Alabama
The Alabama Medicaid Agency’s Durable Medical Equipment Program has announced that it will make the following changes regarding reimbursement: Reimbursement for CPAP (E0601), Humidifier Reimbursement (E0561, E0562), and Mask Reimbursement (A7030, A7032, A7035). For more information, click here.
Also in Alabama. All previously published expiration dates related to the Coronavirus (COVID-19) emergency have once again been extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is earlier than August 31, 2020, the conclusion of the COVID-19 national emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERTs and notices related to the health emergency is available on the Agency’s COVID-19 page.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
The Department of Human Services, Division of Medical Services, published a final rule which amended medical assistance regulations to revise the Medicaid State Plan (SPA 2020-0005) to increase rates for vaccine administration that went into effect July 1. The rule increases rates for flu vaccine administration in the physicians, nurse practitioner, ARKids B, and pharmacy programs to $15.45 and increases rates for other Medicaid payable vaccines to $13.14.
Also in Arkansas. The Department of Human Services also published a final rule that amends medical assistance regulations to revise the Medicaid state plan (SPA 2019-002) to incorporate federal standards on drug utilization review. The rule addresses claims review limitations, programs to monitor antipsychotic medications by children, fraud and abuse identification, and Medicaid managed care organization mandates. The rule also establishes mandatory drug utilization review reporting requirements.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
NACDS and our in-state partners, the California Pharmacists Association and the California Retailers Association, are supporting AB 1710 by Assembly Member Wood, legislation that will leverage pharmacists to administer the COVID-19 vaccine as soon as it is viable.
Also in California. The Board of Pharmacy will be meeting virtually on July 29 and 30, 2020. The agenda and meeting materials are available here.
Also in California. Several temporary pharmacy waivers are set to expire. Below is a list of those waivers that have expired or will be expiring in July.
- Pharmacist Direct Supervision of Interns – Expired July 19
- Prohibited Acts Involving Dangerous Drugs or Devices – Valid through July 24, 2020.
- Use of Alcohol Sanitizer Before Donning Sterile Gloves – Valid through July 24, 2020.
Also in California. The Board of Pharmacy extended three previously approved waivers through September 22, 2020.
- Remote Processing
- Requirements for Consulting Pharmacist to Make Quarterly Visits
- USP <797> Requirements Related to Use of PPE
Also in California. The Board of Pharmacy has published a final rule that amends regulations under 16 CCR 1707 to revise the duty to consult standards for pharmacists. The rule specifies the minimum time requirements a pharmacist must be available to speak to patients, and the maximum amount of time a consumer must wait before speaking to a pharmacist. The rule also expands the current requirements for when a pharmacist must provide oral consultation to all settings, effective October 1, 2020.
Also in California. The Department of Managed Health Care released a notice to announce its All Plan Letter 20-024 to health care service plans in Riverside and Sonoma counties. The notice provides guidance on reporting requirements under a pilot project to assess the impact of health care service plans and pharmacy benefit manager prohibitions on the dispensing of certain amounts of prescription drugs by network retail pharmacies. All reporting will be required annually by July 1. The pilot project will be in effect until Jan. 1, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
The D.C. Council passed B23-758, legislation that protects individuals and businesses during the COVID-19 pandemic, and has been transmitted to Congress for the 30-day review period. Among other provisions, the measure permits an individual licensed to practice pharmacy to authorize and dispense a refill of a patient’s prescription medication before the expiration of the waiting period between refills to allow residents to have an adequate supply of such drugs during a public health emergency. The bill was sponsored by City Council Chairman Phil Mendelson (D).
Also in the District of Columbia. The Committee of the Whole has approved B23-430, sponsored by Councilmember Mary Cheh (D). The bill, which has been advanced after approval, would allow pharmacists to dispense interchangeable biological products and includes notification provisions that align with language that has been adopted in other states and members have supported.
Also in the District of Columbia. NACDS received this response from DC Health to the letter NACDS jointly signed with NCPA, NGA, and FMI asking for clarity around pharmacists’ COVID testing policy. As we read it, they will allow pharmacists to administer all FDA-approved and authorized tests; provide guidance on PPE recognizing not all locations/types of testing requires the same kind of PPE; and consider our request for technicians to be authorized to provide testing. They also confirmed they will continue to require appointments to test and require testing to be done outside.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Indiana
Medicaid has announced an additional 3-month extension of its Prior Authorization waiver policy under COVID-19 waivers. No prior authorization will be needed for medications dispensed before Sept. 1, 2020.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
At the Louisiana Pharmacists Association’s virtual annual meeting this week, NACDS honored Walgreens pharmacist Jeff Gaude as the Louisiana Chain Pharmacist of the Year. Jeff was selected by his peers as an outstanding pharmacist dedicated to the advancement of the profession.
Also in Louisiana. The Board of Pharmacy scheduled a special Board meeting at 9 AM on July 28, 2020. Meeting details and agenda can be found here.
Also in Louisiana. NACDS is continuing efforts to urge the Louisiana Office of Public Health (OPH) to persuade Gov. John Bel Edwards to issue an Executive Order NACDS drafted leveraging pharmacists and other qualified healthcare professionals and vaccinators in mass immunization efforts once COVID-19 vaccines are available. The NACDS model language would also allow pharmacists to delegate technical, non-clinical immunization tasks to pharmacy technicians, and includes a provision requiring insurance carriers, Medicaid, and any contracted pharmacy benefit managers reimburse pharmacies for the cost of acquiring and administering a COVID-19 vaccine.
Also in Louisiana. NACDS virtually attended the Board of Pharmacy’s Regulation Revision Committee (RRC) meeting monitoring the discussions on pharmacy staffing ratios, telepharmacy counseling requirements, and electronic prescribing draft rules. While the Committee voted against increasing the pharmacy technician ratio, they did commit to discussing the issue of pharmacy technicians administering immunizations at the August 12, 2020 Board meeting. The electronic prescribing rules were not discussed, so they remain on the RRC agenda for their next meeting this Fall.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Governor Gretchen Whitmer (D) rescinded the pharmacy waivers found in Executive Order 2020-124 effective July 14 at 8:31 pm. The Department of Licensing and Regulatory Affairs will give providers though 11:59 pm on August 31, 2020, to return to normal order. The three pharmacy-related waivers still in place are as follows: Executive Order 2020-104; Executive Order 2020-149; and Executive Order 2020-152.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
The Division of Medicaid published a proposed rule that would amend regulations under Title 23, Part 200, Chapter 4, to clarify which provider activities constitute a change of ownership. The rule also would require a provider to notify the department of a change of ownership within 35 days. Comments are due July 25, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Nevada
At the in-person Board of Pharmacy meeting in Las Vegas last week, the Board agreed with NACDS, the Retail Association of Nevada (RAN), and chain members to move forward with proposed rules allowing pharmacy technicians to administer all vaccines. NACDS and RAN will continue to advocate expedited adoption by making it an emergency rule.
Also in Nevada. The special legislative session on the budget ended on Sunday, July 19. Lawmakers continue to discuss convening a second special session this Fall to address policy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
In response to a request by chain pharmacies, on July 23 the Board of Pharmacy discussed allowing pharmacy technicians to administer vaccinations to help meet the anticipated public demand for influenza vaccinations this fall, and COVID vaccinations when they are available. NACDS submitted a support letter in advance of the meeting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
Governor Cooper announced this week that North Carolina will continue to stay paused in the “Safer at Home Phase 2”. As a part of this initiative, the Governor’s executive order expired Friday, July 17, and has been extended for three weeks until Friday, August 7, 2020.
Also in North Carolina. The Board of Pharmacy published a temporary rule that 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 prescription drugs on the list only if the prescription bears a written diagnosis from the prescriber consistent with the evidence for its use. This Rule does not apply to prescriptions for a Restricted Drug for a patient previously established on that Restricted Drug on or before March 10, 2020. The rule is effective June 26 and expires on March 23, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
The Insurance Department published a notice to announce an update to Insurance Bulletin LH 2020-02, dated March 17 and April 29, directing health insurers to take certain actions in response to the coronavirus (COVID-19) emergency. The bulletin was rescinded June 30, except for specified provisions regarding telehealth/telemedicine services, electronic signatures, timeframes for utilization review, accesses to diagnosis and treatment without preauthorization requirements, waiver of cost-sharing requirements, extended grace periods, and reasonable measures to facilitate diagnosis and treatment.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Texas
An Emergency Rule issued on March 20 limiting the dispensing of chloroquine, hydroxychloroquine, and other similar drugs expired on July 17. The Board of Pharmacy does not intend to reissue this emergency rule as it was only meant to prevent the stockpiling of the drugs and to ensure that reasonable quantities were available for all patients that require therapy with the drugs, including patients with a COVID-19 diagnosis. The expired language can be found here and guidance issued during the rule’s effective dates here.
Also in Texas. NACDS participated in the Texas Prescription Monitoring Program (PMP) Advisory Council virtual meeting on July 20. The PMP vendor Appriss provided data on the number of users, queries, integration, and recent enhancements to the system.
Also in Texas. To stay connected with legislators, NACDS, along with our in-state partner, the Texas Federation of Drug Stores, and chain pharmacists from HEB and Brookshire met virtually with Brenham State Senator Lois Kolkhorst, Chair of the Senate Health and Human Services Committee, and her staff. During the meeting, discussions focused on several priority issues, including pharmacy staffing, COVID testing, and expanding access to all FDA-authorized immunizations to anyone 7 years and older without a prescription but under a protocol.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy has released a notice announcing its intentions to amend regulations under FAC 64B16-30 to clarify disciplinary guidelines, the range of penalties, and aggravating and mitigating circumstances for pharmacy professionals. Comments will be accepted but a due date is not specified.
Also in Florida. The Board of Pharmacy released a notice announcing its intentions to amend regulations under FAC 64B16-27 to clarify standards for the supervision of pharmacy technicians, including supervising pharmacist responsibilities and requirements for delegation. Comments will be accepted but a due date is not specified.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Michigan
Culminating several years of effort by NACDS and the Michigan Retailers Association, Governor Gretchen Whitmer (D) signed into law e-prescribing legislation (HB 4217, SB 248, and SB 254) as Public Acts 134-136 of 2020. The law applies to all drugs, not just controlled substances, and will become effective on October 1, 2021.
Also in Michigan. The broad regulatory waivers afforded to pharmacists and pharmacies under Executive Order 2020-126 were drastically reduced with Executive Order 2020-152, effective on July 15. The following flexibilities are no longer in effect:
- 60-day emergency supply refills of non-controlled maintenance medication
- Pharmacists may temporarily operate a pharmacy in an area not designated on the pharmacy license, but they may not prepare sterile drug products beyond low-risk preparations, as defined by United States Pharmacopeia (USP) standards, for immediate inpatient administration in such temporary facilities
- Dispensing/administering drugs as needed to treat COVID-19
- Substitutions of therapeutically equivalent medication for a medication subject to critical shortages without the authorization of a prescriber
- Supervision of pharmacy technicians and other pharmacy staff remotely (unless licensed as a tele-pharmacy under Michigan law)
- Allowing out-of-state pharmacies and wholesale distributors holding a license, certificate, or other permit in good standing issued by another state to do business in this state
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
The Division of Medicaid issued a final rule that amends regulations under Title 23, Part 209, Chapters 1 and 2, to clarify requirements for beneficiary signatures for durable medical equipment and/or medical supplies delivered during a national or statewide emergency. During a national or statewide emergency, a signature is not required and the provider must document the emergency and confirmation of delivery by an alternate means including, but not limited to: (1) telephone, (2) text message, or (3) other electronic communication. The rule is effective on August 1, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The Board of Pharmacy will host a “Lunch with the Chief Inspector” webinar on Wednesday, July 29, 2020, at 12 pm CST, featuring MOHealthNet Director of Pharmacy Josh Moore, PharmD.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nebraska
The Nebraska Pharmacists Association (NPA) is looking for member pharmacists to run for its elected Board of Directors. The deadline to submit candidacy is July 17. For more information, contact NPA Chief Executive Office Marcia Mueting.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New York
Medicaid held a pharmacy stakeholder group meeting to discuss the transition of pharmacy benefits from Managed Care back to fee-for-service which is to be finalized by April 1, 2021. The state anticipates a savings of $87.5 million (state share) for SFY 2021-22 which will be achieved through increased rebates to the state, 340B savings, and other efficiencies by eliminating Medicaid Managed Care plans/PBMs which have margins in process now. Medicaid will host pharmacy stakeholder meetings through this transition process.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
SB 808, sponsored by Senator Harry Brown (R) has been signed by Governor Roy Cooper (D). The bill was effective upon signature and makes appropriations for the implementation of the Medicaid Transformation in the state of North Carolina. The bill also verifies Departmental receipts for the 2020-2021 fiscal year to implement the measure and also appropriates such money from the General Fund to the Department of Health and Human Services and the Division of Health benefits to be utilized for Medicaid and NC Health Choice programs to assist with projects related to Medicaid managed care.
Also in North Carolina. The North Carolina Department of Health and Human Services (NC DHHS) issued a Statewide Standing Order for Diagnostic COVID-19 Testing. State Health Director Dr. Betsey Tilson issued a statewide standing order for COVID-19 diagnostic testing as well as a temporary order and associated guidance that, among other things, requires all healthcare providers ordering or conducting COVID-19 diagnostic tests to report all results, positive or negative. NC DHHS also issued patient guidance for isolation and quarantine while waiting for, and after receiving, COVID-19 diagnostic testing results. Additional details and links can be found here.
Also in North Carolina. A qualifying military-trained or military-spouse pharmacist license or pharmacy technician applicant is exempt from the initial application fee. The state has posted FAQs that provide more detail.
Also in North Carolina. The Board of Pharmacy has posted a reminder to all pharmacy and DME permit holders that NABP E-Profile numbers will be required for 2021 renewal. Board Rule .1615 requires all pharmacy and DME permit applicants and holders to obtain and report an e-Profile number issued by the National Association of Boards of Pharmacy (NABP) as a condition of permit issuance or renewal. Details and instructions may be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Pennsylvania
SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate and the House. Commonly referred to as a “gag clause” prohibition, the amended bill is on its way to Governor Wolf (D) for signature.
Also in Pennsylvania. Governor Wolf (D) announced the approval of the Department of State’s request to suspend the age limitation of 9 years old for pharmacist-administered influenza vaccines. The waiver, which specifically allows pharmacists to provide any licensed, age-appropriate flu vaccine to individuals 3 years of age or older, was effective July 2 and will be in effect for 90 days after the current state of emergency related to COVID-19 ends.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
South Carolina Department of Health and Human Services (SCDHHS) issued guidance for Healthy Connections Medicaid providers on how to receive reimbursement through the new COVID19 Limited Benefit Program. Learn more in the Medicaid provider bulletin here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
Last week, Assembly Member Jim Wood (D), chair of the Assembly Health Budget Committee, gutted and amended AB 1710 to allow pharmacists to initiate and administer FDA-approved vaccines. NACDS is seeking an amendment to allow FDA-authorized vaccines too.
Also in California. Prior to the July 1, 2020 deadline required in the state constitution, Gov. Gavin Newsom signed the 2020 Budget Act – a $202.1 billion spending plan that closed a $54.3 billion budget shortfall caused by the COVID-19 recession.
Also in California. Gov. Gavin Newsom extended for 60 more days, until September 9th, his Executive Order issued on May 12, 2020, waiving the restrictions on pharmacists ordering and collecting specimens for COVID-19 tests.
Also in California. Because several legislators have tested positive for COVID, neither the Assembly nor Senate are returning to work at the Capitol next week. The legislature shutdown for two months earlier this year because of the pandemic.
Also in California. NACDS and the California Board of Pharmacy submitted the attached joint letter to the Senate Business, Professions, and Economic Development Committee opposing AB 2983 which imposes inefficient requirements that will impede that automated refill process causing delays in patient access.
Also in California. NACDS virtually presented to the Board of Pharmacy’s Licensing Committee and Legislative and Regulation Committee on pharmacists immunizations and COVID testing and the authority to perform CLIA-waived tests for COVID19. Presentations can be found here.
Also in California. NACDS sent a joint letter with the California Retailers Association and the California Pharmacists Association to Gov. Gavin Newsom urging him to issue an Executive Order removing the remaining barriers to expanding access to COVID testing by pharmacists.
Also in California. In response to the Governor’s emergency declaration and consistent with the authority of the Board to waive Pharmacy Law or the regulations adopted pursuant to it, last week the Board president extended the following previously approved limited waivers:
- Use of PPE in Certain Compounding Aseptic Isolators or Compounding Aseptic Containment Isolators– Effective through August 30, 2020
- Duty to Consult – Effective through September 29, 2020
- Restoration of Retired or Cancelled License – Effective through October 1, 2020
- Certification of Basic Life Support – Effective through August 5, 2020
- Prelicensure Inspection of Proposed ADDS Location – Effective through October 9, 2020
- Reassessment/Revalidation/Re-evaluation Requirements for Sterile Compounding Staff Competencies – Effective through August 12, 2020
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
NACDS submitted a letter to the Colorado Department of Regulatory Agencies- Board of Pharmacy requesting a permanent waiver allowing pharmacists to independently order and administer COVID-19 tests, including serology tests, that have received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA), or equivalent regulatory authorization, subject to the disclaimers and limitations required by the FDA, in addition to any CLIA-waived point-of-care tests. NACDS also recommended that pharmacists may delegate the administration of any vaccines and immunizations, including vaccines authorized by the FDA to trained pharmacy interns or pharmacy technicians.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
On June 29, 2020, Governor Ron DeSantis signed HB.59, sponsored by Representative Matt Willhite (D), which authorizes a community pharmacy to use an automated pharmacy system, effective July 1, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.