Louisiana
The regular session of the state legislature is scheduled to adjourn at 6 PM on June 1, 2020. Immediately after adjournment, at 6:01 PM, Gov. John Bel Edwards is expected to convene a special session to finalize the budget through June 30, the constitution deadline date for a balanced budget.
Also in Louisiana... The Board of Pharmacy held a full Board meeting via Zoom on May 27th . The Board discussed problems with adequate testing sites for pharmacy graduates, and a pending House Concurrent Resolution 71 that if passed and signed by Gov. Edwards, would temporarily suspend the annual licensing fees imposed by licensing boards and agencies on businesses. The Board plans to hold an emergency virtual Board meeting in June to take action on these two issues.
Also in Louisiana... NACDS submitted a comment letter raising concerns about adding seven medications that are used to treat hepatitis, as well as gabapentin and oral liquid formulations of promethazine to the drugs of concern list that must be reported to the Prescription Monitoring Program.
Also in Louisiana... NACDS confirmed that Sen. Mark Abraham will not pursue passage of SB 488, legislation that would have prohibited chain pharmacies from enforcing any policy which would restrict the quantity or dosage of a prescription for a controlled substance or restricts a filling a prescription for a controlled substance issued by a specific prescriber.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
Gov. Larry Hogan (R) issued an executive order to allow pharmacists to order, and to collect or supervise the collection of tests for COVID-19.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Minnesota Board of Pharmacy published a Summary of 2020 Legislation, as well as guidance for implementing HF 3100, the Minnesota Insulin Safety Net Program. The program is to be operational by July 1, 2020, but numerous challenges persist.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
Notice of the Board of Pharmacy announces the suspension of the 2020 live continuing education requirements for pharmacists. The notice specifies that pharmacists, upon request, still will be required to submit evidence of five hours of education on opioid abuse and prevention, drug abuse, or addiction-related issues and a total of 15 hours for the year 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
Concluding a legislative session with relatively few bills enacted, Missouri HB 1682 is headed to the Governor for expected signature. Among its provisions, HB 1682 will require pharmacy benefit management companies to be licensed by the Department of Insurance. The bill also includes language to enable remote dispensing. Meanwhile, legislation to create a statewide Prescription Drug Monitoring Program (PDMP) failed. While Missouri is the only state without a statewide PDMP, a County-based system covers approximately 85% of the state’s population.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nebraska
The Nebraska Unicameral is now scheduled to reconvene on July 20, 2020. Please see the Unicameral Update for more information.
Also in Nebraska... The Nebraska Pharmacists Association is offering a nicotine cessation counseling toolkit, noting opportunities for pharmacist payment from both Medicare and Medicaid.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Pennsylvania
Pennsylvania pharmacies that would like to participate in receiving COVID-19 vaccinations from the state when they become available should consider completing the Memorandum of Agreement (MOA) available at the PA Department of Health’s Pharmacy MOA webpage on the department’s website. Further information on the MOA and submission instructions can be found there. Although the MOA is specific to a pandemic influenza, DOH intends to draft an addendum to include the upcoming COVID-19 vaccine. Only one MOA needs to be signed by your company to cover all your in-state stores.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
NACDS also continues to try to remove the remaining physician order requirement in Texas that poses a barrier to pharmacies expanding COVID-19 testing. NACDS, the Texas Federation of Drug Stores and the Texas Pharmacy Association provided requested updates to the Board of Pharmacy FAQ on COVID-19 testing for pharmacists and pharmacies. The updates included reference to the most recent advisory opinion from the U.S. Department of Health and Human Services (HHS) concluding that the federal PREP Act, in conjunction with HHS’ April 8th guidance, preempts any state or local requirement that prohibits or effectively prohibits a pharmacist from ordering and administering a COVID-19 test that the Food and Drug Administration has authorized.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
NACDS submitted written comments to the Alaska Board of Pharmacy supporting their quick acting temporary rules expanding pharmacy and technician practice, that will become permanent.
Also in Alaska… The Department of Health & Social Services submitted to CMS an 1135 waiver which was approved May 7th. Temporary policies include: no cost-sharing for testing services; allowing service provision and reimbursement of services provided by qualified and enrolled Alaska licensed pharmacists practicing within their authorized scope of practice, statewide standing orders authorized by the AK Chief Medical Officer and HHS Office of the Assistant Secretary for Health; claims for medications with day’s supply up to 68 days shall be permitted unless medication is on the 90-day list, then 90-days will be permitted; allow for a professional dispensing fee to be reimbursed no more than every 14-days per individual at $15.86 for “on road” pharmacies, and $23.78 for “off-road” pharmacies. Shipping will be reimbursed regardless of the location of the pharmacy or beneficiary; and covered outpatient drugs dispensed by a retail-based pharmacy, when a medication’s acquisition cost exceed the standard “lesser of” payment methodology logic, providers may petition for reimbursement at WAC + 1% on a claim-level basis through the point-of-sale and bypass the FUL and NADAC.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
The Board of Pharmacy will be holding a public hearing via Zoom on June 15, 2020 to discuss the following rules:
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Gov. Gavin Newson’s released his May Revised 2020-21 Budget last week projecting a $54.3 billion deficit. Since the state’s constitution requires that the legislature submit a balanced budget to the Governor by June 15, 2020, and that the Governor must sign it before the start of the next fiscal year on July 1, 2020, legislators are scrambling to hold hearings on the proposed massive cuts. NACDS and the California Retailers Association submitted a joint letter to both the Senate and Assembly Budget Committee Chairs strongly opposing the proposed elimination of Medi-Cal reimbursement of pharmacist-delivered services such as providing self-administered hormonal contraceptives, vaccines, nicotine replacement products, travel medications, naloxone directly to patients and PEP/PrEP for HIV prevention.
Also in California... In advance of the Assembly Business & Professions Committee hearing, NACDS and the California Retailers Association submitted a joint letter opposing SB 2983 by Assembly Member Chris Holden, because it would prohibit pharmacies from automatically contacting prescribers to authorize a prescription for any dangerous drug or device for more than a 7-day supply refill without authorization from the prescriber or patient. Further, we objected to the requirement that a pharmacy obtain separate authorization for each prescription.
Also in California... The Assembly Budget Subcommittee on Health and Human Services debated health care cuts proposed by the Department of Finance, which included cuts to the proposed Diabetes Prevention Program. NACDS is a member of a broad-based coalition building support to advance Medi-Cal funding for Continuous Glucose Monitors (CGMs).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Board of Pharmacy held a stakeholder meeting on Tuesday and Board meeting on Thursday to discuss what temporary rules suspended by Gov. Jared Polis should be permanently suspended by the Board. Issues the Colorado Retail Council and NACDS members promoted included recommending the Board to act on include allowing pharmacists to order and administer COVID-19 tests, including serology tests, that have received Emergency Use Authorization (EAU) from the Food and Drug Administration (FDA), or equivalent regulatory authorization and keeping the definition of pharmacy intern and technician roles at remote pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Florida Medicaid has issued an ALERT reminding providers that they cannot charge a recipient for Personal Protective Equipment (PPE) used during the delivery of a Medicaid covered service. Reimbursement from Florida Medicaid is payment in full for all services. Additional information, including balanced billing prohibitions, is in the Agency’s General Medicaid Policy.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Department of Healthcare and Family Services (DHFS) posted a new Provider Notice with a comprehensive billing guide for Medicaid Managed Care Services. In addition, as follow up to its March 30th provider notice, DHFS posted a list of medications added for temporary coverage in a 90-day supply.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Iowa Board of Pharmacy shared an update about pharmacist emergency licenses. Among the information is this reminder: Upon the expiration or termination of the Governor’s Proclamation of Disaster Emergency, the Board will provide notice to all pharmacists with emergency licenses regarding the date by which the required exams must be completed to retain active Iowa pharmacist licensure.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
NACDS and the Louisiana Retailers Association (LRA) submitted a joint letter to Louisiana Governor John Bel Edward’s Rural Development Task Force Chairman Jim Clinton sharing our ideas how community pharmacies are vital to helping reopen the economy. NACDS and LRA also sent a similar letter earlier this month to the Governor’s Health Equity Commission and have been participating in their meetings focused on addressing health disparities during the COVID-19 Pandemic.
Also in Louisiana... Gov. John Bel Edwards issued a proclamation extending the public health emergency until June 5, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Michigan Gov. Gretchen Whitmer (D) extended the duration of her previous Executive Order granting broad authority for pharmacies to engage the COVID-19 pandemic, with policies including emergency refills, therapeutic substitution, and suspension of the technician ratio.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Minnesota
The Board of Pharmacy issued a guidance document to assist with the challenging implementation of the insulin safety net program created by HF 3100.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
NW Pharmacy Conference
The NW Pharmacy Conference sponsored by the Idaho State Pharmacy Association, the Montana Pharmacy Association, and the Washington State Pharmacy Association, will be held virtually next week beginning May 29, 2020. Interested NACDS members can registered through any of the three pharmacy associations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oklahoma
On May 12th, Gov. Kevin Stitt enacted an Executive Order that removed all restrictions regarding prescriptions for Hydroxychloroquine and Chloroquine. Thus a Board of Pharmacy COVID-19 waiver is no longer necessary for dispensing Hydroxychloroquine and Chloroquine prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
South Carolina
The SC Board of Pharmacy has issued the following guidance in regards to COVID testing by pharmacists in the state.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS, the Texas Federation of Drug Stores, and the Texas Pharmacy are all continuing to work with the Board of Pharmacy to urge Gov. Greg Abbott to allow all licensed pharmacies with CLIA-waivers to order and administer all FDA-authorized CLIA-waived tests that can detect COVID or the presence of antigens or antibodies produced in response to the virus.
Also in Texas... On May 15th, the Board of Pharmacy issued the following guidance to pharmacists when dispensing prescriptions for Chloroquine, Hydroxychloroquine, Mefloquine, or Azithromycin in compliance with Emergency Board Rule 291.30.
The rule does not prevent a physician from prescribing one of these drugs for an off-label use. Please note, the intended use for the drug is not required if the practitioner determines the furnishing of this information is not in the best interest of the patient in accordance with Board rule 291.34 (b)(7).
o The intent of Rule 291.30 is to prevent the stockpiling of the drugs and to ensure that reasonable quantities are available for ALL patients that require therapy with the drugs, including patients with a COVID-19 diagnosis.
o It was not the Board’s intent to hinder the use of the drugs on patients that are in need of drug therapy, but rather to prevent unreasonable quantities that would otherwise be representative of hoarding or stockpiling tactics.
o In addition, the Rule does not apply to a prescription issued for a patient already established on the medication (e.g., prescription to treat rheumatoid arthritis or lupus for already established patients).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Wyoming Legislature finished its first of several special sessions focusing on allocating the $1.25 billion allocated to the state through the CARES Act. Of possible interest to NACDS members if the passage of HB 1004 – Business relief programs. The bill sets up a state level business relief program to provide direct grants/stipends to Wyoming businesses impacted by the COVID19 pandemic.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Notice of the Department of Insurance announces that health care providers will receive claim reimbursements from the U.S. Department of Health and Human Services for coronavirus (COVID-19) testing and treatment services provided to uninsured individuals. The reimbursements will be provided at Medicare rates for services or admittance on or after Feb. 4, 2020.
Emergency rule of the Board of Pharmacy amends regulations under AAC 680-X-2 to provide pharmacy technicians an extension to complete required training until Dec. 31, 2020, in response to the coronavirus (COVID-19) public health emergency. The extension applies to technicians who initially registered on or after Jan. 1, 2020, through the end of the state of emergency. The rule is effective March 25, 2020 and expires July 23, 2020.
Emergency rule of the Board of Pharmacy adopts regulations under AAC 680-X-2 to allow the board to issue temporary pharmacist practice permits during the coronavirus (COVID-19) public health emergency. The rule applies to applicants licensed in another state who meet specified criteria. The rule is effective April 2, 2020 and expires July 31, 2020.
Emergency rule of the Board of Pharmacy adopts regulations under AAC 680-X-2 to allow the board to issue temporary in-state pharmacy permits if the applicant meets specified criteria during the coronavirus (COVID-19) public health emergency. The rule is effective April 2, 2020 and expires July 31, 2020.
Emergency rule of the Medicaid Agency adopts regulations under AAC 560-X-13 to temporarily ease the EPSDT referral requirements, “face to face” provider visit requirements, and expiration dates of orders related to Durable Medical Equipment during the state of emergency as it relates to the COVID-19 pandemic. The rule is effective March 24, 2020 and expires July 22, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
NACDS submitted comments to the Arkansas Department of Human Services in support of a Medicaid state plan amendment to increase payment rates for pharmacies and other vaccine providers. Given that appropriate Medicaid vaccine payment rates are key to ensuring access to vaccine services that are vital to public health goals, NACDS comments commended the state for pursuing this rate increase.
For more information, contact NACDS’ Mary Staples at 817-442-1155.