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.
South Carolina
The South Carolina Department of Health and Human Services (SCDHHS) is updating guidance on how providers should submit requests and inquiries related to Medicaid eligibility. The Eligibility Administrative Support Team (EAST) will no longer process inquiries via its fax or email address. Effective immediately, all provider updates and inquiries should only be submitted via the procedures outlined in this ALERT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Wyoming
The Board of Pharmacy published a proposed rule to revise Chapter 16 of the Wyoming Pharmacy Act Rules to include the COVID-19 vaccines, ease requirements for administering vaccines, and update the incorporated CDC recommended vaccination schedules. The proposal currently is in effect as an emergency rule, expiring April 8, 2021. Comments are due May 8, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Board of Pharmacy published a proposed rule that would 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 are due April 10, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
In response to Gov. Gavin Newsom’s emergency declaration and consistent with the authority of the Board of Pharmacy to waive Pharmacy Law or the regulations, the Board president Greg Lippe extended the previously approved limited waiver on pharmacists initiating and administering vaccines through May 29, 2021. More information can be found at the following link. Pharmacists Initiating and Administering Vaccines, CCR section 1746.4(d)
Also in California, On March 24, 2021, CalRecycle staff will conduct a webinar to present the statutory and regulatory requirements, submittal process, and timing for covered drugs and home-generated sharps waste stewardship plans and initial program budgets as required by the Pharmaceutical and Sharps Waste Stewardship law and its implementing regulations.
Also in California, The Senate Budget Subcommittee #3 on Health and Human Services held a hearing this week to review the Governor’s proposal to provide $12 million in funding Medi-Cal coverage of continuous glucose monitors. NACDS is part of a Coalition supporting Medi-Cal coverage of CGMs.
Also in California, The Board of Pharmacy created a voluntary online registry to help consumers find specific health care services that qualified pharmacists may provide to patients without a prescription.
The health services are:
- Self-administered hormonal contraception.
- Emergency contraception.
- Vaccinations.
- Travel medications.
- Nicotine replacement therapy.
- Naloxone.
- HIV preexposure prophylaxis (PrEP).
- HIV postexposure prophylaxis (PEP).
Also in California, The Medi-Cal web portal Provider Registration and Training FAQs are now available and can be accessed here.
Also in California, The Board of Pharmacy will hold a Teleconference Public Meeting on Thursday, March 18, 2021. The agenda includes discussion and consideration of Title 16 CCR Section 1747, related to HIV Prep and PEP, and proposed regulations related to pharmacy technician application, training requirements, and certification programs.
Also in California, The Board of Pharmacy adopted a final rule that modifies the Pharmacy Technician Application (Form 17A – 5) to add information regarding expedited licensure for applicants who meet certain criteria regarding their immigration status and military service. This change without regulatory effect was filed on February 8.
Also in California, the Department of Health Care Services’ Education & Outreach team is surveying providers to learn more about how pharmacies currently conduct business for Medi-Cal Pharmacy Claims. The results of the Medi-Cal Rx Pharmacy Provider and Prescriber Readiness Survey will be used to tailor training offerings for Medi-Cal Rx to ensure pharmacies are prepared for the upcoming transition.
Also in California. Beginning March 15, healthcare providers may use their clinical judgment to vaccinate individuals age 16-64 who are deemed to be at high risk from COVID-19 as the direct result of certain conditions and settings:
- Individuals with one or more severe health conditions
- Individuals with developmental or other severe disabilities or illness
- Individuals who live or work in a high risk congregate residential setting
- Public transit workers
Healthcare providers should thoroughly read the California Department of Public Health’s Provider Bulletin, Fact Sheet, and COVID-19 Vaccine Allocation Guidelines. Additional information is at California’s COVID-19 vaccine website here.
Also in California. Effective April 1, 2021, the Controlled Substance Utilization Review and Evaluation System (CURES) fee will increase from $6 to $11 annually for two years for all the Board’s that prescribe, order, administer, furnish, or dispense Schedule II, Schedule III, Schedule IV, or Schedule V controlled substances. More information is available here.
Lastly in California, NACDS and the California Retailers Association submitted a joint letter to the Senate Business, Professions & Economic Development Committee in support of SB 409 with proposed amendments to include pharmacy technician testing authority as well as authority for pharmacists to initiate treatment according to the test result.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
After months of promoting making permanent Prep Act guidance allowing pharmacy technicians to administer immunizations, the Board of Pharmacy issued a final rule effective March 17, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
The Department of Health published a final rule amending regulations to waive the requirement for pharmacists to complete 10 continuing education (CE) credits through live in-person courses for the licensure period ending February 28. The rule, which allows pharmacists to meet CE requirements through online courses, is in response to the COVID pandemic. The rule became effective on February 26.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Under Executive Order 21-47, additional groups are now eligible to receive a COVID-19 vaccine. These groups are in addition to persons deemed to be extremely vulnerable to COVID-19, as determined by a physician. Such physician determination shall include a statement that the patient meets the defined eligibility criteria established by a form prescribed by the Florida Department of Health.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kentucky
HB 48, legislation that would mandate commercial insurance payments for clinical services to pharmacists has passed both Chambers unanimously and is headed to the Governor for signature. The bill was introduced by Rep. Danny Bentley (R), and mandates payment for services within a pharmacists’ scope of practice and would otherwise be paid if performed by a physician, advanced practice nurse, or physician assistant. NACDS advocated in favor of the passage of the bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Mississippi
Effective, March 1, pharmacy providers are now able to bill all vaccines which are listed on the Centers for Disease Control and Prevention (CDC) Immunization Schedules via NCPDP D.0 pharmacy claims for fee-for-service (FFS) and MSCAN beneficiaries. Also, reimbursement has changed in that vaccine administration fees, equal to those paid to primary care providers, will be paid instead of professional dispensing fees. PCP vaccine administration fees can be found on the Division of Medicaid’s (DOM) Fee Schedule and Rates Website page on the ‘Increased Primary Care Provider’ fee schedule tab.
These changes apply to beneficiaries aged 19 and over and vaccines administered to beneficiaries aged 10 through 18 must be administered by pharmacy providers who are enrolled in the Vaccines for Children (VFC) program. Further guidance will be issued for this age group at a later date.
Also in 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.
New Mexico
The Office of Superintendent of Insurance issued a notice to health insurers regarding the use of telehealth services during the COVID pandemic, clarifying that the HIPAA penalty waiver relating to the use by providers of certain communications technologies will continue through the calendar year 2021 and that the coverage parity requirements that apply to behavioral health services are not linked to the declaration of the COVID-19 public health emergency.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
The Board of Pharmacy published a final rule which amends regulations under 21 NCAC 46 to establish a list of restricted drugs during the coronavirus (Covid-19) public health emergency. The rule also establishes that pharmacists can fill the prescriptions on the list only if the prescription bears a written diagnosis consistent with the evidence for its use.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
NACDS authored and the Ohio Council of Retail Merchants presented joint testimony in support of HB 6 before the House State and Local Government Committee. The bill, sponsored by Rep. Bill Roemer (R), would permanently allow pharmacists to provide COVID-19 and flu vaccines under protocols; as well as immunizations for “any other disease” by prescription to patients aged 7 and older. NACDS will continue working with key legislators to amend the bill to mirror pharmacists’ immunization authority under the Prep Act. Our testimony urged that the General Assembly strongly consider maintaining their constituents’ current access to pharmacy-based vaccine services as the bill moves forward in the process.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
Two bills supported by chain pharmacies are advancing through the committee process in the first house. SB 398 would eliminate the statutory requirement for pharmacists to have an order from a licensed prescriber to administer an immunization, making it consistent with the current practices in place during the pandemic. SB 392 is payment parity legislation that would provide reimbursement to a pharmacist for services if the insurer pays for those same services when provided by other health care professionals.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
Gov. Tom Wolf (D) announced that he has nominated Dr. Denise A. Johnson, M.D., FACOG, FACHE, to serve as Pennsylvania’s physician general. Dr. Johnson will serve as acting physician general until she is confirmed by the Senate. Dr. Johnson was most recently Chief Medical Officer at Meadville Medical Center. She is board certified in Obstetrics and Gynecology by the American Board of Obstetricians and Gynecologists and is a Fellow of the American College of Healthcare Executives. She also serves on the Governor’s Commission for Women.
Also in Pennsylvania, the Department of Insurance (DOI) published a bulletin urging health insurers providing coverage to residents in the Commonwealth to continue exercising flexibility to make both COVID-related services and non-COVID-related services available to enrollees, including COVID testing, immunization, and telehealth.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
The Joint Pharmacist Administered Vaccines Committee revised the Protocol for Pharmacist Administered Vaccines. This revision has been reviewed and approved by the SC Board of Medical Examiners. The updated protocol moves flu to age 3 and up and adds the COVID vaccine to the list of approved vaccines. The protocol can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare has released a new provider notice regarding COVID-19 vaccine pharmacy claims. This notice contains two important updates. One includes the addition of Johnson & Johnson vaccines and the single-dose administration payment. The other update involves a newly established Collaborative Pharmacy Practice Agreement (CPPA) to order and administer COVID-19 vaccines for the State’s TennCare population, which includes CoverKids and CoverRx.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy issued two final rules that went into effect on March 14. One final rule amends the notification requirements for pharmacists who sign prescription orders for dangerous drugs under a written protocol, and another final rule clarifies that the requirement to consult the Prescription Monitoring Program before dispensing opioids, benzodiazepines, barbiturates, or carisoprodol is limited to outpatient prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
HB 2097 has passed both Chambers and is on its way to Governor Northam for signature. The bill, sponsored by Del. Sam Rasoul (D), is a continuation of the pharmacy protocol bill that NACDS, VACDS, and VpHA jointly championed and passed last year that was enacted in January. HB 2097 would further expand pharmacists’ ability to initiate testing and/or treatment for certain conditions including HIV and Tuberculosis under the protocol. It also would allow pharmacists to dispense over-the-counter drugs, devices, controlled paraphernalia, and other supplies and equipment covered by the patient’s health carrier when the patient’s out-of-pocket cost is lower than the out-of-pocket cost to purchase an over-the-counter equivalent of the same. The measure requires the Board of Pharmacy, in collaboration with the Board of Medicine and the Department of Health, to establish protocols for these services by November 1, 2021.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The Health Care Authority submitted a Medicaid state plan amendment (SPA 21-0012) providing the state flexibility to automatically enroll COVID-19 vaccine administration providers that have already completed Medicare application processes for participation. It also allows the Medicaid program the flexibility to not require NPIs for the administration of vaccines to Medicaid recipients during the public health emergency.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
NACDS, jointly with the California Retailers Association and the California Pharmacists Association sent Gov. Gavin Newsome (D) a letter requesting no further delays in the April 1, 2021, planned implementation of the Medi-Cal Rx program. In the letter, we questioned why some providers continue to seem ill-prepared given the nearly two years of lead time given all the collaboration and planning that has been taking place. Further, we stated that both patients and providers are counting on a benefit that is easier to navigate, improves access to pharmacies, and improves California’s drug-price negotiating power. Despite these efforts, the Department of Health Care Services (DHCS) subsequently announced that the transition of Medi-Cal pharmacy services from managed care to fee-for-service is being delayed again and will NOT occur on April 1, 2021, due to the need to review conflict avoidance protocols with respect to the Centene acquisition of Magellan. DHCS stated that they plan to announce further info in May. More information on the announcement can be found here.
Also in California, CalAIM is a multi-year initiative by the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of Californians by implementing broad delivery system, program, and payment reform across Medi-Cal. The DHCS released for public comment draft requirements documents for two components of CalAIM, (1) Enhanced Care Management (ECM) and (2) In Lieu of Services (ILOS). More information can be found on the CalAIM webpage. The public comment ends on March 12, 2021. Comments should be submitted to CalAIMECMILOS@dhcs.ca.gov.
Also in California, The Board of Pharmacy’s Enforcement and Compounding Committee held a virtual meeting on February 18 on white bagging. More information on the meeting can be found here.
Lastly in California, effective February 2, the state Department of Justice issued a final rule amending provisions on access to and use of the Controlled Substance Utilization Review and Evaluation System (CURES), a database of Schedule II, III, and IV controlled substance prescriptions dispensed in the state.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy issued a proposed rule to amend regulations under FAC 64B16-31 to clarify the list of chronic health conditions for which a pharmacist can provide to patients of a collaborating physician pursuant to a pending Collaborative Pharmacy Practice Agreement. Comments and hearing requests are due March 8, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.