Missouri
The Board of Pharmacy held a two-day meeting this week. Among the items discussed were updated on pending legislation that impacts pharmacies and a general discussion on pharmacy workforce conditions.
Also in Missouri, on March 3, CMS approved a SPA to allow pharmacists to bill MO HealthNet for all services within their scope of practice. The effective date was retroactive to January 1, 2021. More information can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The next meeting of the Drug Utilization Review (DUR) Board will be May 11, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Mexico
The Board of Pharmacy issued a proposed rule establishing standards for pharmacist prescribing of protocol formulary dangerous drugs and prescribing of dangerous drugs in conjunction with point-of-care testing. The rule also revises the definition of “hormonal contraception drug therapy” to include formulary products delineated in the written contraception protocol, including emergency contraception, and clarifies reporting of vaccine administration. The Board will hold a virtual hearing during their April 22-23 meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The North Carolina Department of Health and Human Services (NCDHHS) has no-cost antigen tests they would like to share with retail businesses that are interested in screening their employees for COVID-19. The Department of Health and Human Services will also arrange an orientation call with any NCRMA member to discuss what you need to do to request and receive the free tests from DHHS. The North Carolina Department of Health and Human Services has a supply of Abbott BinaxNOW rapid, point-of-care antigen testing supplies available to support testing efforts to quickly identify and respond to cases of COVID-19. Facilities interested in receiving tests from the state must meet ALL the following requirements:
- CLIA Certificate — Obtain a CLIA certificate or partner with an entity with a CLIA certificate
- Physician Order — Secure a signed physician order or elect to use the Statewide Order
- PPE — Maintain an adequate supply of PPE to perform tests
- Medical Waste — Adhere to standards to properly handle and dispose of medical waste
- Training — Ensure all testing personnel have completed BinaxNOW training
- Reporting — Verify ability to complete DHHS reporting requirements. Reporting methods can be found at Getting Started with Automated Reporting.
- Quarantine & Isolation Support – Provide the necessary quarantine and isolation guidance for all individuals with suspected or confirmed cases of COVID-19 or who are close contacts of a COVID-19 case
Request process: All facilities that meet the above requirements may apply to request tests via the request form.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
Gov. Doug Burgum (R) signed several bills of interest to chain pharmacy as emergency measures:
- SB 2221, lowering the age for immunizations and vaccinations to at least three years of age upon an order from a prescriber or by written protocol with a physicians or nurse practitioner; permitting a pharmacist to bill for dispensing a one-time emergency refill of up to a 30-day supply of the prescribed medication under certain conditions, and defining “public health issues” and establishing limited prescriptive authority through a statewide protocol for public health issues within the pharmacist’s scope of practice with the Board of Pharmacy adopting rules to establish standards of care, was signed on March 22.
- SB 2279, permitting the Board of Pharmacy to adopt rules to establish requirements to allow a pharmacy technician to administer a drug under the immediate supervision of a pharmacist, was signed on March 25.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The Board of Pharmacy published a notice to announce the reiteration of certain emergency orders issued in response to the COVID-19 public health emergency, including the suspension of the prohibition on performing remote order entry from an unpermitted site, the temporary authorization of automated pharmacy pickup kiosks, and the establishment of safe harbor provisions concerning personal protective equipment. The notice also reiterates the authorization of a one-time early refill of Schedule III, IV, and V prescriptions for valid refills, and the dispensing of Schedule II controlled substances under specified conditions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The House Public Health Committee held hearings on two bills supported by NACDS members: HB 678 by Rep. Phil Cortez (D) that amends existing laws making permanent pharmacists’ authority to initiate, order, and administer childhood vaccines to anyone 3 and older without a prescription, and HB 2049 by Rep. Donna Howard (D) that would allow pharmacists to test and treat for flu and strep. NACDS members are encouraged to call the House Public Health Committee members to urge them to vote both bills out of the Committee so they can be set for a vote by the House of Representatives.
Photo Caption – (L-R) NACDS chain pharmacists Casey Nichols with Walgreens, Jeff Loesch with Kroger Health, and Aimee Lusson with Walgreens meet with immunization bill sponsor Rep. Phil Cortez in the Texas State Capitol after the House Public Health Committee hearing.
Also in Texas, the Health and Human Services Commission is hosting two vaccine webinars:
- Actively Administering & Advanced VAOS Users – For COVID-19 vaccine coordinators and providers who have received allocations of the COVID-19 vaccine and are actively administering the vaccines. Discussions will focus on important news updates, clinical considerations, and advanced user tips on the systems and processes to support you.
- Basics & Beginners -For providers who are new to the COVID-19 vaccine management program and/or have not yet received allocations of the vaccine. Discussions will focus on important news updates, the enrollment process, how to access VAOS, and how to get started with requesting allocations.
- April 22, 12:00PM-1:30PM CT – Register here
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Board of Pharmacy has asked that we remind members that the emergency rule requiring pharmacy technician trainees to be enrolled in a training program upon registration with the Board became effective January 3.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
West Virginia
Gov. Jim Justice (R) recently signed the following bills:
- SB 182, legislation making permanent the Board of Pharmacy’s emergency rule related to the pharmacist and pharmacy intern’s authority to immunize adults according to the CDC’s Recommended Adult Immunization Schedule as well as individuals ages 11-17 years of age following the CDC’s Recommended Child and Adolescent Schedule according to a prescription and parental consent, if there are no contraindications to the vaccine, was signed on March 31 and became effective on the date of passage on March 23, 2021.
- HB 2263, legislation relating to the regulation of PBMs including establishing a reimbursement rate floor of NADAC (or WAC, if NADAC is not available) plus a $10.64 professional dispensing fee, was signed into law on April 9, 2021, and effective 90 days from passage on June 28, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wyoming
The Board of Pharmacy’s emergency rule amends regulations under Chapter 16 to clarify standards for pharmacists to provide immunizations during the COVID-19 public health emergency. The rule removes the definition of “private space” and the requirement that the individual receiving a vaccine be seated in a chair with back support. The rule also adds vaccines approved by the FDA under the Emergency Use Authorization for COVID-19. The rule extends December 9, emergency rule and became effective April 7, and expires August 5, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
In addition to the three bills signed last week, a fourth bill NACDS supported expanding pharmacies’ scope of practice was signed into law. HB 1246/Act 503 allows pharmacists to screen and prescribe medications for flu and strep under a written statewide protocol approved by the Board of Pharmacy and Medicine.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
NACDS and the California Retailers Association (CRA) submitted a joint letter to the Assembly Business & Professions Committee to register our “oppose unless amended” position on AB 1430, legislation requiring pharmacies to dispense Schedule II prescription drugs in lockable vials. NACDS requested the bill be amended to be voluntary and to remove the onerous administrative requirements (i.e. maintaining patients’ combination codes for locking-cap closure mechanisms). The bill also fails to extend the same liability protection against failure of a particular lockable vial to prevent unauthorized access and/or a particular patient’s inability to access medication in a lockable via that is otherwise afforded to prescribers under the bill; we requested his omission must be remedied.
Also in California, NACDS and CRA submitted a letter to the California Senate Appropriations Committee opposing SB 362 due to the fiscal pressure on the state created by new enforcement costs for the Board of Pharmacy. This is in addition to a similar recent joint letter to the California Senate Business, Professions & Economic Development Committee voicing opposition to this bill which would prohibit community pharmacies from utilizing metrics to evaluate the performance of employees. While SB 362 may be well-intentioned, it contains ambiguous and onerous requirements that are impossible for pharmacies to meet and may ultimately threaten access to pharmacy services and jeopardize patient safety.
Also in California, SB 409, legislation permitting pharmacists to perform SARS-CoV-2 and influenza testing and adding pharmacist-in-charge in the definition of a laboratory director, passed the Senate and was read for the first time in the Assembly.
Also in California, the Department of Consumer Affairs (DCA) issued the following waivers via authority under Governor Gavin Newsom’s Executive Orders N-39-20. A list of current waivers is available on the DCA website.
- DCA Waiver DCA-21-139 Order Waiving Restrictions On Healthcare Students Administering COVID-19 Vaccines In Association With State or Local Vaccination Efforts
- DCA Waiver DCA-21-140 Order Waiving Restrictions On Healthcare Providers With Expired, Inactive Or Lapsed Licenses Ordering And Administering COVID-19 Vaccines In Association With State or Local Vaccination Efforts
Also in California, due to the delayed Go Live date for Medi-Cal Rx, the following events have been postponed. Also, the Department of Health Care Services (DHCS) anticipates providing further information about the Medi-Cal Rx implementation in May.
- The April 14 public forum is being postponed. The next scheduled Medi-Cal Rx public forum is May 19 via webinar. Information will be posted on the DHCS website. For questions or comments related to Medi-Cal Rx, please email RxCarveOut@dhcs.ca.gov.
- The March 22 Medi-Cal Rx Advisory Workgroup meeting was postponed. The next scheduled meeting for this workgroup is May 28 via webinar. These sessions are intended to help facilitate and further inform DHCS’s ongoing efforts to implement pharmacy services improvements through Medi-Cal Rx. Information on how to participate in the next webinar will be provided on the DHCS website.
Also in California, on April 7, 2021, the DHCS posted this Provider Registration and FAQs bulletin on the Medi-Cal Rx Web Portal.
Lastly in California, the Board of Pharmacy is beginning the development of its new strategic plan and is seeking stakeholder feedback. The Department of Consumer Affairs, SOLID Planning Solutions (SOLID), is assisting the Board with its strategic planning process. Completed surveys will provide input as to how the Board is doing by identifying strengths, challenges, and current trends to consider for the future direction of the Board. All responses are anonymous. This survey will be open until April 30, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Georgia
Three pieces of legislation in Georgia have passed both Chambers and are on the way to Governor Kemp for signature. HB316 moves the number of pharmacy technicians a pharmacist may supervise from 3:1 to 4:1. SB46 allows Georgia pharmacists to administer any adult ACIP approved vaccine under a vaccine protocol agreement with a physician. HB653 will statutorily allow Georgia pharmacists to order, administer, and interpret COVID-19 tests for up to twelve months after the expiration of the Federal State of Emergency.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Maryland
HB 1040, legislation that would mirror pharmacists’ federal authority to provide childhood vaccines to children age 3 years and older effective July 1, 2021 thru June 30, 2023, has passed both Chambers and is on its way to Gov. Larry Hogan (R) for signature. The bill was sponsored by Del. Ariana Kelly (D) and also requires the Department of Health to complete a study of pharmacist-administered childhood vaccines by Dec. 1, 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Iowa
NACDS participated in the Iowa Department of Human Services (DHS) – Iowa Medicaid Enterprise (IME) Pharmacy Groups Quarterly Meeting to share information about COVID-19 vaccinations and explore pharmacist payment for other vaccinations under the medical benefit where all providers are paid the same rates and future IME policy changes related to automatic refills and pharmacist scope of practice that will be announced in upcoming Informational Letters. NACDS and the Iowa Pharmacists Association have scheduled a follow-up call to discuss opportunities to expand pharmacist payment for services.
Also in Iowa, the DHS IME’s adopted and filed rule establishing pharmacy policies and procedures for Medicaid coverage and reimbursement of prescription drug refills through an automatic refill program, rather than prohibiting such a program, which became effective March 1. Requirements allowing this may also be found here. This information will be updated in the next Informational Letter released and in the next Provider Manual update.
Also in Iowa, the Board of Pharmacy announced guidance on pharmacy operations under an April 2, 2021, renewed governor’s proclamation of a disaster emergency due to the coronavirus (COVID-19) pandemic. The guidance addresses the practice of pharmacy on an inactive or expired license or technician trainee registration, continuing education requirements, license and registration renewal, practicing with a license from another state, and criminal background check requirements.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
Medicaid is launching a new Medicaid Provider Enrollment Portal in April to screen and enroll all Medicaid providers. The enrollment portal is being designed to meet a Centers for Medicare and Medicaid Services (CMS) requirement and must be used by all Medicaid providers. More information can be found here.
Also in Louisiana, the legislature convenes its budget session Monday, April 12, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
NACDS sponsored the Missouri Pharmacists Association’s Day at the Capitol. MPA’s priority bill, HB 834 by Rep. Dale Wright (R) that regulates PBMs, passed the House and was referred to the Senate Government Accountability and Fiscal Oversight Committee rather than the Senate Health Committee. More information can be found here.
Also in Missouri, the Board of Pharmacy issued a final rule effective May 30, 2021, that allows additional time to fulfill prescription transfer requests from parties other than the patient. The rule requires transfer requests to be completed in a timely manner and ensures no interruption in patient therapy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
The Board of pharmacy issued a notice to announce its intentions to amend and adopt regulations under NAC 453 to establish standards for a computerized program to track controlled substance prescriptions. The rule would provide for the development of patient utilization reports and prescriber utilization reports, address the integration of and access to electronic health records, and address periodic board review and law enforcement access to reports.
Also in Nevada, SB 229 legislation the NACDS, the Retail Association of Nevada, pharmacies, and pharmacists, and the Nevada Department of Health and Human Services support sponsored by Sen. Julia Ratti (D) which will modernize Collaborative Practice Agreements (CPAs) and classify pharmacists as health care providers passed Senate Commerce and Labor Committee on April 6th.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
The 60-day legislative session adjourned on March 20.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
South Carolina
NACDS virtually attended the 2021 SCRA Legislative Days Monday, March 29th, and Tuesday, March 30th. The legislators and state agency representatives the group heard from over two days included, Governor Henry McMaster, Senate Majority Leader Shane Massey, Senate Minority Leader Brad Hutto, and the new Director at the SC Dept. of Health and Environmental Controls (DHEC), Dr. Edward Simmer. Governor McMaster discussed the COVID19 vaccine roll-out and his appreciation for the retail partners’ efforts. He also stated that he anticipated the current State of Emergency to continue for the foreseeable future. Senator Hutto discussed possible legislation mandating the COVID19 vaccine as well as Hate Crime legislation. Dr. Simmer is hoping for continued collaboration in addressing vaccine access.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Oregon Health Authority issued the following:
- Temporary rule amending regulations under OAR 410-121 to revise the practitioner-managed prescription drug plan to update the preferred drug list. The rule is effective April 1, 2021, and expires June 29, 2021.
- Proposed rule amending regulations under OAR 410-121 to revise the practitioner-managed prescription drug plan to update the preferred drug list, beginning April 1, 2021. The rule currently is in effect as a temporary rule, expiring June 29, 2021. Comments are due April 21, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS is asking members to call Chari Stephanie Klick and members of the House Public Health Committee asking for a hearing as soon as possible for TX HB 678 by Rep. Phil Cortez. Our message is that “there is an urgent need to permanently remove the administrative barriers allowing pharmacists to independently order and administer all immunizations to anyone 3 years of age or older without a prescription. Passing HB 678 will guarantee Texans get much better access to convenient, preventive health care.”
Also in Texas, as the state opens COVID-19 vaccine eligibility to everyone age 16 and older, the Texas Department of State Health Services (DSHS) launched the Texas Public Health Vaccine Scheduler, giving people one place to sign up for a COVID-19 shot through multiple public health departments, including the eight DSHS public health regions, which provide public health services in nearly 200 Texas counties, and more than a dozen local health entities across the state.
Also in Texas, beginning April 1st, Health and Human Services (HHSC) set the fee-for-service (FFS) reimbursement rates for COVID vaccines to align with Medicare. The FFS administration reimbursement rate is now $40 for each dose.
Lastly in Texas, the Board of Pharmacy is requesting comments by May 4th on several proposed rules:
- Proposed rule amending regulations allowing pharmacists to electronically sign the data entry attestation statement. The rule also would update references to the DEA 222 order form requirements for distributing Schedule II controlled substances.
- Proposed rule extending the period that Schedule II prescriptions are valid to 30 days to conform to federal standards. The rule also would remove a reference to the effective date of the pharmacy responsibility provisions.
- Proposed rule correcting statutory and regulatory cross-references in the requirements on pharmacy operation.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Pharmacy Quality Assurance Commission issued an emergency rule effective until July 3rd increasing the amount of time to 15 days that a practitioner has to deliver a signed prescription when authorizing an emergency prescription of a Schedule II substance to the pharmacy. The rule also defines “signed prescription” and allows practitioners to fulfill signature requirements through paper, electronic transmission, facsimile, photograph, or scanned copy. The rule extends August 5, 2020, emergency rule is issued in response to the COVID pandemic.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
Gov. Jim Justice (R) signed HB 2262, removing the requirement that a veterinarian monitor the controlled substance monitoring database and adding the requirement that a pharmacist licensed by the West Virginia Board of Pharmacy shall access the West Virginia Controlled Substances Monitoring Program Database for information regarding specific patients upon initially dispensing any Schedule II controlled substance, any opioid or any benzodiazepine to a patient who is not suffering from a terminal illness, and at least annually thereafter should the practitioner or dispenser continue to treat the patient with a controlled substance. The effective date is May 31, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
- HB 1134/Act 406 by pharmacist Rep. Justin Boyd (R) allows Arkansas pharmacists the ability to prescribe and administer all vaccines and immunizations to anyone 3 years of age and older. If pharmacists administer either the flu or COVID vaccine to a patient that is 3-6 years old, then the pharmacist must participate in the Vaccines for Children program and inform adult caregivers of the importance of a well-child visit.
- HB 1135/Act 407 also by pharmacist Rep. Justin Boyd allows Arkansas pharmacy technicians to administer vaccines and immunizations to a person 3 years of age or older if delegated by a supervising pharmacist; pharmacy technicians may not administer other medications.
- HB 1069/Act 408 allows Arkansas pharmacists with proper training to be defined by the Board of Pharmacy to initiate therapy and administer or dispense contraceptives under a statewide protocol.
For more information, contact NACDS’ Mary Staples at 817-442-1155.