Kentucky
The Department for Medicaid Services has published pharmacy guidance, effective August 6, for point-of-care COVID testing, based on the Governor’s previously issued Executive Order. The guidance lays out pharmacy billing requirements under both fee-for-service and managed care. Additionally, the department issued a statewide protocol intended for use by pharmacies that do not have a medical provider to issue an order.
Also in Kentucky. The Board of Pharmacy rescinded the first directive regarding Hydroxychloroquine dispensing that requires a diagnosis code. The remaining directive still applies, which placed restrictions on the dispensing of chloroquine, hydroxychloroquine, mefloquine, and azithromycin.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH), which oversees Medicaid, has issued several updates for pharmacies. Links to those updates are below:
- Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement for Select Medications – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale (POS) Quantity Limits – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale (POS) Edits for Lumateperone (Caplyta™) – August 3, 2020
- Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization for Select Drugs – August 3, 2020
- Louisiana Medicaid Provider Updates
Also in Louisiana. LDH announced several extensions through October 31, 2020, due to COVID. Those extensions apply to:
- Existing approved prior authorizations on prescribed drugs and physician-administered drugs (drugs included as a medical benefit). According to LDH, this will not affect the number of refills originally authorized by the prescriber.
- Member copays for prescribed drugs, which will continue to be waived.
- A 90-day supply of appropriate maintenance medications that are not controlled substances. This includes cardiovascular drugs (hypertension, coronary artery disease, thrombosis), diabetes drugs, respiratory drugs (inhaled and oral), contraceptives, antivirals, direct-acting antivirals for hepatitis C, immunosuppressives, antipsychotics, and antidepressants, among others.
- Member signatures, which will not be required.
Also in Louisiana. The Board of Pharmacy will be holding a virtual full board meeting on Thursday, August 13, 2020. The full agenda can be found here.
Also in Louisiana. The Board of Pharmacy posted its new Pharmacy Law Book. The new law book can be found here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
The Missouri Board of Pharmacy is offering its next “Lunch with the Chief Inspector” webinar on Wednesday, August 19, 2020, at Noon CST, where they will provide a 2020 state legislative update. Click here to register for the webinar.
Also in Missouri. Missouri’s HealthNet Division (MHD) has announced that it will begin accepting ICD-10 diagnosis codes on pharmacy claims starting August 16, 2020. More information can be found here.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
NACDS and the Retail Association of Nevada’s (RAN’s) chain pharmacy members held a call with the Board of Pharmacy Executive Secretary Dave Wuest, who has agreed to move forward with plans to advance a regulation regarding pharmacy technicians administering immunizations at the September 3, 2020, in-person Board meeting in Reno. In addition to adopting permanent rules, the Board plans to pursue the adoption of a temporary regulation using the same language in the permanent regulation, which would serve to bridge the gap until the permanent language is adopted. Lastly, Mr. Wuest informed chain members that he will ask the Board to approve the same language as a non-renewable emergency regulation that would become effective immediately upon filing with the Secretary of State, but will only be effective for 120 days. RAN and NACDS will continue to work closely with the Board to move this language forward in anticipation for the upcoming flu season and release of a vaccine for COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
Governor Chris Sununu (R) signed into law HB 1639, which authorizes pharmacists and pharmacy interns (under direct supervision) to administer a COVID19 vaccine, once available.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Ohio House voted to remove Representative Larry Householder (R) as Speaker of the House by a vote of 90-0. A federal grand jury had previously indicted Representative Larry Householder (R) and four other individuals on various charges, including racketeering. Following that vote, House Republicans chose Representative Bob Cupp (R) to be the next Speaker. Representative Jeffrey Crossman (D) moved to expel Representative Larry Householder (R) from the Legislature during the House session. Ohio House Republicans tabled the motion from further consideration. The Ohio Constitution requires a two-thirds vote for expulsion from the Legislature. Representative Larry Householder (R) retains his House seat and currently has no opponent in the November election. The House is currently in recess until September, and House Rule 1 states only the Speaker can call a session.
Also in Ohio. The Board of Pharmacy has published guidance rescinding rule 4729:5.5.21, which prohibits the sale of Chloroquine and Hydroxychloroquine. The guidance also clarifies that a diagnosis code for COVID is no longer needed to fill those prescriptions as previously required by 4729:5.30.2.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
South Carolina Department of Health and Human Services (SCDHHS) is hosting two provider training sessions. This annual quality improvement training covers retroactive eligibility as it relates to prior authorization, service types, and submission guidelines for prior authorization and includes an overview of the Keystone Peer Review Organization (KEPRO) website and a provider portal. Learn more here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Dakota
NACDS participated in a meeting of a committee comprised of representatives from the Board of Pharmacy, Board of Nursing, and Board of Medical and Osteopathic Examiners. Applicable South Dakota statutes require this group to address pharmacist immunization standards. The committee agreed to allow the Board of Pharmacy’s immunization rule language to proceed. The Board of Pharmacy anticipates holding an August meeting to engage in discussions on the broader rule package shared with members previously.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Texas
On August 4, the Board of Pharmacy agreed to adopt proposed rules from the November 3, 2020 board meeting that would expand pharmacy technician duties(accepting oral prescriptions, transferring a prescription, and contacting the prescriber to clarify information on an existing prescription order)for all classes of pharmacy except Class C hospital pharmacies. The Board also agreed to adopt proposed rules increasing the pharmacists-to-pharmacy technician ratio for Class A retail pharmacies from 1:4 to 1:6.
Also in Texas. Effective October 15, 2020, Samuel M. Poloyac will serve as the next dean of the University of Texas College of Pharmacy. Dean-designate Poloyac currently serves as the associate dean for graduate and postdoctoral programs at the University of Pittsburgh School of Pharmacy. Retiring Dean Lynn Crismon will support Dr. Poloyac throughout the transition.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
For members of the Pharmacy Society of Wisconsin, there is an opportunity to serve on a newly forming Community Pharmacy Advisory Committee. Interested individuals should complete this application by August 13. Please contact Kari Trapskin with any questions.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
California
On July 23, the Board of Pharmacy issued a waiver temporarily increasing the ratio, allowing one additional intern pharmacist for each supervising pharmacist under the following conditions: (1) the additional intern pharmacist is administering immunizations consistent with the provisions of Pharmacy Law, and (2) the pharmacy maintains a readily retrievable record documenting the date and time when the ratio is increased according to this waiver and the staff operating under the waiver. Records must be maintained for one year following the end of the declared emergency. The waiver is set to expire on October 20, 2020.
Also in California. NACDS’ in-state partner, the California Retailers Association, signed a coalition letter to the California Department of Resources Recycling and Recovery (CalRecycle) requesting a 30-day extension to the public comment period on the Second Draft of the Proposed Regulations for the Pharmaceutical and Sharps Waste Stewardship Program, now scheduled to expire on August 3, 2020.
Also in California. In advance of the Senate Business and Professions Committee meeting on August 8, 2020, NACDS and the California Retailers Association submitted a joint letter supporting AB 1710 by Assembly Member Jim Wood, which would allow pharmacists to administer all FDA authorized or approved vaccines.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
The Committee on Health held a hearing on B23-0535, legislation requiring color-coded warning labels on opioid medications. Councilmembers Vincent Gray, Chair of the Committee on Health, and David Grosso both expressed their support for the bill. Additionally, Dr. Shauna White, Executive Director of the Board of Pharmacy, testified in favor of the bill. NACDS submitted written testimony opposing the bill. NACDS will discuss strategy and next steps with members as the bill moves forward.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Kentucky
Kentucky Medicaid’s adoption of a stop-gap measure included in Section 5 subsection 1(a) of SB50 prohibits managed care contractors from reducing pharmacy dispensing fees through the end of this year. While it is likely that the Medicaid contract extension issued July 1, 2020, will include the contract language detailed above, documentation of this cannot be provided at this time as these contract extensions are not publicly available. Regardless of the availability of this language, however, at the very least the stop-gap measure prohibits the reduction of dispensing fees through the end of this year. Additionally, in 2018, the General Assembly enacted a biennial budget that included budget language stated for fiscal year 2020, which will provide for an additional $2 dispensing fee to be added to the existing contracted dispensing fee to retail pharmacies. NACDS supported state advocates’ efforts to adopt SB 50 and thanks the Kentucky Retail Federation for sharing their analysis of the issue with us.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Chain pharmacies have created a new chain drug committee organization called the Louisiana Alliance of Retail Pharmacies under the umbrella organization, the Louisiana Retail Association. NACDS pledged to work closely with the LARP lobbyists on key legislative and regulatory initiatives aimed at broadening the scope of pharmacy practice to help fill the gaps in healthcare.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
Governor Steve Sisolak (D) announced that he may convene a second special legislative session to address criminal justice and coronavirus-related concerns, including business and worker groups’ legal liability and worker protections.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
Reminder to all pharmacy and DME Permit Holders – NABP A NABP E -Profile number will be required for all 2021 renewals. 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.
Also in North Carolina. The next Board of Pharmacy election is scheduled to begin November 1, 2020. One position on the Board will be filled, the Southeastern District, which is comprised of Beaufort, Bladen, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Greene, Harnett, Hoke, Johnston, Jones, Lenoir, New Hanover, Onslow, Pamlico, Pender, Pitt, Robeson, Sampson, Scotland, and Wayne Counties. The winner of this election will begin their term on May 1, 2021. All pharmacists actively licensed by the Board and living in North Carolina at the time of the election will be eligible to vote. Beginning November 1, 2020 pharmacists will simply log in to the Board’s Licensure Gateway and select from the list of candidates. Questions about the election or Board service in general should be directed to Jay Campbell, the Board’s Executive Director.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Pennsylvania
HB 943 (now Act 67) also known as the “Gag Clause Bill,” which was sponsored by Representative Valerie Gaydos (R) has been signed into law by Governor Wolf (D). HB 943 states that a pharmacy or pharmacist has the right to provide a covered individual with information concerning the cost of a prescription drug. This includes the individual’s cost-share. Additionally, under the new law a pharmacy or pharmacist may not be prohibited from or penalized by a pharmacy benefits manager for discussing the cost share information, disclosing the availability of therapeutically equivalent alternative medications, or selling to the covered individual a more affordable alternative if an affordable alternative is available. The measure applies to pharmacy benefit manager (PBM) and pharmacy services administrative organization (PSAO) contracts and is effective July 23.
Also in Pennsylvania. NACDS reminds members that pharmacies can now provide the influenza vaccine to children aged three and above according to a waiver issued by the Wolf Administration. The current statute sets the age floor at 9 years of age.
Also in Pennsylvania. The Department of Human Services (DHS) announced applicants selected through a Request for Applications (RFA) for Pennsylvania’s HealthChoices program, the Medicaid physical health managed care program. However, DHS is unable to move forward with the selections pending filed protests by three companies that were not selected. DHS may not take any further action on the procurement until the protests are resolved. The following are the managed care organizations (MCO) chosen by zone:
- Southeast: Geisinger Health Plan, Health Partners Plans, UnitedHealthCare, UPMC for You, and Vista Health Plan (Keystone First)
- Lehigh/Capital: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
- Northeast: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
- Northwest: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
- Southwest: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
The Tennessee Department of Health (TDH) is preparing for all scenarios and is working to identify providers who could administer vaccinations when available. Part of this effort includes working with pharmacists to assess their level of readiness related to the distribution, storage, and administration of COVID-19 vaccinations. TDH has released a survey, seeking to collect information from pharmacies and health care facilities who would like to collaborate with TDH during a pandemic response. The purpose of this survey is to allow TDH to be prepared to distribute resources should they become available. Partnering providers are asked to consider their pharmacy’s or facility’s capacity to store, distribute, and administer the pandemic vaccine to eligible members of the public and/or to the populations they serve. This survey will also assist TDH in understanding pharmacies’ and facilities’ estimated capacity to assist in pandemic response. TDH is asking for responses that would reflect the “average” capacity for vaccine storage, which may vary by season. Of note, vaccines may require storage under freezing or refrigerated temperatures.
If interested, please submit only ONE pandemic survey per pharmacy/facility/physical location, to avoid duplicate information. Please enter complete information when answering questions regarding the pharmacy’s or facility’s storage capabilities. For TDH to approve a pharmacy or facility to store federally purchased vaccines, all requested information and documentation must be provided. Any questions or requests to make changes to the pharmacy or facility information after submission, or to opt-out of being a pandemic provider at a later date, please contact TDH at VPDIP.Pandemic@tn.gov.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
At the upcoming quarterly Board of Pharmacy, the Board will discuss proposed rules on eliminating ratios on pharmacy technicians and interns for all classes of pharmacy, as well as expanded certain pharmacy technician duties. NACDS submitted a support letter and will testify at the public hearing. Members are encouraged to submit support letters to execassist@pharmacy.texas.gov before the Sunday, August 2, 2020, 11:59 PM CST deadline. Agenda materials are posted here, and live stream information available on this page.
Also in Texas. The Board of Pharmacy will be moving compliance inspections to virtual platforms to a new location which can be found here.
Also in Texas. The Board of Pharmacy’s emergency rule §291.30 concerning Medication Limitations expired on July 17. The rule was adopted on a temporary emergency basis in March 2020.
Also in Texas. The Board of Pharmacy will discontinue issuing 15-day renewal reminder letters to licensees after August 31, 2020 but will continue issuing 75-day renewal reminders. More information about the renewal deadlines can be found here. Select the license type to search by first and last name or by license/registration number.
Also in Texas. On July 27, Governor Greg Abbott (R) announced that Cecile Young will lead Texas Health and Human Services Commission’s 37,000-person agency that oversees both Public Health and Medicaid.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
NACDS submitted comments to the Wyoming Board of Pharmacy in support of their rules implementing electronic prescribing of controlled substances, scheduled to go into effect January 1, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
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.