California
Gov. Gavin Newson's released his May Revised 2020-21 Budget last week projecting a $54.3 billion deficit. Since the state's constitution requires that the legislature submit a balanced budget to the Governor by June 15, 2020, and that the Governor must sign it before the start of the next fiscal year on July 1, 2020, legislators are scrambling to hold hearings on the proposed massive cuts. NACDS and the California Retailers Association submitted a joint letter to both the Senate and Assembly Budget Committee Chairs strongly opposing the proposed elimination of Medi-Cal reimbursement of pharmacist-delivered services such as providing self-administered hormonal contraceptives, vaccines, nicotine replacement products, travel medications, naloxone directly to patients and PEP/PrEP for HIV prevention.
Also in California... In advance of the Assembly Business & Professions Committee hearing, NACDS and the California Retailers Association submitted a joint letter opposing SB 2983 by Assembly Member Chris Holden, because it would prohibit pharmacies from automatically contacting prescribers to authorize a prescription for any dangerous drug or device for more than a 7-day supply refill without authorization from the prescriber or patient. Further, we objected to the requirement that a pharmacy obtain separate authorization for each prescription.
Also in California... The Assembly Budget Subcommittee on Health and Human Services debated health care cuts proposed by the Department of Finance, which included cuts to the proposed Diabetes Prevention Program. NACDS is a member of a broad-based coalition building support to advance Medi-Cal funding for Continuous Glucose Monitors (CGMs).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
The Board of Pharmacy held a stakeholder meeting on Tuesday and Board meeting on Thursday to discuss what temporary rules suspended by Gov. Jared Polis should be permanently suspended by the Board. Issues the Colorado Retail Council and NACDS members promoted included recommending the Board to act on include allowing pharmacists to order and administer COVID-19 tests, including serology tests, that have received Emergency Use Authorization (EAU) from the Food and Drug Administration (FDA), or equivalent regulatory authorization and keeping the definition of pharmacy intern and technician roles at remote pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Florida Medicaid has issued an ALERT reminding providers that they cannot charge a recipient for Personal Protective Equipment (PPE) used during the delivery of a Medicaid covered service. Reimbursement from Florida Medicaid is payment in full for all services. Additional information, including balanced billing prohibitions, is in the Agency’s General Medicaid Policy.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Department of Healthcare and Family Services (DHFS) posted a new Provider Notice with a comprehensive billing guide for Medicaid Managed Care Services. In addition, as follow up to its March 30th provider notice, DHFS posted a list of medications added for temporary coverage in a 90-day supply.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Iowa Board of Pharmacy shared an update about pharmacist emergency licenses. Among the information is this reminder: Upon the expiration or termination of the Governor's Proclamation of Disaster Emergency, the Board will provide notice to all pharmacists with emergency licenses regarding the date by which the required exams must be completed to retain active Iowa pharmacist licensure.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
NACDS and the Louisiana Retailers Association (LRA) submitted a joint letter to Louisiana Governor John Bel Edward's Rural Development Task Force Chairman Jim Clinton sharing our ideas how community pharmacies are vital to helping reopen the economy. NACDS and LRA also sent a similar letter earlier this month to the Governor's Health Equity Commission and have been participating in their meetings focused on addressing health disparities during the COVID-19 Pandemic.
Also in Louisiana... Gov. John Bel Edwards issued a proclamation extending the public health emergency until June 5, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Michigan Gov. Gretchen Whitmer (D) extended the duration of her previous Executive Order granting broad authority for pharmacies to engage the COVID-19 pandemic, with policies including emergency refills, therapeutic substitution, and suspension of the technician ratio.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Minnesota
The Board of Pharmacy issued a guidance document to assist with the challenging implementation of the insulin safety net program created by HF 3100.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Oklahoma
On May 12th, Gov. Kevin Stitt enacted an Executive Order that removed all restrictions regarding prescriptions for Hydroxychloroquine and Chloroquine. Thus a Board of Pharmacy COVID-19 waiver is no longer necessary for dispensing Hydroxychloroquine and Chloroquine prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
South Carolina
The SC Board of Pharmacy has issued the following guidance in regards to COVID testing by pharmacists in the state.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS, the Texas Federation of Drug Stores, and the Texas Pharmacy are all continuing to work with the Board of Pharmacy to urge Gov. Greg Abbott to allow all licensed pharmacies with CLIA-waivers to order and administer all FDA-authorized CLIA-waived tests that can detect COVID or the presence of antigens or antibodies produced in response to the virus.
Also in Texas... On May 15th, the Board of Pharmacy issued the following guidance to pharmacists when dispensing prescriptions for Chloroquine, Hydroxychloroquine, Mefloquine, or Azithromycin in compliance with Emergency Board Rule 291.30.
The rule does not prevent a physician from prescribing one of these drugs for an off-label use. Please note, the intended use for the drug is not required if the practitioner determines the furnishing of this information is not in the best interest of the patient in accordance with Board rule 291.34 (b)(7).
o The intent of Rule 291.30 is to prevent the stockpiling of the drugs and to ensure that reasonable quantities are available for ALL patients that require therapy with the drugs, including patients with a COVID-19 diagnosis.
o It was not the Board's intent to hinder the use of the drugs on patients that are in need of drug therapy, but rather to prevent unreasonable quantities that would otherwise be representative of hoarding or stockpiling tactics.
o In addition, the Rule does not apply to a prescription issued for a patient already established on the medication (e.g., prescription to treat rheumatoid arthritis or lupus for already established patients).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Wyoming Legislature finished its first of several special sessions focusing on allocating the $1.25 billion allocated to the state through the CARES Act. Of possible interest to NACDS members if the passage of HB 1004 – Business relief programs. The bill sets up a state level business relief program to provide direct grants/stipends to Wyoming businesses impacted by the COVID19 pandemic.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Notice of the Department of Insurance announces that health care providers will receive claim reimbursements from the U.S. Department of Health and Human Services for coronavirus (COVID-19) testing and treatment services provided to uninsured individuals. The reimbursements will be provided at Medicare rates for services or admittance on or after Feb. 4, 2020.
Emergency rule of the Board of Pharmacy amends regulations under AAC 680-X-2 to provide pharmacy technicians an extension to complete required training until Dec. 31, 2020, in response to the coronavirus (COVID-19) public health emergency. The extension applies to technicians who initially registered on or after Jan. 1, 2020, through the end of the state of emergency. The rule is effective March 25, 2020 and expires July 23, 2020.
Emergency rule of the Board of Pharmacy adopts regulations under AAC 680-X-2 to allow the board to issue temporary pharmacist practice permits during the coronavirus (COVID-19) public health emergency. The rule applies to applicants licensed in another state who meet specified criteria. The rule is effective April 2, 2020 and expires July 31, 2020.
Emergency rule of the Board of Pharmacy adopts regulations under AAC 680-X-2 to allow the board to issue temporary in-state pharmacy permits if the applicant meets specified criteria during the coronavirus (COVID-19) public health emergency. The rule is effective April 2, 2020 and expires July 31, 2020.
Emergency rule of the Medicaid Agency adopts regulations under AAC 560-X-13 to temporarily ease the EPSDT referral requirements, “face to face” provider visit requirements, and expiration dates of orders related to Durable Medical Equipment during the state of emergency as it relates to the COVID-19 pandemic. The rule is effective March 24, 2020 and expires July 22, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
NACDS submitted comments to the Arkansas Department of Human Services in support of a Medicaid state plan amendment to increase payment rates for pharmacies and other vaccine providers. Given that appropriate Medicaid vaccine payment rates are key to ensuring access to vaccine services that are vital to public health goals, NACDS comments commended the state for pursuing this rate increase.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Finance announced that the state's revenue decline, estimating late last week that the overall budget deficit is approximately $54.3 billion.
Also in California... On May 12th, Gov. Gavin Newsom (D) announced efforts to expand the state's ability to provide more COVID-19 testing, including using pharmacists to test. For pharmacists to help, the Department of Consumer Affairs (DCA) issued the following DCA waiver DCA-20-14 Restrictions on Pharmacists Ordering and Collecting Specimens for COVID-19 Tests.
Also in California... Having received approval from the Centers for Medicare & Medicaid Services (CMS) of the Department of Health Care Services' (DHCS) request for multiple Section 1135 flexibilities related to Medicaid and the Children's Health Insurance Program (CHIP), new guidance was issued. To the extent applicable, the following modifications also apply to CHIP through the duration of the public health emergency:
- Extending pre-existing authorizations.
- Accommodating circumstances that require relocation to an alternative setting to ensure the continuation of needed home and community-based services (HCBS).
- Temporarily waiving written consent under HCBS programs and permitting documented verbal consent as an alternative.
Also in California... NACDS participated in the Zoom Board meeting on May 7th where the following actions were taken.
- Re-elected President Greg Lippe, Vice President Debbie Veale, and Treasurer Maria Serpa to one-year terms as officers.
- Delegated authority to the president to grant Pharmacy Law waivers for up to 90 days and to extend existing waivers for up to 90 additional days.
- Approved a proposed regulation to add Title 16, CCR section 1714.3, Community Pharmacy Staffing without NACDS' amendments.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Georgia
Emergency rule of the Board of Pharmacy adopts regulations under GAC 480-22-0 to specify requirements for dispensing of Schedule II controlled substances during the coronavirus (COVID-19) state of emergency upon receiving oral authorization from the prescribing practitioner. The rule is effective April 1, 2020 and shall be effective for the duration of the emergency or a period of not more than 120 days, whichever is shorter.
Emergency rule of the Board of Pharmacy adopts regulations under GAC 480-10-0 to specify the conditions under which chloroquine, hydroxychloroquine, or mefloquine may be dispensed or distributed during the coronavirus (COVID-19) public health emergency. The rule specifies that the substances cannot be dispensed unless the prescription or practitioner drug order includes a diagnosis and establishes a limit of 14 day supplies with no refill. The rule is effective March 27, 2020 and expires July 25, 2020.
Emergency rule of the Board of Pharmacy adopts regulations under GAC 480-15-0 to establish standards for temporary pharmacy technician registration during the coronavirus (COVID-19) state of emergency. The rule is effective April 1, 2020 and shall be effective for the duration of the emergency or a period of not more than 120 days, whichever is shorter.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
NACDS and the Louisiana Retailers Association submitted a joint letter to the COVID-19 Health Equity Task Force charged with addressing health disparities. In our letter, we described how pharmacies and pharmacists can help increase access to care and improve health equity for minority and vulnerable populations throughout the state.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Mississippi
Effective May 11, 2020, providers – whether medical or pharmacy – are prohibited from collecting co-payments from Medicaid beneficiaries. For more pharmacy specific information, please click here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
The Missouri Board of Pharmacy webinar originally scheduled for March 26th has been rescheduled to May 21, at 12:00 pm. Attendees must re-register for the new date here. The webinar will feature Chief Inspector Tom Glenski and Bureau of Narcotics and Dangerous Drugs Administrator Michael Boeger.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nebraska
The Nebraska Board of Pharmacy is seeking a pharmacist to replace a member whose term expires November 30, 2020. Information about Board service can be found here.
Also in Nebraska... Nebraska Medicaid issued a provider bulletin regarding the suspension of copays for all services and medicines effective May 1st.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
On May 6th, the Board of Pharmacy updated is waiver temporarily authorizing registered pharmacists, intern pharmacists, and pharmaceutical technicians to perform COVID-19. The guidance can be accessed here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
Emergency rule of the Medical Board adopts regulations under 21 NCAC 32B to establish the restricted drug list during the new coronavirus (COVID-19) public health emergency. The rule also establishes standards for pharmacists to receive and document oral prescriptions for restricted drugs. The rule is effective April 6, 2020 and expires June 5, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
North Dakota Medicaid issued an update with information about personnel changes in the Pharmacy Services team
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Texas
In an effort to stay connected with Texas state legislators during the interim, NACDS, the Texas Federation of Drug Stores and our chain pharmacists from HEB, Kroger, Walgreens and United have been engaged in Zoom meetings. Over the past couple of weeks, we have met with nine lawmakers — West Texas State Senators Charles Perry & Kel Seliger, Ft. Worth State Senator Beverly Powell, San Antonio State Representative Phillip Cortez, Houston State Representative Garnet Coleman, El Paso State Representative Lina Ortega, Arlington State Representative Chris Turner, Dallas State Senator Nathan Johnson and Wichita Falls State Representative James Franks. During these meetings, we covered a wide range of issues beyond the great work pharmacist and pharmacies are doing during the pandemic throughout Texas to ensure access to medications, promoting our scope regulatory and legislative agenda, — expanding technician duties and eliminating arbitrary ratios, and enhancing access to immunizations without a prescription. We also urged them to tell Gov. Greg Abbott to allow pharmacists to test now for COVID and treat later when the vaccines become available.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The March ForwardHealth Update pertaining to COVID-19 has been updated and can be found here
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.