Arkansas
NACDS participated in conference call with Gov. Asa Hutchinson (R) last week where he announced that the state had submitted a State Plan Amendment to CMS to increase the payment rates for pharmacist administered vaccines effective in late July 2020. The SPA increases the rates to $15.45 for administration of the influenza immunization. The SPA also increases rates for other Medicaid payable vaccines to $13.14. NACDS will be submitting a comment letter supporting the increase.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
NACDS, the California Retailers Association, and the California Pharmacists Association have submitted numerous requests over the past several weeks and continue to encourage the Gov. Gavin Newsom’s (D) Administration to waive existing barriers to allow pharmacists to order and administer COVID-19 and anti-body tests. By allowing pharmacists the ability test, as the state reopens, it will be able to better implement track and trace policies crucial to getting the state’s population back to work.
Also in California… The Assembly returned to the Capitol on Monday, May 4th, and the Senate announced their session will resume on Monday, May 11th.
Also in California… An emergency rulemaking action to add section 1747 to Title 16 of the California Code of Regulations relating to the independent initiation and furnishing of HIV preexposure and postexposure prophylaxis as authorized by Statutes of 2019, chapter 532 (SB 159) was finally approved by the Office of Administrative Law. The Notice of Approval and the text of CCR section 1747 – Independent HIV Preexposure and Postexposure Prophylaxis Furnishing, can be viewed on the Approved Regulations page at the Board of Pharmacy’s website, www.pharmacy.ca.gov.
Also in California… Effective April 1, 2020, an Order of Adoption of a proposal to amend the Protocol for Pharmacists Furnishing Naloxone Hydrochloride was announced by the Board of Pharmacy. To view the regulation and Naloxone Fact Sheet, go to the Approved Regulations on the Board’s website – www.pharmacy.ca.gov.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
May 18, 2020 is the tentative date for the Legislature to resume the session that was paused on March 14th. While there are more than 350 bills pending, it is very likely that most will die and the legislators will focus only on COVID issues and the state's budget, which forecasters estimate it to be around a $3.2-4 billion shortfall.
Also in Colorado. The Department of Public Health and Environment, Prevention Services Division, issued a Final rule repealing regulations regarding the state's Cancer Drug Repository Program, effective May 15, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
This week Connecticut State Officials from the Governor’s Office and Department of Consumer Protection met with NACDS, the Connecticut Community Pharmacy Association and pharmacies to discuss any impediments to pharmacists being able to order, administer and interpret COVID tests. State officials felt strongly that the key to rapidly increasing the testing of its citizens required the support of the pharmacy community. State officials agreed to consider several actions to expedite the process.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Louisiana
The legislature reconvened their session on Monday, May 4, and by constitution, must adjourn by June 1. While the budget is their main focus, several committees did post hearings for this week, including a payment parity bill, HB 459, filed by Rep. Joseph Stagni. The payment parity bill garnered broad support from the Louisiana Pharmacy Congress that represents eight pharmacy organizations — Alliance for Pharmacy Compounding, Louisiana Independent Pharmacies Association, Louisiana Pharmacists Association, Louisiana Society of Health-System Pharmacists, Louisiana State Board of Pharmacy, National Association of Chain Drug Stores, University of Louisiana at Monroe – School of Pharmacy, Xavier University of Louisiana – College of Pharmacy – was scheduled for a hearing in the House Insurance Committee on May 6. Both NACDS launched a RxIMPACT alert to mobilize support for the bill, and so did the Louisiana Pharmacists Association. NACDS and the Louisiana Retailers Association submitted a joint support letter to the committee. Mounting opposition to the bill were the family physicians and insurers led by Blue Cross/Blue Shield. Unfortunately, late Tuesday, the bill was removed from the committee calendar because it was deemed too controversial.
Also in Louisiana... At their April Board of Pharmacy reduced the number of live CE requirements for 2020. They determined it appropriate to modify the CE requirements for pharmacist license renewal for Calendar Year 2021 such that a total of 15 hours of ACPE-accredited pharmacist-specific CE will qualify for license renewal without regard to whether the CE is acquired through live presentations or home study methods.
Also in Louisiana... The Board of Pharmacy is holding a May 29, 2020 hearing on a proposed rule to add nine drugs of concern, including seven drugs for the treatment of hepatitis, promethazine oral liquid formation, and gabapentin. The rule also would add recordkeeping requirements for prescription transactions. NACDS will be submitting a comment letter.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
The New Hampshire Board of Pharmacy Licensed Advanced Practice Technician (LAPT) Committee continues to meet with interested stakeholders, including NACDS, on the duties and educational training for the newly created LAPT position. The committee agreed to draft their recommendations for full Board of Pharmacy consideration at their summer meeting.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Governor Cooper signed new Executive Order 138. The Executive Order does not lift the stay-at-home order but replaces previous executive orders to begin Phase 1 on Friday, May 8 at 5pm. The order is set to expire on Friday, May 22 at 5pm at which point the Governor will examine whether North Carolina will enter Phase 2.
Also in North Carolina... The General Assembly convened their scheduled short session last Tuesday, April 28 and quickly approved a pandemic relief package of nearly $1.6 billion that Governor Cooper signed into law on Monday, May 4th. The legislation is effective immediately and included, among other items, language that authorizes pharmacists to administer a COVID-19 vaccine or immunization once one is developed and recommended by the CDC. Two liability protection provisions, one covers health care workers, protecting them from civil and criminal liability as they provide COVID-19 treatment and the second protects any essential business whose employees or customers contract COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Prior to the May 5th quarterly Zoom Board meeting, the Executive Director Allison Benz announced that the discussion on expanding technician duties and eliminating the arbitrary ratio would be postponed until the August 4th in-person Board meeting.
Also in Texas... The Health and Human Services Commission's Vendor Drug Program (Medicaid) finally submitted their 1115 Waiver on April 22nd, that would allow reimbursement to pharmacies for administering flu vaccines, long acting antipsychotics, and drugs used to treat substance use disorder or opioid dependency.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
In response to Governor Ralph Northam’s (D) declared state of emergency regarding COVID-19 and as authorized in §54.1-3307.3, the Board of Pharmacy clarified that pharmacists can perform all CLIA-waived point of care tests, including COVID-19 tests. Additionally, they made updates to their Emergency Provisions During the COVID-19 Declared Emergency that includes waiver of the signature requirement as proof of delivery.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The Washington Health Care Authority (Medicaid) has added the following optional benefits to their state plan: Allow pharmacists practicing within their scope of practice to order, collect specimens, conduct and interpret necessary tests, initiate treatment when appropriate, and administer vaccines for the diagnosis, treatment and prevention of COVID-19; and allow pharmacists practicing within their scope of practice to administer any prescribed injectable, covered, outpatient drug during the COVID-19 pandemic.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wisconsin
The Pharmacy Society of Wisconsin (PSW) has appointed Sarah Sorum, PharmD, as its new Chief Executive Officer. Dr. Sorum has been with PSW since 2007 in various roles, including as its PSW Senior Vice President of Professional and Educational Services, before being named Interim CEO. NACDS congratulates Dr. Sorum on her appointment and wishes PSW the best in its next chapter.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Wyoming
The Wyoming Board of Pharmacy has approved the elimination of the technician ratio which was previously 3:1.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is May 30, 2020, or at the conclusion of the COVID-19 National emergency, whichever occurs first.
Also in Alabama… the Board of Pharmacy is providing Notice and guidance to pharmacists on testing for coronavirus, including conditions under which pharmacists, and pharmacy interns under the immediate supervision of a pharmacist, can perform the allowed tests with appropriate training. Pharmacy technicians can only be involved in completing required paperwork, including the required reporting. Pharmacies must also provide staff with appropriate personal protective equipment. Note: Pharmacies conducting COVID-19 tests are subject to the reporting requirements specified on the Alabama Department of Public Health web page.
Also in Alabama… Alabama Medicaid is providing notice that the State Plan Amendment (SPA) request to modify the default/backup pharmacy reimbursement methodology when no AAC is present on brand drugs only from WAC + 0% to WAC – 4% has been approved by CMS. The plan is now to proceed with the Administrative Code change for an implementation date to be determined later this year.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
Gov. Asa Hutchinson (R) announced that he would begin lifting restrictions on May 4, 2020. He recently appointed 27 leaders, including Charlie Spakes with the Arkansas Grocery and Retail Merchant Association, to his Economic Recovery Task Force to provide guidance to help the Governor develop a strategy for recovery based on the best public health information available.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
Gov. Jared Polis (D) provided guidelines for Colorado’s reopening after the statewide stay-at-home order expired on April 26th. Retailers will have the option to open May 1,2020, as long as they have social-distancing policies in place. The Governor also directed that workers in critical businesses wear masks or face cloth coverings
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Florida Department of Health issued Executive Order 20-006 which allows for COVID-19 Testing by Pharmacists. This order suspends the provision of Section 418.813 of the Florida Statutes that requires a pharmacist to be separately licensed to perform a clinical laboratory tests and also suspends the provision of Section 465.003 (13) of the Florida Statutes that may prohibit a pharmacist from ordering, administering, or reporting the results of COVID-19 tests, including serology tests, authorized by the FDA at a location with a clear and active pharmacy license.
Also in Florida… the Agency for Health Care Administration has issued an ALERT to provide Florida Medicaid coverage updates of laboratory testing for COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
Governor Kemp announced that he will begin the reopening of Georgia's economy which will happen incrementally in three phases using the methods outlined by President Trump. He also stated that Georgia is on-track to meet Phase I of such a plan soon. To that end, the Governor issued a new Executive Order, as well as guidance for those businesses named. The Shelter in Place order remains in place and Georgians must continue to abide by that order until it expires. Governor Kemp then issued an additional Executive Order. That clarifies certain provisions in the EO issued on April 23rd. Specifically, the provisions of the Executive Order issued on April 23rd, unless otherwise stated in that Order, go into effect on May 1st, 2020 and shall be effective through May 13th, 2020.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Iowa Department of Human Services reminds pharmacies that its latest biennial Medicaid Cost of Dispensing survey is due Thursday, April 30th.
Also in Iowa… The Iowa Board of Pharmacy issued a press release with information about rules relating to the distribution of COVID-19 testing kits, including serology tests, into the state of Iowa.
Also in Iowa... Gov. Kim Reynolds (R) issued an extension of the emergency proclamation, permitting regulatory relief to pharmacies through May 27, 2020. The Board of Pharmacy responded with this guidance.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
The Board of Pharmacy issued a Proposed rule amending regulations to add nine drugs of concern, including seven drugs for the treatment of hepatitis, promethazine oral liquid formation, and gabapentin. The rule also requires recordkeeping for prescription transactions and revises provisions on authorized access privileges, access registration procedures, and methods of access. In addition, the rule would extend the automatic registration procedures to include dispensers and remove redundant provisions. Comments are due to mstaples@nacds.org by COB May 15, 2020 so that we can submit a comment letter in advance of the May 29, 2020 public hearing.
Also in Louisiana… The Board of Pharmacy issued a Proposed rule to remove the requirement for pharmacists to publicly display a paper copy of their current license renewal. Comments are due May 29, 2020.
Also in Louisiana... Dr. Courtney N. Phillips officially joined the Louisiana Department of Health to serve as the Secretary. Dr. Phillips mos
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Michigan Gov. Gretchen Whitmer (D) announced an extension of her previous Executive Order with wide-ranging scope of practice and operational measures to facilitate pharmacy engagement in response to COVID-19. The new order will apply through May 19, 2020.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
Mississippi State Department of Health issued the following guidance this week. HHS recently authorized pharmacists to order and administer COVID-19 tests. Pharmacies will need a CLIA Certificate of Waiver from the Mississippi State Department of Health (MSDH) to participate in testing. It will be up to the pharmacy and the pharmacist-in-charge to deem all appropriate training for the testing to be completed. For anyone interested in conducting COVID-19 testing, please stay alert for any changes made by the FDA, HHS, MSDH, or Mississippi Board of Pharmacy. Positive test results must be reported to MSDH with patient information; negative results must be reported daily in aggregate (number) without patient information.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Carolina
Governor Cooper has announced the extension of the current stay-at-home Executive Order 121 until May 8,2020 at 5pm and a 3-phase plan for reopening. Executive Order 121 that enacted stay-at-home requirements has been in place since March 30th and was originally scheduled to expire next Thursday, April 30th. This order does not alter any provisions of the previous executive order other than technical changes.
Also in North Carolina... Effective April 27, 2020, prescriptions for NC Medicaid and NC Health Choice beneficiaries are eligible for the addition of a mailing or delivery fee via the guidelines below. NC Medicaid encourages beneficiaries to request, and pharmacy providers to mail or deliver prescriptions to beneficiaries, during the COVID-19 pandemic to achieve better social distancing within their community. This measure should be considered for all beneficiaries, but especially those that are considered at higher risk for severe COVID-19 illness. For more information please click here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Pennsylvania
HB 943, legislation prohibiting PBMs and PSAOs from penalizing pharmacies for disclosing a patient's cost share for a prescription drug and discussing available alternatives, has been reported from the Senate Health Committee and received first consideration on the Senate Floor. The legislation, commonly referred to as a "gag clause" bill was sponsored by Rep. Valerie Gaydos (R), and previously passed the House unanimously.
Also in Pennsylvania... Rep. Seth Grove (R) has introduced legislation that would expand pharmacists' immunization authority and allow them to order and administer COVID-19 and CLIA-waived tests for the duration of the Governor's disaster emergency declaration. Specifically, HB 2461 would allow pharmacist to provide any vaccine on the CDC or ACIP schedules and any injectable or biological medication for the treatment or prevention of COVID to patients 9 years of age or older, including any upcoming COVID-19 vaccine. Additionally, it would suspend the provisions of the Pennsylvania Lab Act that requires prior work experience in a laboratory for pharmacists to register with the state to perform CLIA-waived tests, including those for COVID-19. The legislation was introduced at the behest of NACDS and the Pennsylvania Association of Chain Drug Stores (PACDS).
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Texas Federation of Drug Stores submitted several requests to Gov. Greg Abbott (R) requesting additional waivers, including one for pharmacists testing requesting either a waiver or statewide order from the Department of State Health Services, and one on telepharmacy.
Also in Texas... Gov. Greg Abbott (R) appointed Chairman and CEO of Brookshire Grocery Company Brad Brookshire to his Strike Force to Open Texas to develop plans on how to best reopen the state.
Also in Texas... Gov. Greg Abbott (R) announced that he was mobilizing the Texas National Guard for COVID-19 mobile testing teams. Forty-five teams will be mobilized across the state to provide greater access to medical testing. The teams will have eleven medical professionals and support staff, as well as thirty-four soldiers. Currently, the Texas National Guard has the capacity to test 150 people per day at each mobile testing location.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The California State Board of Pharmacy (Board) is proposing an emergency action to add regulations related to the independent initiation and furnishing of HIV preexposure prophylaxis (PrEP) and HIV postexposure prophylaxis (PEP) recommended by the federal Centers for Disease Control and Prevention (CDC) to patients, as authorized by Senate Bill (SB) 159 (Wiener, Chapter 532, Statutes of 2019). The proposed regulation would establish the criteria that a training program for participating pharmacists must meet for approval by the Board and the recordkeeping requirements for a pharmacist who has completed the training program.
Also in California... Despite the fact that the Board of Pharmacy announced that they would extend the comment period to April 30, 2020, NACDS and the California Retailers Association submitted a joint comment letter to the Board of Pharmacy to express our concerns regarding the proposed regulations as unworkable and over-restrictive for staffing requirements for community pharmacies. Our letter stressed that it is crucial that pharmacies have the ability to address fluctuations in staffing but also designate the type of employee that will provide assistance rather than a particular individual.
For more information, contact NACDS’ Mary Staples at 817-442-1155.