In The States – Page 128 – Weekly news about states

Arizona

SB 1248, legislation repealing several components of the sunrise process for scope expansion, including pharmacy, passed the Senate (21-9) and the House (42-18) and was sent to the Gov. Katie Hobbs (D) for signature. The sunrise process will require material changes to certification, registration, or licensure.

Also in Arizona, on February 20, SB 1254 (Senate Engrossed), legislation repealing the requirement for a Schedule II opioid prescription that is directly dispensed by a pharmacist and that is not for the immediate administration to the ultimate user to have a red cap, passed the Senate and was transmitted to the House.

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

Michael Silber2023-03-03T10:12:04-05:00March 3, 2023|Arizona|

California

The Department of Health Care Services (DHCS) posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal. 

Policy Update of Remdesivir (Veklury) for the Outpatient Treatment of COVID-19 as a Pharmacy Benefit (March 1)
Enteral Nutrition Update: Changes to the Published Enteral Nutrition Policy in the Medi-Cal Rx Provider Manual, Effective April 1, 2023 (March 1)
Maximum Allowable Ingredient Cost 30-day Pharmacy Provider Notice (March 1)
Pharmacy Provider Dispensing Fee Self-Attestation (March 1)
Medi-Cal Rx Monthly Bulletin for March (March 1)
Changes to Contract Drugs List (CDL) (March 1)
Changes to Contract Drugs List (CDL) – Over-the-Counter Drugs (March 1)
Updates to the Medi-Cal Rx Provider Manual (March 1)
Medi-Cal Rx Weekly Wrap-Up for February 17-23 (February 24)
Reinstatement Spotlight (February 24)
30-day Countdown – Phase III, Lift 1: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older (February 23)
New Resources for Providers: COVID-19 Testing and Treatment Support (February 21)
Medi-Cal Rx Weekly Wrap-up for February 10-16 (February 17)
Reinstatement Spotlight (February 17)

Also in California, Medi-Cal posted the following:

CDPH Offers New Warmline for COVID-19 Testing and Treatment (March 2)
Breast and Cervical Cancer Treatment Program: End of Medi-Cal Continuous Coverage (March 1)
Medi-Cal Update – Pharmacy – February 2023 – Bulletin 1034 (

Also in California, on March 23, 2020, the DHCS published a regulatory provider bulletin (Requirements and Procedures for Emergency Medi-Cal Provider Enrollment) that established amended enrollment requirements and procedures for providers to temporarily and provisionally enroll in the Medi-Cal program during the COVID-19 public health emergency (PHE) as authorized by the Section 1135 waiver granted by the CMS. Effective March 29, 2023, DHCS is discontinuing the provider enrollment flexibilities authorized by the Section 1135 waiver. Providers will have 90 days from the end of the waiver period on March 29, to submit an application for enrollment via the Provider Application and Validation for Enrollment (PAVE) portal. Providers who have not submitted an application by June 27, will have their temporary enrollment deactivated, effective June 28.

Also in California, Magellan Rx Management posted the archived webinar for the Medi-Cal Rx Pharmacy Provider Dispensing Fee Self-Attestation that was held on February 23. This online seminar was hosted by Mercer and covered the attestation pharmacies must submit to determine the fee-for-service professional dispensing fee component of the pharmacy claim reimbursement for claims with dates of service within the state’s following fiscal year. The DHCS also posted a current version of the Pharmacy Provider Dispensing Fee Self-Attestation FAQs.

Finally in California, the Board of Pharmacy posted the agenda and meeting materials for the Medication Error Reduction and Workforce Committee Meeting on March 8. The agenda includes a presentation by Peggy Binzer, Executive Director with the Alliance for Quality Improvements and Patient Safety and a discussion of the most recent report of the Well-Being Index.

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

Michael Silber2023-03-03T10:11:27-05:00March 3, 2023|California|

Illinois

This notice relays information released from the Drug Enforcement Administration (DEA) regarding removal of the DATA Waiver (X-Waiver) requirement for practitioners prescribing buprenorphine. This information applies to customers covered under the Medicaid fee-for-service (FFS) program and by the managed care organizations (MCOs).

Previously, the federal government required practitioners with DEA licenses to also obtain a special waiver (known as an X-Waiver because the DEA Registration Number began with an X) to prescribe medications such as buprenorphine for the treatment of opioid use disorder (OUD) in office-based settings outside of federally registered opioid treatment programs. Health care providers were also restricted in the number of patients with OUD they could treat.

Section 1262 of the Consolidated Appropriations Act, 2023 (also known as the Omnibus bill), removes the federal requirement for practitioners to submit a Notice of Intent (have a waiver) to prescribe buprenorphine for the treatment of OUD. All practitioners who have a current DEA registration that includes Schedule III authority may now prescribe buprenorphine for OUD. There are no longer any annual limits on the number of patients that a prescriber may treat for OUD with buprenorphine. The January 12, 2023, letter from the DEA to waiver registrants identified these changes.

Pharmacies need to be aware of this change, as HFS [Department of Healthcare and Family Services] has received complaints that prescribers without a DEA X-Waiver are having trouble getting their prescriptions honored at local pharmacies.

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for the FFS population or the applicable MCO.

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

Michael Silber2023-03-03T10:10:30-05:00March 3, 2023|Illinois|

Iowa

The Department of Health and Human Services published INFORMATIONAL LETTER NO. 2428-MC-FFS with April 2023 Iowa Medicaid Pharmacy Program Changes related to the following:

New Drug Prior Authorization (PA) Criteria
Changes to Existing PA Criteria
Removal of PA Criteria
Point-of-Sale Billing Updates
DUR [Drug Utilization Review] Update

Also in Iowa, effective April 1, the Department of Health, and Human Services (Iowa HHS) will no longer require positive COVID-19 tests to be reported to the state Public Health Division. Since the development and widespread availability of rapid in-home tests – which are not required to be reported – the case and positive test counts in the state are no longer as meaningful as they once were. Iowa has no mandatory reporting order for any other respiratory viral illnesses such as influenza, RSV, and rhinovirus.

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

Michael Silber2023-03-03T10:09:48-05:00March 3, 2023|Iowa|

Montana

HB 710, legislation permitting pharmacy interns and technicians to administer immunizations, was introduced on February 21 and passed the Business and Labor Committee on February 24. After SB 239 failed to advance, the Montana Retail Association and the Montana Pharmacy Association found a new sponsor to pursue this legislation.

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

Michael Silber2023-03-03T10:08:16-05:00March 3, 2023|Montana|

Nebraska

The Department of Health and Human Services (DHHS) published Provider Bulletin 23-06: Continuous Glucose Monitoring Updated Medicaid Reimbursement Policy that provides an update to Provider Bulletin 22-22 regarding coverage for eligible beneficiaries with diabetes effective January 1, 2023.

Also in Nebraska, the Board of Pharmacy posted a revised agenda for the March 6 meeting.

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

Michael Silber2023-03-03T10:07:43-05:00March 3, 2023|Nebraska|

New York

On February 21, the State Department of Health held an online seminar to update interested parties on the latest information regarding the Medicaid Pharmacy Benefit Transition from Managed Care to NYRx effective April 1. The next presentation and meeting will be March 21 at 1:00 p.m.

Also in New York, the Department of Financial Services (Department) Pharmacy Benefits Bureau (“PBB”) announced a final request for public engagement as the Department looks to develop nation-leading regulatory standards for Pharmacy Benefit Managers (PBMs).

This request asks for information on PBM audits of pharmacies, which are meant to eliminate or reduce fraud, waste, and abuse, but often are overly burdensome and costly without meeting this intended goal. Instead, pharmacy owners are taken away from providing healthcare, requiring them to review and defend claims from years in the past at the sole direction of PBMs without justification. The information collected will inform the scope of regulations necessary to ensure audits follow a clear and transparent process and have guardrails in place to meet the goal of preventing fraud, misuse, and waste. The Department is in the process of developing a series of PBM regulations that together will form the most comprehensive regulatory framework in the country.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

Michael Silber2023-03-03T10:07:08-05:00March 3, 2023|New York|

North Dakota

Engrossed HB 1095,legislation to include comprehensive medication management services in health benefit plans, unanimously passed the House and was sent to the Senate where it was referred to the Human Services Committee. A hearing has been scheduled for March 7 at 9:00 a.m.

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

Michael Silber2023-03-03T10:06:40-05:00March 3, 2023|North Dakota|

Oregon

Dana Hittle has been appointed as the permanent Medicaid director and will oversee Oregon’s Medicaid program, including the Oregon Health Plan. Hittle previously served as interim state Medicaid director for the last two years and, before that, was deputy Medicaid director.

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

Michael Silber2023-03-03T10:06:03-05:00March 3, 2023|Oregon|