California
The Department of Managed Health Care announced All Plan Letter 21-011 to provide an overview of new guidance from the federal Departments of Labor, Health and Human Services, and the Treasury that address the implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and other health coverage issues related to COVID-19. The letter discusses coverage of diagnostic testing, especially public health surveillance testing.
Also in California, The Board of Pharmacy posted its monthly news roundup. Among the items of interest are the March 2021 issue of “The Script” with articles about new pharmacy laws, new requirements for controlled substance prescription forms and for reporting to CURES, tips on how to avoid processing delays for pharmacy technician license applications, and a reminder that pharmacists-in-charge are required to complete a self-assessment of the pharmacy’s compliance with state and federal laws before July 1 of each odd-numbered year. Current forms and draft versions under review for possible adoption are available online under “Facility License Information/Renewal.” Effective April 1, 2021, the CURES fee will increase from $6 to $11 annually for two years in which most licensees will see a $22 CURES fee due to the biennial renewal cycle.
Also in California. The Board of Pharmacy posted “Guidance on Eligible Personnel for Vaccines Administered in Pharmacies.” Please visit the above link for more information.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Via an emergency regulation effective February 24, the Division of Insurance amends regulations under 3 CCR 702-4 to specify that carriers must provide coverage for persons undergoing treatment and receiving vaccines for COVID-19.
Also in Colorado, The Division of Insurance amends regulations under 3 CCR 702-4 related to coverage and cost-sharing requirements for the commercial insurance market coverage of COVID-19 claims. “Section 6 Access to Prescription Drugs During the COVID-19 Emergency” includes language to allow 90-day refills before the scheduled refill date and to prohibit carriers from applying a different cost-sharing amount for early refills. This emergency regulation 21-E-04 was effective March 19.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
Effective April 2021, HIV post-exposure (PEP) and Pre-exposure (PrEP) treatment for MCO beneficiaries will be carved out of managed care. Claims should be submitted through the Magellan POS system.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Iowa
The Department of Human Services, Iowa Medicaid Enterprise issued Informational Letter No. 2225-MC-FFS-CVD announcing the $40 administration rate per COVID-19 vaccine dose is effective April 1, 2021. This is $80 total for a two-dose series and $40 for a single-dose vaccine.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
HB 48, a bill that requires commercial insurances and the state employee health plan to pay pharmacists for both prescription drug claims and patient procedures or services within their scope of practice at a rate not less than that paid to other non-physician practitioners, was signed by Gov. Andy Beshear (D) last week and will be effective 90 days after sine die, which was March 30.
Also in Kentucky, NACDS has been informed that in a meeting this week DMS verbally shared that they have finalized the single PBM pharmacy reimbursement model as NADAC (including current FFS “lesser of” computation) + PDF of $10.64 — the current fee-for-service model. Notably, although SB 50 of the last session allowed Medicaid to implement tiering, the final proposal will reimburse all pharmacies equally. Commissioner Lisa Lee reported that MedImpact and the Managed Care Organizations are expected to and will be required to meet the July 1, 2021 implementation date. NACDS thanks the Kentucky Retail Federation and the Kentucky Pharmacists Association for their work on this issue during and after the passage of SB 50 of the last session. NACDS served on the Medicaid PTAC Committee which recommended this methodology to Medicaid.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
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.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
SB.2119, has been signed by Governor Tate Reeves (R). Effective January 1, 2022, the measure amends the statute to authorize pharmacies to sell products that contain pseudoephedrine or ephedrine and requires pharmacies that do to use the NPLEX system before selling those products. This measure also requires pharmacies to maintain an electronic log of information for each transaction and to require that purchasers be at least 18 years old and to show identification. This measure requires these products to be stored behind the counter.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
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 is pending referral to a Senate Committee. More information can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Minnesota
COVID-19 vaccination reimbursement under Medicaid will be at the Medicare rate effective April 1, 2021. HF 1428/SF 1156 successfully passed both chambers and was signed by Gov. Jim Walz (D) on March 31.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Montana
On March 31, 2021, Gov. Greg Gianforte (R) announced a directive to reduce barriers to vaccine administration in pharmacies across Montana. The directive permits pharmacists to use any qualified, licensed health care providers, under their scope of practice, to assist with the administration of COVID-19 vaccines for the remainder of the state of emergency and temporarily waives the current restriction on the number of pharmacy technicians a pharmacist may supervise for the administration of COVID-19 vaccines and associated administrative duties and procedures. The directive is in effect for the remainder of Montana’s state of emergency per Executive Order 2-2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
The Board of Pharmacy published 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.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Dakota
SB 2294, increasing the retail sales quantity from 2 grams to 2.4 grams of ephedrine, pseudoephedrine, or phenylpropanolamine base, was signed by Gov. Doug Burgum (R) on March 23, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
Effective March 23, the Health Authority adopted a final rule amending regulations as follows:
- Repeals Temporary 333-018-0005 from PH 3-2021 & Amends 333-018-0005: Requires reporting of out-of-state (non-Oregon) cases of COVID-19 to the jurisdictional public health authority of the patient’s residence, rather than to OHA. Housekeeping changes remove outdated reporting language.
- Amends OAR 333-018-0015: Housekeeping changes clarify in all relevant places that “intoxications” are among the illnesses to be reported and removes outdated reporting language, which is no longer applicable.
- Amends OAR 333-018-0016: Requires reporting of positive and negative COVID-19 laboratory reports of tests “waived” in accordance with the federal Clinical Laboratory Improvement Amendments of 1988 (CLIA), whether or not the tests were performed in a laboratory accredited for higher complexity testing.
Also in Oregon, Via a temporary rule effective March 24 and expiring September 19, 2021, the Board of Pharmacy amends regulations under OAR 855-041 to remove the limit of the number of epinephrine devices that may be dispensed to an entity. For COVID-19 vaccines, appropriate medical treatment for severe allergic reactions must be immediately available if an acute anaphylactic reaction occurs following administration of a COVID-19 vaccine.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
NACDS is asking members to call Rep. Stephanie Klick’s office, the Chair of the House Public Health Committee, urging her to schedule a hearing as soon as possible for TX HB 678 by Rep. Phil Cortez (D). 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.” Capitol Phone: (512) 463-0599; District Phone: (817) 281-0079 & Public Health Committee Phone: (512) 463-0806
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.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
HB 2263, relating to the regulation of PBMs, advances to the desk of Gov. Jim Justice (R) for signature. Both the House of Representatives and the Senate adopted the Joint House and Senate Conference Committee Report and passed the bill. Among the various provisions is language establishing a reimbursement rate floor of NADAC (or WAC, if NADAC is not available) plus a $10.49 professional dispensing fee.
Also in West Virginia, SB 182, legislation enacting the Board of Pharmacy’s emergency rule related to the pharmacist and pharmacy intern authority to immunize, was approved by Gov. Jim Justice (R) on April 1. The emergency rule permits pharmacists and pharmacy interns to administer vaccines to adults listed in the CDC’s Recommended Adult Immunization Schedule as well as to individuals ages 11-17 years of age listed in the CDC’s Recommended Child and Adolescent Schedule according to a prescription and parental consent if there are no contraindications to the vaccine.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
The Board of Medical Examiners issued a final rule to adopt regulations under AAC 540-X-26 to establish requirements for collaborative practice agreements between physicians and pharmacists. The rule adds requirements for collaborative drug therapy management agreements, standards for physicians, reporting, patient care protocols, and the formulary and is effective April 12, 2021.
Also in Alabama, The Board of Pharmacy issued a final rule to amend regulations under AAC 680-X-2 to further specify the standards and requirements for approval of hospital and non-hospital pharmacy remote or off-site order entry, where prescriptions are filled by remotely accessing another pharmacy’s electronic database from outside the pharmacy. The rule is effective April 12, 2021.
Lastly in Alabama, The Board of Pharmacy also published a proposed rule to amend regulations under AAC 680-X-2 to clarify provisions on the non-disciplinary administrative penalty for late renewal of a license, permit, registration, certification, or similar document. A hearing is scheduled for April 21, 2021, in Birmingham. Comments to the proposed rule are due April 10, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Board of Pharmacy published emergency regulations to make permanent 12 AAC 52.110 related to emergency licensure to practice as a pharmacist, pharmacy intern, or pharmacy technician. The emergency rule is effective retroactively to November 19. For more information, please see the March 15, 2021, filing notice which can be found here.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Effective July 1, 2021, the Board of Pharmacy will adopt amended regulations to consolidate the renewal license types into two categories: (1) a premises or facility license, and (2) a license issued to an individual, other than a pharmacist or an advanced practice pharmacist. This regulatory action amends and repeals regulations under 16 CCR 1702, 1702.1, 1702.2, and 1702.5 to consolidate standards for various board license types. The rule also requires disclosure of all continuing education requirements to renew a pharmacist or advanced pharmacist license as required by section 1732.5.
Also in California, the Board of Pharmacy readopts regulations originally adopted in emergency action 2020 – 0420 – 02E relating to the independent initiation and furnishing of HIV pre-exposure and post-exposure prophylaxis to patients as authorized by Statutes 2019, chapter 532 (SB 159). The rule is effective February 25 and expires August 24, 2021.
Also in California, NACDS and the California Retailers Association (CRA) submitted a joint letter to the California Senate Business, Professions & Economic Development Committee in opposition of SB 362 which would prohibit community pharmacies from utilizing metrics to evaluate the performance of employees. NACDS and CRA commented that while SB 362 is well-intentioned, it contains ambiguous and onerous requirements that are impossible for pharmacies to meet and maya ultimately threaten access to pharmacy services and jeopardize patient safety.
Also in California, NACDS and the California Retailers Association (CRA) submitted a joint letter to the California Senate Business, Professions & Economic Development Committee supporting AB 671, which will require the Department of Health Care Services (DHCS) to provide disease management or similar payment to DHCS contracted pharmacies dispensing specialty drugs to Medi-Cal beneficiaries.
Also in California, the Department of Health Care Services issued the Medical Rx Pharmacy Provider and Prescriber Readiness Survey to survey pharmacies on their current process to conducting business for Medi-Cal pharmacy services. The data in the survey will be held confidential and the results will be used by the Education & Outreach team to design training offerings for Medi-Cal Rx to prepare providers for the upcoming Medi-CAl Rx Transition.
Also in California, the Department of Justice, Office of the Attorney General announced the Office of Administrative Law’s (OAL) approval of new rules to strengthen the language of the California Consumer Privacy Act (CCPA) regulations approved by OAL in August 2020, including protecting consumers from unlawful business practices that may be deceptive or misleading.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Department of Business and Professional Regulation issued a notice to announce its intentions to amend regulations under FAC 61N-1 regarding drug and device labeling requirements to make technical revisions to conform to statutes. The Department will be accepting comments but no due date has been specified.
Also in Florida, the Department of Health issued an emergency rule to adopt regulations under FAC 64DER21-4 to require all health care practitioners and other enrolled COVID-19 vaccine providers to report to the online immunization information system within 24 hours the administration of any COVID-19 vaccine with an emergency use authorization from the FDA. The rule replaces a December 15 rule on the same topic. The rule is effective March 15 and expires June 13, 2021.
Lastly, in Florida, the Department of Health issued an emergency rule to adopt regulations under FAC 64DER21-5 to authorize redistribution of the COVID vaccine between vaccine providers within the state. The rule requires providers to receive approval from the Florida Vaccines for Children and Adults Program and requires tracking of vaccine redistribution between enrolled providers. The rule is a readoption of a December 21 emergency rule. The rule is effective March 17 and expires June 15, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Board of Pharmacy issued guidance on a recent amendment to the federal PREP Act that added retired and inactive pharmacists and pharmacy interns and certain student pharmacists to the list of health care professionals authorized to administer COVID-19 vaccines. The PREP Act provides immunity from liability for covered persons.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
Effective March 22, the Office of Pharmacy Services (OPS) will be updating the incentive fee for all FDA-approved COVID-19 vaccines administered by pharmacy providers. The new incentive fee will be $40 for the administration of each dose of the vaccine. The incentive fee will be the same regardless of the vaccine and the number of doses required for the vaccination. Payment for the ingredient cost should be $ 0.01. See Advisory 224 for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Mississippi
The Division of Medicaid published a final rule to amend regulations under Title 23, Part 224, Chapter 1, to provide for coverage of vaccine administration by pharmacists. The rule is effective April 1, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Carolina
The North Carolina Medicaid Department issued a proposed rule to require Medicaid recipients to get a 90-day supply of non-controlled, maintenance medications and remove the requirement that Medicaid (or a managed care company after July 1, 2021) would have to pay NADAC or the State MAC Price for the prescription. More details can be found at the above link on page 8. Comments can be submitted here and are due April 12, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Outpatient pharmacies in Ohio must now store all schedule II controlled substance dangerous drugs in a “securely locked, substantially constructed cabinet or safe,” which must remain locked and secured when not in use. Ohio Admin. Code 4729:5-5-23(A)(5). Schedule II substances can no longer be dispersed among a pharmacy’s stock of dangerous drugs. Pharmacies may store schedule III through V controlled substance dangerous drugs with schedule II controlled substance dangerous drugs in a safe or cabinet or continue to disperse them among non-controlled substances. For more detail see page 45 of the updated Inspection Guide. Though it was originally effective December 1, 2020, the Board of Pharmacy delayed implementation of this new requirement until March 31, 2021, because of COVID-19.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
NACDS has learned that the PALS application process for the Authorization to Administer Injectables for Pharmacy Interns has been released. Interns should log into or create a PALS account and select Board of Pharmacy then “Authorization to Administer Injectables for Pharmacy Interns.” The Board is asking that pharmacy interns who previously submitted an intent to immunize also now register through this process.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.