Iowa
The Board of Pharmacy issued a notice to pharmacies regarding multiple fraudulent prescriptions for promethazine with codeine being faxed into pharmacies. Note: they are often accompanied by prescriptions for a Z-Pak (azithromycin).
Also in Iowa, the Board of Pharmacy announced the registration fee for all certified pharmacy technicians will be prorated as of August 16, 2021.
Also in Iowa, the Iowa Pharmacy Association will conduct a webinar entitled "Medicaid: Provider Enrollment and Medical Billings" on September 7 from 2:00 p.m.-3:00 p.m. The speaker will be Desiree Smith, Provider Services Operations Manager, Iowa Medicaid Enterprise (IME). She will be joined by representatives of the state's Medicaid Managed Care Organizations. Registration is required.
Finally in Iowa, NACDS submitted comments to the Board of Pharmacy on the proposed rulemaking revising the requirements for perpetual inventory. On behalf of members, we stated concerned that the proposed rule changes under ARC 5834C that expand the perpetual inventory requirements to apply to all controlled substance medications would be burdensome and would only add more "non-patient care related tasks" to busy pharmacists' workday. NACDS requested the Board to reject the proposed rule change that would require perpetual inventories at all times for all controlled substances, and instead continue to apply this requirement only to Schedule II controlled substances.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
The BOP has withdrawn its recent regulation 201 KAR 2:410E expanding pharmacies immunization authority and replaced it with an emergency revised regulation that includes the most recent HHS Guidance allowing pharmacy technicians to administer influenza vaccines to adults. The regulation maintains the ability of any pharmacist to order and administer vaccinations for anyone over the age of three years old, under a protocol. The regulation will next be reviewed by the Administrative Regulatory Review Subcommittee of the General Assembly. However, because it was filed as an emergency regulation, it is in effect now.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maryland
Medicaid published Advisory #231 from the Office of Pharmacy Services in reference to the Pharmacy Provider Guidance on COVID-19 Additional Vaccine Dose for The Maryland Medicaid Fee-for-Service (FFS) Program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The Michigan Department of Health and Human Services has scheduled a Medicaid Pharmacy Provider Liaison meeting to allow Medicaid staff and Medicaid Pharmacy Providers to meet and discuss policy and operational issues. This quarter’s Pharmacy Liaison Meeting Notice contains the link and phone number to join, and will take place Thursday, September 9th from 2:30-4:30pm.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Nebraska
The Department of Health and Human Services announced the COVID-19 Ad-Hoc Schedule 3rd Dose Vaccine Update. Effective date was August 12, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Mexico
Below are highlights from the September issue of the Board of Pharmacy newsletter. See the newsletter for additional details and more information.
- HIV Post-Exposure Prophylaxis and Point-of-Care Testing: Pharmacist prescriptive authority for the prescribing of HIV post-exposure prophylaxis therapy in conjunction with point-of-care testing was approved by the Board during its April 2021 meeting. Pharmacists who wish to obtain this prescriptive authority must go through Board-approved training and adhere to the Board-approved protocol.
- Regulation Updates
- 16.19.4 NMAC – Medical cannabis
- 16.19.20 NMAC – Changes to the scheduling status of certain substances
- 16.19.30 NMAC – Changes to the compounding of nonsterile pharmaceuticals.
- 16.19.31 NMAC – Emergency Provisions adding a section outlining Board authority to authorize extensions for unavailable training or testing during a declared emergency. This includes pharmacist license under reciprocity, technician registration, or pharmacist prescriptive authority.
- 2021 Law Update Schedule
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
Senator Bradley Hoylman (D) introduced S 7320 legislation which would expand pharmacists' authority to administer COVID immunizations down to age two. No hearing has been scheduled yet.
Also in New York, the NYS Department of Health held a webinar to update the pharmacy stakeholders on implementation of a single statewide formulary for opioid dependence agents and opioid antagonists effective October 1, 2021. The full presentation will be available on the Department of Health Website within the week. The Department of Health highlighted that a single formulary would provide consistent same rules for all Medicaid programs both FFS and MC for these categories of drugs.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Pennsylvania
The Governor’s Opioid Command Center in conjunction with the Department of Drug and Alcohol Programs have announced their intent to implement the Naloxone Copay Assistance Program on Oct. 1, 2021. Any PACE provider may submit claims to the new Naloxone Copay Assistance Program for up to $75 per claim for any Commonwealth resident (does not have to be a PACE beneficiary) through the existing PACE adjudication system. Additional program details will be provided in the next 2 weeks. The program is a result of a partnership between the state and NACDS and Pennsylvania Association of Chain Drug Stores (PACDS). We are currently working with members and the PACE program to develop the patient criteria and operationalize the program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
The Tennessee Pharmacy Association has produced a flowchart to help guide pharmacists through the process of filing complaints when PBMs are not following the new law. This flowchart was developed after hearing from the Tennessee Department of Commerce and Insurance (TDCI) that they are receiving incomplete claims, claims that still need to go through the MAC Appeal Process, or claims for Medicare, over which TDCI has no jurisdiction. This will be the first in a series of educational materials that TPA will provide in the coming weeks.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alabama
After further review, the Agency will not resume the EPSDT referral requirement as referenced in the July 27, 2021 Provider ALERT. This allowance will continue through the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Department of Health and Social Services and the Alaska Pharmacists Association (AKPhA) have a four-question survey to understand chronic disease management practices in pharmacies operating in the state. Individuals who received continuing education credits from the AKPhA’s 55th Annual Convention & Tradeshow held earlier this year have already completed the survey.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arizona
The Board of Pharmacy reminds prescribers and dispensers that mandatory e-prescribing of Schedule II controlled substances that are opioids resumed on July 9.
Also in Arizona, the Board of Pharmacy issued a notice of proposed rulemaking allowing pharmacy technicians to perform additional tasks delegated by pharmacists, including administration of a vaccine. Oral proceedings will be held on September 21.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Magellan Complete Care Members will transfer to Molina Healthcare of Florida, Inc. Molina Healthcare of Florida, Inc. (Molina) acquired Florida MHS, Inc., D/B/A Magellan Complete Care (Magellan), a Medicaid specialty plan specializing in the care of those with Serious Mental Illness (SMI). The Agency for Health Care Administration will move Magellan’s membership to Molina effective September 1, 2021. Molina will be issuing new Medicaid ID cards. All billing and claims reimbursement will be provided by Molina for dates of service beginning September 1, 2021. All claims for service dates prior to September 1, 2021, must continue to be submitted through Magellan and related questions may be directed to Magellan at 1-800-327-8613. Providers that are out of network as of September 1, 2021, will be eligible for a 60-day continuity of care period where claims will be payable to allow time for members to transition to a new provider, if necessary. The continuity of care period ends on October 31, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
SB1682, sponsored by Senator Scott Bennett (D), was signed by Governor JB Pritzker (D) on August 16, 2021. The measure will take effect on January 1, 2022, this measure amends statute to provide for additional drug pricing transparency from pharmacies.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Human Services issued INFORMATIONAL LETTER NO. 2256 updating the prospective safety edits for subsequent fills for opioids with information about point of sale (POS) billing and prior authorization (PA). Note: this informational letter replaces INFORMATIONAL LETTER NO. 2245-MC-FFS issued July 14.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
The Department of Medicaid Services (DMS) and MedImpact have announced a delay in the implementation of the planned 7–day payment cycle. The plan to migrate to a 7-day cycle is the result of continued pharmacy provider confusion and cashflow concerns regarding the previously established MedImpact payment cycle (14-day cycle and payment transfer/EFT timing and visibility). The change may be effective for the cycle end date 09/02/2021, barring unforeseen circumstances. EOB/claim file production will be aligned with this new schedule. If you have questions regarding your payments, you can contact MedImpact’s Pharmacy Network Department.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
At the August 18th Board of Pharmacy meeting, the Board approved proposed rules.
Title 46 (la.gov) that allows pharmacy interns and pharmacy technicians to administer medications independently of the Prep Act, and also repeals the requirement to report immunizations to physicians.
Also in Louisiana, the Department of Health (LDH) announced that they will be reimbursing for pharmacist administered influence vaccines for the 2021-2022 flu season beginning on September 15, 2021.
Finally in Louisiana, the Department of Insurance is soliciting feedback from stakeholders on the roles and responsibilities of Pharmacy Benefit Managers (PBM) and Pharmacy Services Administrative Organizations (PSAO). Submit comments to jeffrey.zewe@ldi.la.gov under the title "Response to Act 192 Request for Information" by November 1, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
The Board of Pharmacy issued on an update to the MA BOP’s Covid-19 Practice. This document reviews the issues related to license expirations, temporary emergency practice authorizations and orders, workforce issues and perpetual inventory.
Also in Massachusetts, effective August 12, 2021, MassHealth will cover the administration of the third dose of the Pfizer-BioNTech and Moderna COVID-19 vaccines to individuals who qualify for the additional dose. There is no cost sharing for any COVID-19 vaccines. MassHealth expects it will pay $45.87 for administration of the third dose of the Pfizer-BioNTech and Moderna COVID-19 vaccines, the same rate it pays for administration of first or second doses, using CPT code 0003A for the third dose of the Pfizer- BioNTech vaccine and CPT code 0013A for the third dose of the Moderna vaccine. Here is their updated policy.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Minnesota
The Insurance Division of the Department of Commerce has published a proposed rule on PBM Licensure and Regulation. The rule is a result of the passage of legislation in the 2019 Legislative Session and will be the subject of a hearing on September 20. NACDS intends to draft comments that will be sent out for member review. Should you have comments in the meantime, please send them to Jill McCormack by Sept. 3. Instructions for accessing the hearing virtually and by telephone are included in the rule.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Centers for Medicare and Medicaid approved the Department of Health and Human Services' State Plan Amendment for Medication-Assisted Treatment (MAT) on August 17. MAT is a covered service for all Medicaid beneficiaries meeting the medical necessity criteria for the service beginning October 1 and ending September 30, 2025.
Also in Nebraska, Provider Bulletin 21-18 includes two important updates:
- Starting October 1, the Heritage Health Adult (HHA) will move from a two-tier benefit system to a single benefit plan, meaning all adults enrolled in HHA will receive full state plan coverage including comprehensive physical and behavioral healthcare plus vision, dental and over-the-counter drug coverage.
- Medicaid and Long-term Care will be hosting one-hour educational webinars to provide information about the Medicaid Expansion program.
Finally in Nebraska, the Department of Health and Human Services announced that COVID-19 Medicaid Provider Calls will resume on September 1.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
An opinion letter https://www.nacds.org/ceo/2021/0827/7-22-21-Practicing-Pharmacy-into-Nevada.pdf issued by the Board's General Counsel in July now interprets the law to require that any pharmacist who dispenses or compounds prescriptions for a controlled substance or dangerous drug for a patient located in the state of Nevada needs to be registered/licensed with the Board. This interpretation is a complete reversal of the Board's long-standing practice of requiring a non-resident pharmacy to hold a Nevada license, but not the individual pharmacists who work at the pharmacy.
Also in Nevada, the Board of Pharmacy will hold a three-day Board meeting in Las Vegas on August 31-September 2. The Board's agenda and information on the videoconference link are available here – January 2000 Agenda (nv.gov)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
This week the New York State Board of Pharmacy released the finalized Board of Pharmacy Advisory memo on licensure requirement changes being proposed to the Board of Regents.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
HB96, sponsored by Representative Wayne Sasser (R), was signed by Governor Roy Cooper (D) on August 20, 2021. The measure becomes effective October 1, 2021, and provides for pharmacist vaccine administration, administration of long acting injectables, tobacco cessation, hormonal contraceptives, administration of the COVID vaccine and more. The North Carolina Board of Pharmacy issued guidance on how the Board is interpreting HB 96. This important guidance can be found here. Thank you to NACDS Members, North Carolina Retail Merchants and the North Carolina Pharmacy Association who worked on this bill.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Medicaid (OCM) announced this week that they project July 1, 2022, as the launch date on implementation of the new managed care model that includes the seven next generation managed care plans, the Single Pharmacy Benefit Manager (SPBM), Provider Network Management (PNM) module, Centralized Credentialing, and Fiscal Intermediary. More detail is available on ODM's managed care page.
Also in Ohio, ODM has released a FAQ announcing the rates for the Managed Care Supplemental Tiered Dispensing Fee for state fiscal year 2022-23. This in in addition to the dispensing fee currently paid by the plans. Members should expect the first payment of the biennium in November 2021.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The House Professional Licensure Committee will hold an informational meeting on Monday, September 20, 2021, at 10:00 a.m. to discuss the pharmacy-related regulatory waivers and suspensions issued by the Department of State during the COVID-19 pandemic and brief the members of the committee. NACDS plans to testify in favor of making the PREP Act permanent in state statute in coordination with the Pennsylvania Association of Chain Drug Stores (PACDS), the Pennsylvania Pharmacy Association (PPA) and other partners.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.