Mississippi
The Board of Pharmacy issued a proposed rule that amends regulations under Title 30, Part 3001, Article IV to change the number of required continuing education hours that a licensed pharmacist must take that address opioid abuse to two hours. Comments on these proposed changes are due August 21, 2020.
Also in Mississippi. The Board of Pharmacy also issued a proposed rule that amends regulations under Title 30, Part 3001, Article VII, to require a pharmacist in charge to be physically present at a facility for at least 50% of the time or 20 hours per week. The rule also would require that a permit for a pharmacy becomes inactive if an application for a new pharmacist in charge is not submitted within 15 days. Comments to the proposed changes are due August 21, 2020.
Lastly in Mississippi. The Board of Pharmacy issued a proposed rule to adopt regulations under Title 30, Part 3001, Article XLVIII to establish standards and procedures for delivering pharmacy services through a telehealth system that monitors the dispensing of prescription drugs and provides for related drug use review and patient counseling services by an electronic method including audio, video, still image capture, and store and forward. Comments are due August 21, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Nevada
The Board of Pharmacy issued a proposed rule to amend regulations under NAC 453 adding certain substances to schedule I; providing that certain drug products that contain CBD are not a controlled substance; removing certain drug products that contain CBD from the list of controlled substances on Schedule V, and providing other matters properly relating thereto. Comments on these proposed changes will be accepted but no due date has been specified by the state.
Also in Nevada. On August 6, the legislature adjourned the 6-day special session. Only 11 bills were passed, most notably a bill expanding access to mail-in ballots for the November general election, providing limited liability protections from COVID for businesses, and certain government entities and non-profit organizations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
On August 5, the Environment Department (NMED) filed an emergency amendment to require employers to report positive COVID-19 cases in the workplace to the NMED Occupational Health and Safety Bureau within four hours of being notified of the case. The emergency rule is effective for 120-days, or until December 3, 2020, unless NMED proposes and the Environmental Improvement Board adopts a permanent rule. Guidance documents can be found here.
Also in New Mexico. The Board of Pharmacy approved the recommendations by the Board’s Practice Committee for a new protocol allowing pharmacists to treat patients with a positive CLIA-waived result. The five treatment areas under the new protocol are flu, strep, HIV PEP, and COVID-19. Notably, the new protocol includes language allowing the treatments to be FDA approved or FDA Emergency Use Authorizations (EAU). Certain COVID-19 tests have received authorization from the FDA that classify them as CLIA-waived tests. The protocol must now gain approval from both the Medical and Nursing Boards in August who may then return the revised protocol to the Board of Pharmacy for final approval. Protocols can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
The Board of Pharmacy posted guidance to remind pharmacies about their Pharmacy Personnel Licensure and Registration Requirements. Guidance can be found here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Health and Human Services Commission announced that effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy across fee-for-service and managed care programs to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to people receiving hospice care or palliative care, treatment for cancer, residents of a long-term care facility or another facility for which residents receive opioid substitution therapy for the treatment of opioid use disorder (OUD), or other people they elect to exempt based on an objective, confirmable physical pathology known to cause severe chronic pain not ameliorated by other therapies and for which opioid treatment is appropriate. According to the announcement, if diagnoses are not available in the medical data, exemptions will be handled on a case-by-case basis through the prior authorization process. More information can be found here.
Also in Texas. The Department of Insurance adopted an emergency rule that requires health benefit plans to extend established prior authorization approvals for drugs by 90 days and requires plans to authorize payment for a one-time additional 90-day supply of a covered drug. The rule also requires plans to cover prescription drugs from out-of-network pharmacies with no additional cost-sharing when the enrollee cannot obtain them in-network, requires plans to make alternative drugs available in the event of shortages, and prohibits plans from requiring an enrollee signature at the point of delivery. Also, the rule prohibits plans from refusing or reducing payment for a prescription drug based on the fact such a drug was delivered by a local pharmacy. The rule expires on September 27, 2020 (see page 2378 in the link: https://www.sos.state.tx.us/texreg/pdf/backview/0410/0410is.pdf).
Also in Texas. On August 8, Governor Greg Abbott extended his Disaster Declaration for all Texas counties in response to COVID-19 for another 30-days. Originally issued on March 13, 2020, the Disaster Declaration provides the state with a variety of resources to effectively serve Texans as the Lone Star State continues to mitigate the spread of COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Board of Pharmacy has posted the agenda for second meeting of the workgroup on pharmacists protocols scheduled for Monday, Aug. 17 at 9 a.m. The agenda includes the draft protocols (contraceptives, prenatal vitamins, naloxone, epinephrine, and OTC drugs) and the draft regulation that the workgroup will consider for recommendation to the full board. The joint Board of Pharmacy and Board of Medicine workgroup is required by HB 1506 of 2020 to write protocols to allow pharmacists to initiate therapies and administer medications.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
California
The California Board of Pharmacy held a two-day virtual meeting to discuss pending legislation, AB 1710 which the Board voted to support, which would allow pharmacists to administer FDA-authorized COVID immunizations. The Board also discussed proposed rules on automatic refills, pharmacists working alone, and removing the barriers that restrict the use of CLIA-waived COVID tests at pharmacies. The Board voted to pursue a proposal to amend BPC 4052.8 related to pharmacist authority to administer vaccines approved by the FDA and approved amendments to initial proposed text for Title 16, CCR section 1746.6, Independent HIV Preexposure and Postexposure Prophylaxis Furnishing.
Also in California. NACDS sponsored and participated in the California Pharmacists Association’s Virtual Advocacy Day virtual meeting with Chairman Evan Low, Assembly Member Cecelia Aguiar-Curry, and Assembly Member Jim Wood, sponsor of AB 1710 and the Medi-Cal reimbursement fix bill that would address below acquisition cost reimbursement issues (AB 2100).
Also in California. The Department of Public Health’s (CDPH) issued updated COVID-19 Industry Guidance for testing, outlining different tiers to help determine who should be tested. Additionally, the Department of Consumer Affairs (DCA) developed a testing priority flyer to be placed in provider offices to provide additional guidance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Department of Consumer Affairs (DORA), the agency that oversees the state’s Medicaid Fee-for-Service program, Health Colorado First (covers approximately 1.3M lives), announced that they will begin paying pharmacies on the medical benefit side for the administration of 7 adult influenza vaccinations and reimbursement for the cost of the vaccine in mid-August, 2020.
Also in Colorado. In advance of the August 6 Pharmacy Stakeholder meeting on proposed rules that would implement the Statewide Protocol Pre-Exposure and Post-Exposure Prophylaxis of HIV (PEP/PrEP) law (CO20-HB 1061), NACDS submitted a comment letter to the Board of Pharmacy recommending a one-hour training program for pharmacists that should not be accredited by ACPE. We also recommended changes to the recordkeeping and documentation requirements.
Also in Colorado. August 29, 2020 is the deadline for pharmacy technicians to obtain a certification from the Board of Pharmacy. Details can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
The legislature just passed Bill number 6003, which gives pharmacists the ability to dispense and prescribe emergency insulin to diabetics. The legislation also addresses a proposal to provide insulin for the uninsured. The Governor is expected to sign into law.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Iowa
The Iowa Department of Human Services (DHS) announced Medicaid Director Michael Randol will be leaving his position on Friday, August 14, 2020. Deputy Medicaid Director Julie Lovelady will serve in the interim while DHS recruits a replacement.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Kentucky
The Department for Medicaid Services has published pharmacy guidance, effective August 6, for point-of-care COVID testing, based on the Governor’s previously issued Executive Order. The guidance lays out pharmacy billing requirements under both fee-for-service and managed care. Additionally, the department issued a statewide protocol intended for use by pharmacies that do not have a medical provider to issue an order.
Also in Kentucky. The Board of Pharmacy rescinded the first directive regarding Hydroxychloroquine dispensing that requires a diagnosis code. The remaining directive still applies, which placed restrictions on the dispensing of chloroquine, hydroxychloroquine, mefloquine, and azithromycin.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH), which oversees Medicaid, has issued several updates for pharmacies. Links to those updates are below:
- Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement for Select Medications – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale (POS) Quantity Limits – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale (POS) Edits for Lumateperone (Caplyta™) – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization for Select Drugs – August 3, 2020
- Louisiana Medicaid Provider Updates
Also in Louisiana. LDH announced several extensions through October 31, 2020, due to COVID. Those extensions apply to:
- Existing approved prior authorizations on prescribed drugs and physician-administered drugs (drugs included as a medical benefit). According to LDH, this will not affect the number of refills originally authorized by the prescriber.
- Member copays for prescribed drugs, which will continue to be waived.
- A 90-day supply of appropriate maintenance medications that are not controlled substances. This includes cardiovascular drugs (hypertension, coronary artery disease, thrombosis), diabetes drugs, respiratory drugs (inhaled and oral), contraceptives, antivirals, direct-acting antivirals for hepatitis C, immunosuppressives, antipsychotics, and antidepressants, among others.
- Member signatures, which will not be required.
Also in Louisiana. The Board of Pharmacy will be holding a virtual full board meeting on Thursday, August 13, 2020. The full agenda can be found here.
Also in Louisiana. The Board of Pharmacy posted its new Pharmacy Law Book. The new law book can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
The Missouri Board of Pharmacy is offering its next “Lunch with the Chief Inspector” webinar on Wednesday, August 19, 2020, at Noon CST, where they will provide a 2020 state legislative update. Click here to register for the webinar.
Also in Missouri. Missouri’s HealthNet Division (MHD) has announced that it will begin accepting ICD-10 diagnosis codes on pharmacy claims starting August 16, 2020. More information can be found here.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
NACDS and the Retail Association of Nevada’s (RAN’s) chain pharmacy members held a call with the Board of Pharmacy Executive Secretary Dave Wuest, who has agreed to move forward with plans to advance a regulation regarding pharmacy technicians administering immunizations at the September 3, 2020, in-person Board meeting in Reno. In addition to adopting permanent rules, the Board plans to pursue the adoption of a temporary regulation using the same language in the permanent regulation, which would serve to bridge the gap until the permanent language is adopted. Lastly, Mr. Wuest informed chain members that he will ask the Board to approve the same language as a non-renewable emergency regulation that would become effective immediately upon filing with the Secretary of State, but will only be effective for 120 days. RAN and NACDS will continue to work closely with the Board to move this language forward in anticipation for the upcoming flu season and release of a vaccine for COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
Governor Chris Sununu (R) signed into law HB 1639, which authorizes pharmacists and pharmacy interns (under direct supervision) to administer a COVID19 vaccine, once available.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Ohio
The Ohio House voted to remove Representative Larry Householder (R) as Speaker of the House by a vote of 90-0. A federal grand jury had previously indicted Representative Larry Householder (R) and four other individuals on various charges, including racketeering. Following that vote, House Republicans chose Representative Bob Cupp (R) to be the next Speaker. Representative Jeffrey Crossman (D) moved to expel Representative Larry Householder (R) from the Legislature during the House session. Ohio House Republicans tabled the motion from further consideration. The Ohio Constitution requires a two-thirds vote for expulsion from the Legislature. Representative Larry Householder (R) retains his House seat and currently has no opponent in the November election. The House is currently in recess until September, and House Rule 1 states only the Speaker can call a session.
Also in Ohio. The Board of Pharmacy has published guidance rescinding rule 4729:5.5.21, which prohibits the sale of Chloroquine and Hydroxychloroquine. The guidance also clarifies that a diagnosis code for COVID is no longer needed to fill those prescriptions as previously required by 4729:5.30.2.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
South Carolina Department of Health and Human Services (SCDHHS) is hosting two provider training sessions. This annual quality improvement training covers retroactive eligibility as it relates to prior authorization, service types, and submission guidelines for prior authorization and includes an overview of the Keystone Peer Review Organization (KEPRO) website and a provider portal. Learn more here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Dakota
NACDS participated in a meeting of a committee comprised of representatives from the Board of Pharmacy, Board of Nursing, and Board of Medical and Osteopathic Examiners. Applicable South Dakota statutes require this group to address pharmacist immunization standards. The committee agreed to allow the Board of Pharmacy’s immunization rule language to proceed. The Board of Pharmacy anticipates holding an August meeting to engage in discussions on the broader rule package shared with members previously.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Texas
On August 4, the Board of Pharmacy agreed to adopt proposed rules from the November 3, 2020 board meeting that would expand pharmacy technician duties(accepting oral prescriptions, transferring a prescription, and contacting the prescriber to clarify information on an existing prescription order)for all classes of pharmacy except Class C hospital pharmacies. The Board also agreed to adopt proposed rules increasing the pharmacists-to-pharmacy technician ratio for Class A retail pharmacies from 1:4 to 1:6.
Also in Texas. Effective October 15, 2020, Samuel M. Poloyac will serve as the next dean of the University of Texas College of Pharmacy. Dean-designate Poloyac currently serves as the associate dean for graduate and postdoctoral programs at the University of Pittsburgh School of Pharmacy. Retiring Dean Lynn Crismon will support Dr. Poloyac throughout the transition.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
For members of the Pharmacy Society of Wisconsin, there is an opportunity to serve on a newly forming Community Pharmacy Advisory Committee. Interested individuals should complete this application by August 13. Please contact Kari Trapskin with any questions.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
California
On July 23, the Board of Pharmacy issued a waiver temporarily increasing the ratio, allowing one additional intern pharmacist for each supervising pharmacist under the following conditions: (1) the additional intern pharmacist is administering immunizations consistent with the provisions of Pharmacy Law, and (2) the pharmacy maintains a readily retrievable record documenting the date and time when the ratio is increased according to this waiver and the staff operating under the waiver. Records must be maintained for one year following the end of the declared emergency. The waiver is set to expire on October 20, 2020.
Also in California. NACDS’ in-state partner, the California Retailers Association, signed a coalition letter to the California Department of Resources Recycling and Recovery (CalRecycle) requesting a 30-day extension to the public comment period on the Second Draft of the Proposed Regulations for the Pharmaceutical and Sharps Waste Stewardship Program, now scheduled to expire on August 3, 2020.
Also in California. In advance of the Senate Business and Professions Committee meeting on August 8, 2020, NACDS and the California Retailers Association submitted a joint letter supporting AB 1710 by Assembly Member Jim Wood, which would allow pharmacists to administer all FDA authorized or approved vaccines.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
The Committee on Health held a hearing on B23-0535, legislation requiring color-coded warning labels on opioid medications. Councilmembers Vincent Gray, Chair of the Committee on Health, and David Grosso both expressed their support for the bill. Additionally, Dr. Shauna White, Executive Director of the Board of Pharmacy, testified in favor of the bill. NACDS submitted written testimony opposing the bill. NACDS will discuss strategy and next steps with members as the bill moves forward.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Kentucky
Kentucky Medicaid’s adoption of a stop-gap measure included in Section 5 subsection 1(a) of SB50 prohibits managed care contractors from reducing pharmacy dispensing fees through the end of this year. While it is likely that the Medicaid contract extension issued July 1, 2020, will include the contract language detailed above, documentation of this cannot be provided at this time as these contract extensions are not publicly available. Regardless of the availability of this language, however, at the very least the stop-gap measure prohibits the reduction of dispensing fees through the end of this year. Additionally, in 2018, the General Assembly enacted a biennial budget that included budget language stated for fiscal year 2020, which will provide for an additional $2 dispensing fee to be added to the existing contracted dispensing fee to retail pharmacies. NACDS supported state advocates’ efforts to adopt SB 50 and thanks the Kentucky Retail Federation for sharing their analysis of the issue with us.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Chain pharmacies have created a new chain drug committee organization called the Louisiana Alliance of Retail Pharmacies under the umbrella organization, the Louisiana Retail Association. NACDS pledged to work closely with the LARP lobbyists on key legislative and regulatory initiatives aimed at broadening the scope of pharmacy practice to help fill the gaps in healthcare.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
Governor Steve Sisolak (D) announced that he may convene a second special legislative session to address criminal justice and coronavirus-related concerns, including business and worker groups’ legal liability and worker protections.
For more information, contact NACDS’ Mary Staples at 817-442-1155.