Pennsylvania
SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate and the House. Commonly referred to as a “gag clause” prohibition, the amended bill is on its way to Governor Wolf (D) for signature.
Also in Pennsylvania. Governor Wolf (D) announced the approval of the Department of State’s request to suspend the age limitation of 9 years old for pharmacist-administered influenza vaccines. The waiver, which specifically allows pharmacists to provide any licensed, age-appropriate flu vaccine to individuals 3 years of age or older, was effective July 2 and will be in effect for 90 days after the current state of emergency related to COVID-19 ends.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
South Carolina Department of Health and Human Services (SCDHHS) issued guidance for Healthy Connections Medicaid providers on how to receive reimbursement through the new COVID19 Limited Benefit Program. Learn more in the Medicaid provider bulletin here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
Last week, Assembly Member Jim Wood (D), chair of the Assembly Health Budget Committee, gutted and amended AB 1710 to allow pharmacists to initiate and administer FDA-approved vaccines. NACDS is seeking an amendment to allow FDA-authorized vaccines too.
Also in California. Prior to the July 1, 2020 deadline required in the state constitution, Gov. Gavin Newsom signed the 2020 Budget Act – a $202.1 billion spending plan that closed a $54.3 billion budget shortfall caused by the COVID-19 recession.
Also in California. Gov. Gavin Newsom extended for 60 more days, until September 9th, his Executive Order issued on May 12, 2020, waiving the restrictions on pharmacists ordering and collecting specimens for COVID-19 tests.
Also in California. Because several legislators have tested positive for COVID, neither the Assembly nor Senate are returning to work at the Capitol next week. The legislature shutdown for two months earlier this year because of the pandemic.
Also in California. NACDS and the California Board of Pharmacy submitted the attached joint letter to the Senate Business, Professions, and Economic Development Committee opposing AB 2983 which imposes inefficient requirements that will impede that automated refill process causing delays in patient access.
Also in California. NACDS virtually presented to the Board of Pharmacy’s Licensing Committee and Legislative and Regulation Committee on pharmacists immunizations and COVID testing and the authority to perform CLIA-waived tests for COVID19. Presentations can be found here.
Also in California. NACDS sent a joint letter with the California Retailers Association and the California Pharmacists Association to Gov. Gavin Newsom urging him to issue an Executive Order removing the remaining barriers to expanding access to COVID testing by pharmacists.
Also in California. In response to the Governor’s emergency declaration and consistent with the authority of the Board to waive Pharmacy Law or the regulations adopted pursuant to it, last week the Board president extended the following previously approved limited waivers:
- Use of PPE in Certain Compounding Aseptic Isolators or Compounding Aseptic Containment Isolators– Effective through August 30, 2020
- Duty to Consult – Effective through September 29, 2020
- Restoration of Retired or Cancelled License – Effective through October 1, 2020
- Certification of Basic Life Support – Effective through August 5, 2020
- Prelicensure Inspection of Proposed ADDS Location – Effective through October 9, 2020
- Reassessment/Revalidation/Re-evaluation Requirements for Sterile Compounding Staff Competencies – Effective through August 12, 2020
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
NACDS submitted a letter to the Colorado Department of Regulatory Agencies- Board of Pharmacy requesting a permanent waiver allowing pharmacists to independently order and administer COVID-19 tests, including serology tests, that have received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA), or equivalent regulatory authorization, subject to the disclaimers and limitations required by the FDA, in addition to any CLIA-waived point-of-care tests. NACDS also recommended that pharmacists may delegate the administration of any vaccines and immunizations, including vaccines authorized by the FDA to trained pharmacy interns or pharmacy technicians.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
On June 29, 2020, Governor Ron DeSantis signed HB.59, sponsored by Representative Matt Willhite (D), which authorizes a community pharmacy to use an automated pharmacy system, effective July 1, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
With SF 2357 recently signed into law, prescriptions issued by a Physician Assistant are no longer required to include the name of the supervising physician. For more information, please see the Iowa Board of Pharmacy newsletter.
Also in Iowa. The Iowa Board of Pharmacy published a response to the June 25 Proclamation of Disaster Emergency issued by Gov. Kim Reynolds.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
During the 2020 Regular Session, the Legislature adopted House Concurrent Resolution 71 which directs all professional licensing boards to adopt emergency rules to suspend the collection of license renewal fees for existing businesses located in Louisiana for licenses, certificates, permits, and registrations. To be in compliance, at the June 25th teleconference meeting, the Board adopted emergency rules effective July 1, 2020, through June 30, 2021.
Also in Louisiana. The Legislature reached a balanced budget agreement last week and adjourned their special session on June 30th. Lawmakers may return for another special session in October to either spend more federal coronavirus aid or make cuts if the budget situation worsens.
Also in Louisiana. Gov. Edwards issued Proclamation 83 JBE 2020 extending the public health emergency until July 24, 2020, unless terminated sooner which means that all previously issued waivers and guidance from the Board relative to this public health emergency have also been extended.
Also in Louisiana. At the June 25th Board of Pharmacy meeting, Board members voted to terminate their recognition of NABP Passport effective July 31, 2020. A copy of that notice is here. Holders of the NABP Passport who have been practicing within or for the State of Louisiana without a separate credential issued by the Louisiana Board of Pharmacy will no longer be authorized to do so after July 31, 2020. The Board also approved an Emergency Rule suspending the collection of license renewal fees from existing businesses located within Louisiana for those credentials scheduled to expire between July 1, 2020, and June 30, 2021.
Lastly in Louisiana. Effective June 20th, final rules on drug disposal and pain medication treatment guidelines were adopted. In addition, the following Final and Emergency rules have also been published.
- Final rule of the Board of Pharmacy amends regulations under LAC 46:LIII, Chapters 15, 25, and 27, to allow pharmacies to accept returns of previously dispensed drugs for disposal and specify requirements for the disposal of controlled substances and hazardous drugs. The rule also removes the requirement that pharmacies accept returns of controlled substances for disposal and instead allows pharmacies to accept such drugs for disposal. In addition, the rule requires pharmacies to advise patients or their designees of drug disposal options.
- Final rule of the Office of Workers’ Compensation Administration amends regulations under LAC 40:I, Chapter 21, to revise chronic pain disorder medical treatment guidelines. The rule revises guidelines for nonoperative therapeutic procedures.
The Department of Public Health extended until October 22, 2020, an Emergency rule amending regulations for the continuation of Medicaid programs and services during the coronavirus (COVID-19) public health emergency. The rule relaxes requirements related to fair hearing requests and asset verification, provides for coverage of diagnostic testing for uninsured individuals, waives the requirement for daily visits by hospice providers, and allows for telemedicine visits by hospice providers. The rule also allows for reimbursement of ambulance providers for allowable services on-site without transport, waives copayments for pharmacy services, and allows a 90-day supply of maintenance medications.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Gov. Gretchen Whitmer (D) signed into law the interconnected HB 4217, SB 248 and SB 254) to require the electronic prescribing of all drugs effective October 1, 2021. NACDS salutes the leadership of the Michigan Retailers Association on this legislation.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Minnesota
For those who could not participate in the Minnesota Retailers Association’s webinar about the Insulin Safety Net Program, a recording is available. While the program is in effect and operational, the Pharmaceutical Research and Manufacturers of America (PhRMA) have filed a federal lawsuit.
Also in Minnesota. Kendra Metz, PharmD, RPh, was recently appointed to the Minnesota Board of Pharmacy for a four-year term. A Pharmacist-In-Charge for NACDS member company Thrifty White in Moose Lake, more information about Dr. Metz can be found in her Board biography. Gov. Walz (D) also reappointed Mary Phipps, PharmD, RPh, of St Cloud, to a four-year term. Dr. Phipps is the system director of pharmacy for CentraCare Health.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
The Mississippi House and Senate adjourned last week and will return no later than October 5, 2020 for a 6-day extension of the session.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The following is from the Missouri Department of Commerce and Insurance: “Governor Michael Parson recently announced that all COVID-19 statutory/rule waivers approved by the Governor pursuant to Executive Order 20-02 have been extended until December 30, 2020. All Board waivers that were set to expire on June 15, 2020, and September 1, 2020, will now be in effect until December 30, 2020. A list of approved Board COVID-19 waivers is available on the Board’s website. Please e-mail the Board at compliance@pr.mo.gov, if you have any additional questions.”
Also in Missouri. The Department of Social Services has published a provider survey about MOHealthNet’s response to the COVID-19 pandemic. One of the survey questions asks providers about temporary regulatory flexibilities that should be made permanent. The survey is open until July 17, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
On July 8th, Gov. Steve Sisolak convened a legislative special session and issued a Proclamation to address the State’s Fiscal Year 2021 budget dramatically impacted by the COVID-19 global pandemic. The legislative office building is closed to the public.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Jersey
This week the Assembly passed A4012/S2436 legislation which would authorize pharmacists to administer COVID19 testing. The Senate passed an identical version earlier this year. The bill has been sent to Governor Phil Murphy (D) for his signature and passage into law.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
The state’s Department of Health and Human Services, Division of Medicaid Assistance has announced that Myers and Stauffer will be conducting a Cost of Dispensing Study which will be utilized to determine the dispensing fee for pharmacists for the North Carolina Medicaid program. The surveys will be mailed on July 7, 2020, and the due date is August 18, 2020.
Also in North Carolina. The General Assembly adjourned this week but will return on September 2, 2020. The adjournment resolution limits activity during the September session to COVID-19 funding issues, appointments, and veto overrides.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
HB 341, a bill that would allow pharmacists to administer long-acting or extended-release drugs to treat addiction, has passed out of the Legislature. Sponsored by Rep. Timothy Ginter (R), the bill is on its way to Gov. Mike DeWine (R) for signature.
Also in Ohio. Medicaid (ODM) released guidance on pharmacy billing COVID-19 test specimen collection. Unfortunately, the guidance does not follow the new NCPDP standard. NACDS is working with members and in-state partners to correct this.
Also in Ohio. Medicaid ODM published draft rules to implement SB 265 of 2019, permissive provider status for pharmacists. The rules will allow pharmacists to receive payment for managing medication therapy, administering immunizations and medications only if the service is medically necessary and is substantiated by a written order from a prescriber. NACDS has urged ODM to amend the language to allow pharmacists to perform services that are s within a pharmacist’s scope of practice and deemed appropriate based on the pharmacist’s professional judgement.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
Senator Judy Ward (R) introduced SB 1210, legislation that would allow pharmacists to perform independent COVID-19 point of care tests authorized by the FDA by suspending the laboratory work experience required by state law. NACDS drafted the language and is working jointly with the Pennsylvania Association of Chain Drug Stores (PACDS) to push this measure forward.
Also in Pennsylvania. HB 941 sponsored by Rep. Doyle Heffley (R) was amended and reported out of the Senate Health Committee. The bill contains PBM transparency provisions, as well as language intended to set reimbursement rates in managed care. The committee indicated there is more work to be done on this measure over the summer. NACDS will be supporting PACDS efforts to make the reimbursement language more definitive during this process.
Also in Pennsylvania. SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate. Commonly referred to as a “gag clause” prohibition, the amended bill is now eligible for concurrence in the House.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
Effective July 15, 2020, South Carolina Department of Health and Human Services will update the standard basis of payment for the FFS pharmacy benefit to provide payment at the lowest of:
- The actual acquisition cost (AAC) plus a professional dispensing fee (PDF) of $10.50;
- The state’s maximum allowable cost plus a PDF of $10.50; or,
- The usual and customary charges to the general public.
The AAC is defined as the National Average Drug Acquisition Cost (NADAC). In those instances where the NADAC does not exist, the AAC is defined as the wholesale acquisition cost. For more information, click here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Drug Utilization Review Board announced that they will be performing a clinical review anticonvulsant, antihemophilic, antineoplastic, antiretroviral, and medications used to treat multiple sclerosis at the October 23, 2020 meeting. These are protected drug classes not currently reviewed on the Texas Medicaid Preferred Drug List. All medications within these drug classes will be preferred and continue to be available without prior authorization. For more information, contact vdp-formulary@hhsc.state.tx.us.
Also in Texas. Health and Human Service Commission’s Vendor Drug Program plans to publish the semi-annual update of the Medicaid preferred drug list on July 27, 2020. The new preferred drug classes are Glucagon Agents, Immunomodulators, Asthma and Sickle Cell Anemia Treatments.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
ForwardHealth reminds providers that they are to resume collecting co-pays starting July 1st. Please see the ForwardHealth Update for more information. Please recall the temporary copay suspension was introduced in the December 2019 Update.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Alabama
All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of July 31, 2020, the conclusion of the COVID-19 National emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERT and notices related to the health emergency is available on the Agency’s COVID-19 page.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
In advance of the start of the new fiscal year on July 1, 2020, Gov. Gavin Newsom and the Legislature reached an agreement on the budget this week. Below are highlights of two budget trailer bills of interest to pharmacies.
(AB 89/SB 121) contains language related to federal funding for contact tracing. Specifically, it allows Department of Finance (DOF) to allocate those funds as directed by California Department of Public Health (CDPH), as long as the funds are not used by any state or local entity for applications that collect information relating to a person’s location and movement. Please see below:
SEC. 104.
Section 11.95 is added to the Budget Act of 2020, to read:
SEC. 11.95.
(a) Federal legislation enacted between March 6, 2020, and April 24, 2020, is providing funding to the state to support testing and contact tracing in response to the COVID-19 public health emergency. The Department of Finance may allocate these funds to support testing and contact tracing as directed by the State Department of Public Health, provided that funds are not used by any state or local entity for applications that collect information related to an individual’s location and movement. This subdivision does not preclude a contact tracer from using a program to store, organize, or analyze any data otherwise affirmatively provided to the contact tracer by an individual. All testing and contact tracing must be conducted in compliance with applicable federal and state privacy laws.
(b) Funds described in subdivision (a) may be allocated to offset or reduce appropriations in the 2019−20 and 2020−21 fiscal years that support the COVID-19 response between March 1, 2020 and June 30, 2021. If no item for a department currently exists to allow for adjustments for the additional federal funds allocation or additional reimbursements to be allocated, then an item may be created for this purpose.
(c) The Department of Finance may adjust any item in Section 2.00 to account for additional federal funding or any additional reimbursements to support testing and contact tracing. If no item for a department currently exists in Section 2.00 of this Act to allow for adjustments for the additional federal funds allocation or additional reimbursements to be allocated, then an item may be created for this purpose.
(d) Changes to any item in Section 2.00 may be authorized not sooner than 10 days after written notification to the Joint Legislative Budget Committee of the changes to the planned expenditures to support testing and contact tracing. The chairperson of the Joint Legislative Budget Committee or the chairperson’s designee may shorten the 10 days by written notification.
AB 80/SB 102 does not include the proposed pharmacy reimbursement cuts for services such as providing self-administered hormonal contraceptives, vaccines, nicotine replacement products, travel medications, naloxone directly to patients and PEP/PrEP for HIV prevention.
- Requires CalOSHA to establish the Health Care Payments Data Program to implement and administer the Health Care Payments Data System, including health care data submitted by health plans and insurers, cities or counties that offer plans and other mandatory or voluntary submitters. Provisions require the office to use the data to produce reports, analyses, studies, etc. to support goals for improving public health, reducing disparities, and reducing health care costs and specifies that personally identifiable data submitted are exempt from disclosure.
- Authorizes CDPH to subsidize up to 30 days of PrEP and PEP medications without regard to whether a person was a victim of sexual assault.
- Contains several pharmacy provisions, including removing the Rx copay in Medi-Cal and requiring DHCS to implement a supplemental payment pool for non-hospital 340B clinics.
- Contains the “best price” language, specifically defining “best price” to mean the negotiated price for any specified entity, including entities both within and outside the USA.
- Authorizes DHSC, upon approval of DOF, to seek the necessary federal approvals to establish and administer a drug rebate program to collect rebate payments from drug manufacturers for drugs furnished to select populations of CA residents who are ineligible for full-scope Medical.
- Repeals the provision that limits prescribed drugs under the Medi-Cal program to not more than 6 drugs per month, unless prior authorization is obtained.
Also in California... Legislation of interest to chain pharmacies passed the Assembly and was referred to the Senate Health Committee for further consideration.
- AB 2077 (Ting) Hypodermic needles and syringes – NACDS supports
- AB 2203 (Nazarian) Insulin cost-sharing cap – NACDS neutral
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
In a letter submitted on June 19th , NACDS and the Colorado Retailers Association urges Gov. Jared Polis to sign into law HB20-1061, legislation increasing access to care by authorizing pharmacists to prescribe and dispense Human Immunodeficiency Virus (HIV) prevention medication to patients.
Also in Colorado... NACDS met with the Department of Regulatory Agencies (DORA) to provide additional information on statutes and rules related to the modernization of the practice of pharmacy, responding to questions raised regarding the alignment of Colorado state law with the federal Drug Supply Chain Security Act (DSCSA) and the non-discretionary duties of pharmacy technicians.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Notice announces the intention of the Department of Health to amend regulations under FAC 64D-3 to add the coronavirus (COVID-19) to the list of reportable diseases and conditions. A comment due date is not specified
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
Legislators are continuing to meet in a special session convened earlier this month attempting to negotiate a balance budget agreement prior to the star of the new fiscal year on July 1, 2020.
Also in Louisiana... Two COVID-19 emergency rules have been extended until November.
Emergency rule of the Department of Health, Bureau of Health Services Financing, adopts regulations under LAC 50:I, Chapter 5, to establish provisions for the delivery of telemedicine during a declared disaster under the Medical Assistance Program. The rule provides that services may temporarily be provided through the use of an interactive audio telecommunications system, without the requirement of video, if such action is determined to be necessary. The rule, which is issued in response to the coronavirus (Covid-19) pandemic, extends a March 16th emergency rule. The rule is effective July 15, 2020, and expires Nov. 12, 2020.
Emergency rule of the Department of Health amends regulations under LAC 51:II, Chapter 1, to add coronavirus disease 2019 (Covid-19)/infections with SARS-CoV-2 to the list of reportable diseases. The rule also requires laboratories and health care facilities to report testing results. The rule is effective July 5, 2020 and expires Nov. 2, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
Missouri’s MOHealthNet has updated information about its copay policy related to COVID-19. The following is an excerpt: Providers who have collected copayments from participants for dates of service January 1, 2020 through the end of the public health emergency must refund the copayments to the participants. Shared dispensing fees should not be retroactively adjusted.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.