Nebraska
On May 5, 2021, Gov. Pete Ricketts (R) signed LB 583, requiring Schedule II-V controlled substances prescriptions to be electronically prescribed with exceptions effective January 1, 2022. However, dentists will be required to do so beginning January 1, 2024.
Also in Nebraska, the Department of Health and Human Services published the agenda for the next conference call meeting of the Board of Pharmacy on Monday, May 24, 2021. The March 22 conference call meeting minutes are also available.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The Board of Pharmacy issued a proposed rule to amend and adopt regulations under 21 NCAC 46 to establish new requirements for limited-service permits for certain pharmacies where services are provided by pharmacist-managers serving multiple pharmacies. The rule also would allow pharmacist-managers to be present at limited-service permits for less time than at regular pharmacy permits, allow pharmacist-managers to designate an assistant pharmacy-manager for limited-service permits, and provide that pharmacist-managers do not need to personally package drugs dispensed by nurse practitioners or physician assistants, among other conforming changes. A hearing is scheduled for July 20, 2021, via webcast and teleconference. Comments are due July 20, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Board of Pharmacy published the following proposed rules with a deadline for comments on May 26, 2021. Also, hearings are scheduled for May 26, 2021, via teleconference.
- Proposed rule amends regulations under OAR 855-007 to allow pharmacists at immunizing clinics to supervise as many state-licensed immunizing interns as they determine will maintain public health and safety during a declared public health emergency. The proposal, which is the response to the COVID-19 pandemic, currently is in effect as a temporary rule, expiring June 18, 2021.
- Proposed rule amends and adopts regulations under OAR 855-019, -021, -025, and -031 to incorporate cultural competency continuing education requirements for pharmacists, pharmacy technicians, and pharmacy interns.
- Proposed rule amends, adopts, and repeals regulations under OAR 855-080 to update the incorporation by reference to the federal controlled substance schedules and prescription requirements. The rule also would add provisions on persons who are exempt from controlled substances registration requirements and remove outdated provisions on verification of research registration and drug disposal.
- Proposed rule amends regulations under OAR 855-041 to remove the limit on epinephrine dispensed to an entity to allow maintenance of epinephrine at coronavirus (COVID-19) vaccination locations. The proposal currently is in effect as a temporary rule, expiring Sept. 19, 2021.
- Proposed rule amends regulations under OAR 855-041 to revise provisions on returned drugs and devices and on secure and responsible drug disposal to implement requirements for drug take-back programs. Note: Requirements for pharmacies that operate collections sites would be updated to include notifying the Board if they initiate or cease to operate such a program.
- Proposed rule amends regulations under OAR 855-001 and -041 to revise requirements for inspection of drug outlets and pharmacy records. The rule would require records to be stored on-site for 12 months, require records to be provided to the board upon request, and allow for off-site storage after 12 months.
- Proposed rule amends regulations under OAR 855-110 to revise the late fee expiration dates for licensees and registrants.
- Proposed rule amends regulations under OAR 855-006 and repeals regulations under OAR 855-050 to remove outdated restrictions on retail drug sales and make a confirming change to incorporate the definition of “prescription drug.”
- Proposed rule amends regulations under OAR 855-041, -043, and -044 to add requirements on information inserts for prescription drugs dispensed to limited English proficiency patients.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
Gov. Wolf issued a revised waiver clarifying that pharmacists may administer the COVID vaccine to patients 12 years of age and above. As in previous versions of this waiver, it does not mention pharmacy technicians but does recognize the PREP act pre-emption.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Utah
The Department of Commerce issued a final rule to amend regulations under R156-17b to conform the rule to statutory changes made by S.B. 145, S.B.157, H.B. 24, and H.B. 207 passed during the 2020 General Session. These bills amended the Pharmacy Practice Act regarding dispensing scope of practice for pharmacist and pharmacy interns and changed the requirements for the charitable prescription drug recycling program. Additionally, the Division of Occupational and Professional Licensing in collaboration with the Board of Pharmacy recommends certain amendments to the preceptor language to reflect the current practice in the profession. The rule was effective March 11.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
West Virginia
The Board of Pharmacy rules package was approved by the legislature via SB 182. This action authorizes the Board to promulgate legislative rules as outlined below. All are effective June 11, 2021.
- 15 CSR 01 – relating to licensure and practice of pharmacist care; adds a new definition of “electronic supervision” and adds “electronic” supervision of a pharmacy technician by a pharmacist to the definition of “pharmacy technician”. For more background information click here.
- 15 CSR 02 – relating to the Uniform Controlled Substances Act; adds Schedule V prescriptions to 8.15 Refilling Schedule III, IV, or V prescriptions. For more background information click here.
- 15 CSR 03 – relating to continuing education requirements for pharmacists to maintain their license to practice pharmacy in the state. For more background information click here.
- 15 CSR 05 – relating to wholesale distributors, third-party logistics, and manufacturers of prescription drugs. For more background information click here.
- 15 CSR 08 – relating to the controlled substances monitoring program; adds Schedule V prescriptions and removes gabapentin from list of drugs of concern. For more background information click here.
- 15 CSR 12 – relating to immunizations administered by pharmacists and pharmacy interns; makes permanent the current emergency rule. For more background information click here.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wyoming
The Board of Pharmacy issued the following effective May 13.
- Final rule amending regulations under Commissioner of Drugs and Substances Control Chapter 10 to revise standards for issuing and dispensing prescriptions for controlled substances. The rule exempts from electronic prescribing requirements any controlled substance prescriptions that are to be dispensed from a pharmacy within federal jurisdiction.
- Final rule amending regulations under Chapter 17 to revise standards for sterile compounding to reflect industry standards. The rule updates definitions specify pharmacy staff training and evaluation requirements and addresses garbing and facility controls.
Also in Wyoming, the Office of the Attorney General issued a final rule amending regulations under Schedule II Controlled Substances, Chapter 1, to add the fentanyl precursor 4-anilino-N-phenethyl-4-piperidine (ANPP) to the list of Schedule II controlled substances effective May 13.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Medi-Cal has announced that it will accept pharmacy claims for dates of service on or after April 1, 2021, that use Moderna’s new National Drug Code (NDC) when billing for the administration of either dose of the Moderna COVID-19 vaccine. Details have been posted to the Medi-Cal News area of each provider community page on the Medi-Cal Provider website
Also in California, the Department of Health Care Services issued an All Plan Letter 20-022 (Revised) to all Medi-Cal Managed Care Health Plans regarding COVID-19 vaccine administration. In the letter, DHCS indicates, that in addition to arranging appointments for vaccines for homebound members via My Turn, Managed Care Health Plans may also continue to schedule vaccines for homebound members that work best for this population of patients.
Also in California, Medi-Cal announced a temporary increase in COVID-19 durable medical equipment (DME) oxygen and respiratory rates. Effective for dates of service on or after March 1, 2020, and updated effective January 1, 2021, DME oxygen and respiratory rates are temporarily increased due to the ongoing COVID-19 Public Health Emergency.
Also in California, the Global Medi-Cal DUR Board will meet via webinar on May 18, 2021. The following information has been posted to the DUR Board Meetings page of the Medi-Cal website including the Agenda, Meeting Packet, and Registration.
Also in California, the State Board of Pharmacy elected new officers for terms beginning June 1, 2021, They include the following: Dr. Seung Oh, President; Dr. Maria Serpa, Vice President; Jignesh “Jig” Patel, Treasurer.
Lastly in California, the State Board of Pharmacy added a teleconference Board Meeting date scheduled for May 27, 2021. The agenda will be posted on the Board’s website 10 days before the meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Board of Pharmacy’s Sunset bill SB21-094, which includes several provisions expanding pharmacists’ scope of practice, therapeutic substitution, prescription adaptation, and ability to order long-acting injectables passed the Senate 35-0. The bill was amended by the House Health and Insurance Committee on a vote of 11-2 on May 12 and now advances to the House Finance Committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
Gov. Eric Holcomb (R) signed into law House Bill 1468 – Various health matters – Indiana General Assembly, 2021 Session by Rep. Steven Davisson, a broad health care provider bill NACDS supported that included the following provisions that impact pharmacy practice:
- Increases to 8:1 the pharmacy technician-to-pharmacists ratio;
- Allows pharmacy technicians to work remotely performing certain non-dispensing duties including data entry and insurance processing;
- Permits pharmacists, pharmacy students, and pharmacy technicians to administer the COVID-19 vaccine according to a prescription, protocol, or standing order in addition to the 11 other vaccination categories listed in statute;
- Allows pharmacies to transfer unfilled C-II prescriptions;
- Expands therapeutic substitution under a protocol;
- Removes the requirement for shared record-keeping systems for pharmacists that engage in a collaborative practice agreement;
- Delays e-prescribing for controlled substances until January 1, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy issued guidance on pharmacy operations under the April 30, 2021, renewed governor’s proclamation of a disaster emergency due to the COVID-19 pandemic. The guidance extends the suspension of certain regulatory provisions established under prior notices through May 30, 2021. As noted in the Board’s response, “… The Board will continue to monitor the situation as additional information is available and make necessary adjustments to provide pharmacy professionals with the guidance needed to navigate the current public health emergency.”
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Missouri
The Department of Social Services HealthNet Division (DSSHD) issued a rule removing obsolete provisions in addition to referencing new provisions establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. DSSHD also adopted regulations establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. These rules are effective July 1, 2021, and expire on February 24, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
SB190 by Sen. Nicole Cannizzaro (D) that NACDS and the Retail Association of Nevada support allowing a pharmacist to dispense a self-administered hormonal contraceptive under the standing order passed the Senate 21-0 and was heard in the Assembly Commerce and Labor Committee on May 10.
Also in Nevada, AB177, legislation NACDS opposed filed by Majority Leader Benitez-Thompson (D) that requires pharmacies to post the rights of patients to demand information that at the request of the patient, pharmacies provide written translations on the prescription label in a language other than English. Despite opposition from NACDS and pharmacists, the bill passed the Assembly by a vote of 26-16. It was referred to the Senate where it was amended on May 11th and is awaiting a vote out of the Senate Health and Human Services Committee.
Also in Nevada, SB229, legislation expanding pharmacy collaborative practice agreements that NACDS and the Retail Association of Nevada support passed the Senate 17-4, was heard in the Assembly Commerce and Labor Committee in late April. A second work session was held on May 12. The next step is for the Committee to approve the bill and send it to the full Assembly.
Lastly in Nevada, AB178 by Assemblywoman Hardy allows under certain conditions a pharmacist to fill or refill a prescription in an amount that is greater than the amount authorized by the prescriber but cannot exceed a 30-day supply when a disaster or state of emergency is in effect.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The May 20, 2021, Continuing Education Rules Advisory Committee meeting agenda is now available.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
NACDS reminds members that on March 29 the new Acting Physician General Denise Johnson signed a new standing order for naloxone. All prescriptions using the standing order from former Secretary of Health Levine or former Acting Physician General Braund, and any remaining refills on those prescriptions are null and void.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
On May 6, HB678 by Rep. Phil Cortez (D), overwhelmingly passed the House by a vote of 139-7. HB678, supported by NACDS, allows pharmacists to independently order, and both pharmacists and technicians to administer, all immunizations to anyone 3 years of age or older without a prescription. The bill will now be heard by the Senate Health and Human Services Committee. NACDS members are urged to call their State Senator to ask them to HB678 expanding access to immunizations by permanently removing existing administrative barriers.
Also in Texas, the Board of Pharmacy launched a new podcast for Board news and updates. The first episode covers the November 2020 and February 2021 Board meeting rule adoptions, along with recent Board news and an important scam alert. www.pharmacy.texas.gov/podcast
Laslty in Texas, the Texas Department of State Health Services Commissioner John Hellerstedt is encouraging vaccine providers to order additional COVID-19 vaccines as needed as the state is now receiving about 1.5 million a week. Texas has now administered more than 18.3 million doses of the vaccine. More than 11 million people have received at least one dose, and over 7.9 million are now fully vaccinated. covidvaccine.texas.gov.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Department of Health, Pharmacy Quality Assurance Commission adopted regulations allowing retired pharmacists to apply for a retired active pharmacist license status and practice pharmacy under certain conditions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
For veterinary prescriptions that may not be refilled between May 1, and June 30, 2021 (due to the one-year time limitation on prescriptions), the director of the Department of Consumer Affairs extends an order waiving the California Code of Regulations, title 16, section 2032.1, subdivision (c) to the extent it prohibits a veterinarian from prescribing a drug for a duration longer than one year from the date the veterinarian examined the animal and prescribed the drug, subject to the condition that any such prescription may be refilled for a total period not to exceed 18 months from the date the veterinarian last examined the animal and prescribed the drug.
Also in California, recent Medi-Cal Rx News updates include the following:
• The Pharmacy Provider Self-Attestation Process has been extended through May 9, 2021, and has a new web address. If your company already submitted your self-attestation and received a confirmation email from CODSurvey@mercer.com, please disregard April 30, 2021, notice.
• Changes to the Contract Drugs List have been made effective May 1, 2021.
• Changes to the Contract Drugs List – Authorized Drug Manufacturer Labeler Codes have also been made effective May 1.
Lastly in California, the Medi-Cal Update Bulletin 990 – April 2021 includes the following items of interest. See bulletin for additional information.
• A new DUR Educational Article titled “Drug Safety Communication: Potential Increased Arrhythmia Risk from Lamotrigine (PDF)” is available on the DUR: Educational Articles page of the Medi-Cal website.
• Updates to the List of Enteral Nutrition Products effective for dates of service on or after March 1 have been made available.
• The MAPC per Unit of Measure for HCPCS code A4657 in The Medical Supplies Billing Codes, Units, and Quantity Limits spreadsheet has been corrected to ‘By Report”.
For more information, contact NACDS’ Sandra Guckian at 703-837-4195.
Florida
The Board of Pharmacy published a notice to amend regulations under FAC 64B16-31 to update the incorporated pharmacist licensure and pharmacy intern and technician registration forms.
Also in Florida, the Department of Health published a notice of a workshop to adopt regulations under FAC 64J-4 to establish requirements for the Prescription Drug Donation Repository Program. The workshop is scheduled for May 14, 2021, via video and teleconference.
For more information, contact NACDS’ Leigh Knotts at 803-408-9774.
Hawaii
HB 386, mandating the pharmaceutical industry fund a product stewardship program for the collection and destruction of unused drugs, failed to pass before adjournment of the legislature.
For more information, contact NACDS’ Sandra Guckian at 703-837-4195.
Kentucky
MedImpact will hold a series of informational webinars for providers to share information on the transition to a single PBM, which will be effective July 1, 2021. The seminars will be held on May 14, June 15, and July 15, 2021. For more information on the seminars and other information about the transition, click here.
For more information, contact NACDS’ Jill McCormack at 717-525-8962.
North Carolina
The Board of Pharmacy has issued guidance that allows for the pharmacist-manager to expand the pharmacist-technician ratio to 3:1 or 4:1 if in the judgment of the pharmacist-manager demonstrates that the pharmacy employs enough certified technicians to meet the ratio.
Also in North Carolina, the Board of Pharmacy has initiated rulemaking to expand the use of centralized processing for all pharmacies. The Board will hold a remote public hearing on July 20, 2021, at 10:00 am. Written comments will be accepted until July 20, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-408-9774.
Arkansas
Gov. Asa Hutchinson (R) signed into law SB 505/Act 651 legislation requiring prescribers to co-prescribe an opioid antagonist to patients under certain conditions: (1) dosage is equal to or above 50MME per day; (2) benzodiazepine has been prescribed or will be prescribed at the same time as the opioid; and (3) the patient has a history of drug abuse or a drug overdose.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The COVID-19 Vaccine Administration Frequently Asked Questions (FAQs) page previously found on the Medi-Cal Provider website has been divided into separate FAQs for providers and beneficiaries. These documents are available on the COVID-19 Medi-Cal Response webpage under the FAQs section. As a reminder, the Coronavirus (COVID-19) Uninsured Group FAQs are also available along with the providers and beneficiaries FAQs.
Also in California, the Department of Health Care Services launched its series of ongoing releases of enhancements, updates, and changes to improve and enhance its website navigation and user experience. A complete list of the enhancements, updates, and additional website changes can be viewed within the Medi-Cal Provider Website Release Change Log. Providers are also encouraged to subscribe to the free Medi-Cal Subscription Service (MCSS). The MCSS allows each subscriber to choose and tailor both the subject matters and types of communications they wish to receive from the Medi-Cal Program.
Lastly in California, the Board of Pharmacy recently distributed the following to licensees and stakeholders:
- Updated draft versions of self-assessment forms for pharmacies and wholesalers are now posted in addition to currently adopted versions on the Board of Pharmacy website. The Board is in the process of approving the draft versions through formal rulemaking. Board regulations require pharmacies and wholesalers to complete adopted versions of self-assessment forms. However, completion of either adopted or draft versions is acceptable. The Board believes updated draft versions provide a more helpful assessment of pharmacies and wholesalers. The drafts include references to statutory and regulatory changes that occurred between 2012 and the revision date of each draft form. Self-assessments must be performed before July 1 of every odd-numbered year. Completed self-assessment forms must remain at the facility unless the Board requests submission of the form. To find the forms, go to pharmacy.ca.gov. Under the “Licensees” tab, click on Facility License Information/Renewal and scroll down to the link for Self-Assessment Forms.
- The California State Board of Pharmacy extends its gratitude to all its licensees working to address the COVID-19 pandemic, including the most recent vaccination efforts underway in many pharmacies. As vaccine supplies continue to increase and vaccine eligibility expands, the Board would like to encourage pharmacies to plan appropriately when electing to provide COVID-19 vaccination services. Such planning should include:
- Ensuring sufficient staffing to maintain other pharmacy services while balancing vaccination services.
- Ensuring sufficient space to provide vaccinations safely, and sufficient space and chairs for patients to remain seated during the recommended period of observation.
- Ensuring appropriate staff is observing patients following administration of the vaccine.
- Ensuring vaccination appointments can safely be accommodated with the staffing resources available.
- In light of Governor Gavin Newsom’s declaration of emergency and the national declaration of emergency, and consistent with Business and Professions Code (BPC) section 4062, the California State Board of Pharmacy (Board) or the Board president through delegated authority has issued the following waivers.
- Mass Vaccination Sites
- Amended and Reissued: April 21, 2021
- Expiration: July 18, 2021
- Mass Vaccination Sites
- Supervision of Pharmacy Interns
- Effective: April 22, 2021
- Expiration: July 20, 2021
- Supervision of Pharmacy Interns
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
On April 24, the Pharmacy Sunset legislation pharmacies support that expands our scope of practice unanimously passed the Senate and is now pending further action in the House where we will push to have it scheduled in committee as soon as possible.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.