitant to pick up the prescription due to cost. The Naloxone Copay Assistance Program is funded through federal grants and will begin October 1, 2021. The program will run on the PACE platform; however, the program will reimburse a pharmacy up to $75 per claim for any patient regardless of their insurance plan. There are adjudication testing opportunities available prior to Oct 1. Should you wish to run test claims, please contact NACDS’ Jill McCormack. For more detail, see the program bulletin and detailed adjudication specifications. NACDS thanks Governor Wolf, the Governor’s Opioid Command Center, PACE, and our members that helped advocate for this important lifesaving program over the last few years.
Also in Pennsylvania, Acting Secretary of Health Alison Beam signed an order this week with guidance on administering COVID-19 booster shots once they are available. It requires vaccine providers, as possible, to:
- provide online scheduling for vaccination appointments,
- provide a telephone number, with prompts to a live agent during normal business hours, to assist in scheduling appointments,
- offer walk-in appointments, and
- work with local Area Agencies on Aging (AAA) and Medical Assistance Managed Care Organizations (MCO) to help schedule eligible adults and people who cannot leave their homes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
Public Chapter 569 went into effect on July 1, 2021. To assist with the implementation process, especially regarding the filing of PBM complaints with the Tennessee Department of Commerce and Insurance (TDCI), the Tennessee Pharmacy Association has worked with TDCI to troubleshoot the complaint process and has been working to develop materials to guide pharmacies as they submit formal PBM complaints. TPA will be conducting several 30-minute open-forum webinars to share the latest news and information related to implementation of Public Chapter 569. These webinars will allow members to hear from TPA staff and other stakeholders, as well as serve as an opportunity to hear from you about the resources you still need.
Also in Tennessee, the Tennessee Board of Pharmacy, at the September meeting, determined that, for purposes of pharmacist-to-technician waivers, certified technicians could be those trained by an ACPE-approved program outlined in a PREP Amendment. The BOP will discuss USP standards at its November 16-17 meeting.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Texas Department of State Health Services (DSHS) has updated the Texas COVID-19 Vaccine Program Provider Manual (Click her for manual)
Also in Texas, the Legislature returned to the Capitol on September 20th for a third 30-day special session to tackle several issues including redistricting, property tax reform, and allocating the $16B in federal COVID relief funds. (Link to special session)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
Effective October 1, 2021, Continuous Glucose Monitoring (CGM) systems and supplies will be available ONLY through retail pharmacy channels and will no longer be accepted via DME provider channels. Prior authorization requirements that had been waived temporarily because of the COVID-19 Public Health Emergency will be reinstated. Prescribers may send prescriptions electronically to the pharmacy or hand write prescriptions for patients. Claims will adjudicate in "real time" through the Pharmacy Point of Sale (POS) system which will allow for faster and easier access for patients.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Washington
The Pharmacy & Therapeutics Committee and Drug Utilization Review Board are meeting virtually on October 20th at 9 AM to review drug classes for the Apple Health (Medicaid) PDL. To preregister and access the meeting materials, go to WA P&T Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
The Insurance Commissioner recently released the Insurance Bulletin No. 21-07 regarding how recent legislation impacts the state's network adequacy requirements. Of note, the bulletin emphasizes that any sub-networks for specialty drugs that consist of only mail order pharmacies violates the state's network adequacy standards.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Alabama Pharmacy Association has partnered with the Tennessee Pharmacists Research and Education Foundation to offer live OSHA training. If you are a pharmacist providing immunizations or CLIA-waived testing services, or a pharmacy technician or other health care professional assisting with these services, you must have live OSHA training on bloodborne pathogens every year. The Tennessee Pharmacists Research and Education Foundation (TPREF) is offering a webinar that meets all of OSHA’s training requirements, including the live component. This webinar will provide attendees with one (1.0) contact hour of live ACPE Continuing Education. More information and registration can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
NACDS and the California Retailers Association (CRA) submitted the following letters to Gov. Gavin Newsom (D):
- a joint letter urging the governor to sign into law AB 1064, legislation authorizing a pharmacist to independently initiate and administer any vaccine that has been approved or authorized by the FDA and received an ACIP individual vaccine recommendation published by the CDC for persons 3 years of age and older,
- a joint letter urging the governor to sign into law SB 409, the Board of Pharmacy’s legislation permanently authorizing pharmacists to perform CLIA-waived testing services, including COVID-19 and flu tests and
- a joint letter expressing significant concerns with specific provisions AB 1533, the Board of Pharmacy sunset legislation. These provisions would allow the Board of Pharmacy to levy penalties of up to $150,000 on chain community pharmacies that would be excessive and disproportionate to the violations in question, which may jeopardize access to critical healthcare services.
Also in California, NACDS submitted a joint letter with the California Retailers Association to the Board of Pharmacy on an issue pertaining to the state’s electronic prescribing mandate that will go into effect in 2022. Specifically, chain pharmacy encouraged the Board to clarify compliance requirements for the transfer of unfilled electronic controlled substances between pharmacies considering the federal DEA requirements and existing NCPDP standards for Electronic Prescribing of Controlled Substances that constrain what pharmacies can currently do.
Also in California, SB 362, legislation sponsored by the United Food and Commercial Workers and the California Pharmacists Association, that prohibits chain community pharmacies (75 or more stores under one ownership in California) from establishing pharmacy quotas as defined in the bill with certain exceptions, passed both chambers and was sent to the governor for signature. Capitol Advocacy, on behalf of NACDS and CRA, advocated for amendments refining the definition of “quota” and creating exceptions related to measurement and evaluation of performance, competence or quality of care provided to patients by a pharmacist or pharmacy technician.
Finally in California, Both the agenda and meeting materials for the Board of Pharmacy meeting on September 23 are posted. Note: Agenda Item VI. Strategic Planning Session will include the results of the 2021 Environmental Scan conducted earlier this year.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
The Department of Healthcare Finance will hold its virtual Quarterly Pharmacy Provider Forum on September 21 from 10-12am and September 22 from 1-3pm. The content for both is the same. To RSVP and receive meeting link, contact Allison Williams.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Effective October 1, 2021, fee-for-service (FFS) pharmacy claims must identify prescribers by their National Provider Identifier (NPI) and the prescribers must be actively enrolled with Florida Medicaid or the claims will be denied at the point of sale. Prescribers must be enrolled with Florida Medicaid in accordance with Title 42, Code of Federal Regulations, Section 455.410(b). This requirement does not pertain to pharmacists, state-authorized pharmacy interns, and qualified pharmacy technicians who administer pediatric and COVID-19 immunizations under the Public Readiness and Emergency Preparedness (PREP) Act. Pharmacy claims must continue to identify the administering pharmacist by Florida pharmacist license number (i.e., PSXXXXXXX), submitted as the prescriber ID in the National Council for Prescription Drug Programs (NCPDP) field 411-DB for the following vaccines and immunizations covered under the PREP Act, in accordance with or identified by the Advisor Committee on Immunization Practices (ACIP CDC vaccines). More information can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Department of Healthcare and Family Services has posted a new Provider Notice regarding Prior Approval Requests for Synagis Continued through September 30, 2021. You may view the new Notice at the following link:
Also in Illinois, the Department of Healthcare and Family Services has posted an Updated Preferred Drug List Illinois Medicaid October 1, 2021. You may view the Updated List at the following link.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
The Department of Health (LDH) hired Patrick Gillies to serve as the new Medicaid Director.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Maine Board of Pharmacy released the minutes from its August 5 meeting. The next zoom Board meeting will be October 7 at 8:30 am.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts:
MassHealth recently released its pharmacy providers newsletter. This edition of MassHealth Pharmacy Facts addresses Durable Medical Equipment and Inhalers.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Montana
The Board of Pharmacy has scheduled the following meetings:
- Screening Panel on September 23 (Executive Session-Closed)
- Adjudication Panel on September 24 (Prior to full Board)
- Full Board on September 24 (Open Via Teleconference Only) – Note: Full agenda will be posted on the Board Events website within 10 days of the meeting date with changes permitted up to three days prior to the meeting date.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Board of Pharmacy met in-person earlier this week on September 13 and distributed the draft meeting minutes from its two prior meetings held on July 26 and August 16. NACDS will share the draft meeting minutes from the September meeting once available.
Also in Nebraska, the Department of Health and Human Services (DHHS) issued several updates:
- The next COVID-19 Provider call will take place on September 22 at noon. Information to access the call has been posted on the DHHS website.
- Provider Bulletin 21-19 includes information related to the following:
- Full approval of the Pfizer COVID-19 vaccine for individuals ages 16 and older, which does not change the reimbursement rate;
- Coverage of an additional dose of some COVID-19 vaccines for immunocompromised individuals; and
- A change in the number of additional fees that can be reimbursed for at-home vaccine administration.
- Provider Bulletin 21-18 includes a reminder that effective October 1, Heritage Health Adult will move from a two-tier benefit system to a single benefit package, including comprehensive physical and behavioral healthcare as well as vision, dental and over-the-counter drug coverage. A series of one-hour educational webinars have been scheduled for providers regarding these changes. See bulletin for dates and times.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The Board of Pharmacy issued the following information concerning a change to the federal PREP Act authorizing pharmacists “to order and administer,” and qualified pharmacy technicians and interns “to administer” select COVID-19 therapeutics to patient populations authorized by the FDA including monoclonal antibody combinations.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The Board of Pharmacy distributed its September 2021 newsletter. Highlights include the following. Please see newsletter for details and additional information.
- DEA issued a direct final rule amending its regulations that either the purchaser or the supplier may enter a supplier’s DEA registration number on the single-sheet DEA Form 222 effective October 18.
- Drug Supply Chain Security Act Updates
- SB 2221 – Practice Changes – previously published in the June 2021 newsletter with edits
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Board of Pharmacy filed a temporary rule effective September 1, 2021 through February 27, 2022, adding COVID-19 monoclonal antibody protocol to the Protocol Compendia based on the Public Health & Pharmacy Formulary Advisory Committee recommendation.
Also in Oregon, the Board of Pharmacy Rules Advisory Committee will meet via teleconference on September 23 to discuss technician rules. Information to participate by phone is printed in the agenda.
Also in Oregon, the Public Health and Pharmacy Formulary Advisory Committee will meet on September 24. Topics of interest include pseudoephedrine, PEP/PrEP and vaccines. See agenda for details.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The Rhode Island Department of Health has issued a new regulation which requires that all employees, interns and volunteers in RIDOH licensed healthcare facilities and all RIDOH licenses healthcare providers must receive their final dose of COVID19 vaccines by October 1, 2021. The regulation applies to all individuals who in RIDOH licensed Health care facilities AND all licensed healthcare providers, whether they work in a licensed facility or not. The Department of Health has developed an FAQ which will be updated as needed.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
South Carolina
The South Carolina Department of Health and Human Services (SCDHHS) will reimburse for the administration of additional doses of the COVID-19 vaccine consistent with the updated emergency use authorization issued by the U.S. Food and Drug Administration (FDA) and the recommendations of the Centers for Disease Control and Prevention (CDC). More information can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.