Oregon

The Department of Human Services began issuing $170 million in Pandemic EBT (P-EBT) food benefits to 434,000 students and young children in late March through May. These additional food benefits are part of the Pandemic EBT (P-EBT) program, a temporary COVID-19 response program meant to provide additional food support for children whose access to food provided through school programs may have been impacted by COVID-19. A P-EBT card containing $391 in food benefits, which is different from a regular electronic benefit transfer (EBT) card, will be sent by mail to each eligible child. 

Also in Oregon, the Oregon Health Authority published a final rule effective April 1, amending Prior Authorization Approval Criteria Guide & Preferred Drug List DUR/P&T Actions. (OAR 410-121-0030, OAR 410-121-0040) 

Also in Oregon, the Board of Pharmacy published a final rule effective April 4, amending Committee Member Compensation. (OAR 855-010-0016) 

Also in Oregon, the Board of Pharmacy posted the following: 

  • Interns Workgroup – May 3 at 1:00 p.m. – Agenda 
  • Collaborative Drug Therapy Management / Clinical Pharmacy Agreements Workgroup – May 4 at 1:00 p.m. — Agenda and Meeting Materials 

Also in Oregon, the Board of Pharmacy is proposing to adopt the following rules and announced a May 23 public hearing. Written comments may be sent to pharmacy.rulemaking@bop.oregon.gov no later than 4:30 p.m. on May 23.  

Finally in Oregon, the Board of Pharmacy adopted the following Temporary Rule, effective May 5: Division 045 – related to USP <795> and USP <797> Adopted Standards by Reference 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-04-28T11:58:27-04:00April 28, 2023|Oregon|

Texas

HB 1105 by Rep. Four Price (R), legislation that lowers the age to 3-years old and up for pharmacists, pharmacist interns and certified pharmacy technicians to administer all vaccines and immunizations without a patient specific prescription or medical order was voted favorably out of the House Public Health Committee on April 26th by a 7-4 vote. 

Also in Texas, on April 25th, the House Human Services Committee held a hearing on HB 1293, Rep. Toni Rose’s (D) Medicaid rate floor bill that all pharmacy groups support, would require PBMs’ pharmacy reimbursement to at least cover the pharmacy costs. Committee members questioned Priscilla Parrilla with the Health and Humans Services Commission’s Vendor Drug Program about the concerning fiscal note, and requested VDP (Vendor Drug Program) provide the committee with more information on how that was calculated. The bill was left pending in the committee. 

Also in Texas, on April 26th, the Senate Health and Human Services held a hearing on SB 1619 by Sen. Charles Perry (R), legislation supported by all pharmacy groups that would prohibit the Health and Human Services Commission’s Vendor Drug Program from including any discount price offered for the prescription drug, including a discount offered through a third-party discount card when defining the price of a prescription drug for purposes of determining the Usual and Customary (U&C) reimbursement rate for Medicaid. The bill was left pending in the committee. 

The Senate Health and Human Services also took testimony on SB 1137 by Sen. Charles Schwertner (R), PBM ERISA (Employee Retirement Income Security Act) reform legislation being led by the Texas Pharmacy Association and the Texas Pharmacy Business Council that is supported by all pharmacy groups. The companion bill by Rep. Tom Oliverson (R), HB 2021, was heard in the House Insurance Committee on March 21st. Both bills were left pending in committee. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2023-04-28T12:15:55-04:00April 28, 2023|Texas|

Wyoming

The Wyoming Attorney General (Commissioner of Drugs and Substances Control) issued a proposed rules to additional substances to Schedule I and Schedule IV in the Wyoming Controlled Substances Act of 1971. Comments may be emailed to melissa.rexius@wyo.gov; the comment period ends on June 1, 2023.  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-04-28T11:55:16-04:00April 28, 2023|Wyoming|

Alabama

The Alabama Medicaid Agency (Medicaid) is announcing the final extension of the COVID-19 public health emergency (PHE). The new expiration date is May 11, 2023, which correlates with the expiration date of the national emergency. A Provider ALERT will be forthcoming from Medicaid to communicate changes to services related to the COVID-19 PHE.  

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. Providers should include appropriate COVID-19 diagnosis code(s) on claims submitted to help with tracking of COVID-19. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

2023-03-31T09:47:07-04:00March 31, 2023|Alabama|

Arkansas

Janet Mann is the new Medicaid Director with the Department of Human Services. Mann has over 20 years of experience in health care and finance, including working in Mississippi Medicaid.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2023-03-31T09:46:43-04:00March 31, 2023|Arkansas|

California

The Board of Pharmacy posted the agenda and meeting materials for the April 5 meeting of the Licensing Committee. 

Also in California, the Department of Health Care Services posted the following updates: 

  • On March 29, DHCS received approval from CMS to waive the asset test at redeterminations for members enrolled in Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal. The waiver flexibility is effective for renewals retroactive to March 1 through December 31. Asset elimination takes effect on January 1, 2024. This waiver flexibility ensures continuity of coverage for seniors and persons with disabilities who meet all other Medi-Cal eligibility criteria, such as income, and will prevent potential disruptions in their Medi-Cal coverage once redeterminations resume in April 2023.  DHCS issued Medi-Cal Eligibility Division Letter (MEDIL) 23-19 to provide counties with immediate guidance on operationalizing the waiver flexibility.  
  • This week, DHCS posted the Medi-Cal Continuous Coverage toolkit in 17 Medi-Cal threshold languages (in addition to the previously posted English and Spanish). Each toolkit includes materials that can be customized to help DHCS Coverage Ambassadors and partners assist Medi-Cal members with the redetermination process. The content encourages members to update their contact information to ensure they receive important information about keeping their Medi-Cal coverage. On April 6, from 1 to 2 p.m., DHCS will host a Continuous Coverage Unwinding and Communications Campaign webinar (advance WebEx registration required) to discuss the Medi-Cal renewal and redetermination process, communications campaign updates, and how DHCS Coverage Ambassadors and other partners can continue to help assist in this important effort. 
  • DHCS released a COVID-19 Uninsured Group (UIG) Program toolkit (in English and Spanish) to provide information to more than 500,000 UIG Program members about how to apply for ongoing coverage through Medi-Cal or Covered California before the program ends on May 31, 2023. Due to the COVID-19 Public Health Emergency ending, Covered California will open a special enrollment period for UIG Program members that have their coverage ending. The special enrollment period will end 60 days after May 31, 2023. The toolkit offers vital information for DHCS Coverage Ambassadors to share broadly with their networks about where UIG Program members can find the resources to apply for health coverage, including contact details for their local county offices and how to apply online. More information about DHCS’ strategy to unwind the UIG Program is available in the Medi-Cal COVID-19 Public Health Emergency and Continuous Coverage Unwinding Plan posted on the Keeping Medi-Cal Members Covered webpage. 
  • As of March 24, Phase III, Lift 1 of the Medi-Cal Rx Reinstatement plan has been successfully implemented. Providers are required to submit prior authorizations for new and renewing prescriptions in specific drug classes for members 22 years of age and older.   
  • On March 29, the California Health & Human Services Agency, Department of Managed Health Care, and DHCS held a webinar to walk through the Governor’s proposal to modernize California’s behavioral health system. The proposal builds on the Administrations’ previous investments and policy reforms to re-envision how the state treats mental health and substance use disorders. More information and the presentation are available on the ​Modernizing our Behavioral Health Initiative webpage.  

Also in California, the Department of Health Care Services (DHCS) posted the following alert on the Medi-Cal Rx Web Portal: Mpox Vaccine No Longer a Family PACT Pharmacy Benefit (March 30).    

Finally in California, Medi-Cal posted the following:   

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-03-31T09:46:16-04:00March 31, 2023|California|

Idaho

HB 215, legislation adding enforcement language to Title 41-349 related to PBMs permitting the director [Department of Insurance] to act, issue penalties and make remedies for PBMs who violate the law in accordance with authorities in the Idaho Code, passed the House (61-9) and Senate (25-8-2). On March 29, it was sent to Gov. Brad Little (R) for consideration. 

Also in Idaho, HB 291, legislation establishing the Fair Pharmacy Audits Act and creating standards and criteria for the audit of pharmacies by PBMs or other authorized entities, passed the House (61-7-2) and Senate (27-7-1). On March 29, it was sent to Gov. Brad Little (R) for consideration. 

Finally in Idaho, the Board of Pharmacy posted its March 2023 Newsletter including the following items: 

  • 2023 Summary of Pending Statute and Administrative Rule Changes 
  • Idaho Telehealth Access Act COVID-19 Guidance Updated 
  • Announcement and Reminder: Prescription Drug Monitoring Program 
  • Idaho to License Virtual Wholesalers That Operate in and into Idaho 
  • Enforcement of Mandatory Checking of the PDMP to Begin April 1, 2023 
  • Board Executive Officer Awarded the Judy Smetzer Just Culture Champion Scholarship 
  • Board Sets 2023 Meeting Schedule 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

2023-03-31T09:45:19-04:00March 31, 2023|Idaho|

Maryland

SB 678 has passed the House and Senate and is on its way to the Gov. Wes Moore’s (D) desk. It will require Medicaid, CHIP and commercial health plans to pay for services provided by pharmacists within their scope of practice.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2023-03-31T09:44:31-04:00March 31, 2023|Maryland|

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