Alabama
Medicaid has proposed a new default reimbursement methodology if no AAC exists for a drug product. Currently, if no AAC exists, the alternative is WAC+0%. Medicaid is suggesting a change to WAC-4% for brand drugs only. Comments on the proposal are due at 12:00 noon on Friday, October 11.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
The Board of Pharmacy’s Regulation Revision Committee will be meeting on Thursday, October 17. In advance of the meeting, members are encouraged to submit letters of support urging the Board to amend rules to eliminate the pharmacy technician-to-pharmacist ratio.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Department of Health and Human Services (MDHHS) is proposing to transition all pharmacy drug coverage to Medicaid fee-for-service effective Sunday, December 1. Comments are due to MDHHS by Monday, November 4.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New Mexico
On October 10, NACDS along with the New Mexico Pharmacists Association and the New Mexico Retail Association met with Attorney General Hector Balderas (D) and his staff to discuss how chain pharmacies are a critical part of the solution to the opioid abuse crisis, to highlight examples of how chain pharmacies are working prevent opioid abuse and increase access to treatment, and to promote NACDS’ public policy solutions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy has developed several tools to help pharmacies prepare for inspections. A new online video. (1). To watch the program, visit the board’s website and click the links to go to Licensees > Important Information for Licensees > Ask an Inspector. (2) A new brochure – “Pharmacy Inspections by the California State Board of Pharmacy” – to help licensees understand and prepare for inspections.
Also in California… As part of the “Use, Don’t Abuse” safe disposal of prescription drugs campaign, the Board of Pharmacy is sponsoring billboards statewide with a public service message reminding Californians to safely dispose of unused or unwanted prescription drugs.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
Effective October 1, the Department of Health (LDH) implemented a new educational alert at the point-of-sale for concurrent uses of opiates and antipsychotic medicines for the Medicaid fee-for-service program
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
On October 2, the State Department of Health released its proposed regulations to implement the drug disposal law passed in 2018 (Chapter 120) which requires chain pharmacies of 10 or more and non-resident pharmacies to offer patients a drug disposal/drug takeback option via an in-store receptacle or mail back program. Under the law, the program is to be managed and funded by the drug manufacturers. NACDS engaged in numerous meetings with both state regulators and drug manufacturers to insure a workable program for all.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Board of Pharmacy will not begin enforcing USP Chapter <800> on Sunday, December 1. The Board will discuss the effective date of updated compounding rules that require adherence to USP <800> at its November meeting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Prescription Monitoring Program’s Interagency Advisory Committee Group will meet on Tuesday, October 15 to discuss implementing certain requirements in several new laws, including setting standards for waivers from the electronic prescription requirements in HB 2174.
Also in Texas… In response to a request from the State Board of Pharmacy, NACDS submitted comments identifying issues that the Board should address as it works to develop its Strategic Plan for Fiscal Years 2021 through 2025. Among these issues, NACDS urged the Board to implement policy changes that expand the scope of services that pharmacists can provide to Texans, optimize the use of pharmacy technicians, enable pharmacies to utilize new technologies and implement innovate practices to better serve their patients and to address other burdensome provisions in the existing rules and regulations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
NACDS submitted comments to the Joint Commission on Health Care related to the Commission’s ongoing study on the expansion of pharmacist authority through statewide protocols, standing orders and collaborative practice agreements. This opportunity is in alignment with NACDS’ Scope of Business campaign for Track 1 states to expand pharmacists’ scope of practice and payment/coverage within the state. The Commission is finalizing its report early this fall.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
California
The Department of Health Care Services (DHCS) announced that they have an alternative Medi-Cal recoupment process for pharmacies meeting certain criteria. Any pharmacy interested in applying for the alternative repayment process will have to do so via an online portal between Monday, October 28 and Friday, November 22. DHCS will be posting FAQs online in October. For providers who do not seek alternative repayment, the recoupments will resume in March 2020. To calculate repayment for pharmacies that choose not to do the alternative payment process, pharmacies can take the amount of the recoupment that occurred after the first iteration and multiple that by 22.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
Effective September 21, the pharmacy technician–to–pharmacist ratio increased from 3:1 to 4:1. The Board of Pharmacy still has a mechanism in place for pharmacies to request a waiver from the Board for additional technicians by providing a utilization plan.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Effective Tuesday, October 1, IngenioRx, Inc. (IngenioRx) will begin to administer the prescription benefits for Simply Healthcare of Florida Inc. (Simply) Comprehensive Plan and Clear Health Alliance Specialty Plans. Members may be transitioned to a network pharmacy with IngenioRx that continues to meet member access requirements.
Providers that are out of network as of Tuesday, October 1 will be eligible for a 60-day continuity of care period where claims will be payable to allow time for members to transition to a new pharmacy, if necessary. All members were notified of this transition by mail on August 2. The continuity of care period ends on Saturday, November 30.
The pharmacy claim processing information to IngenioRx for Simply Comprehensive Plan and Clear Health Alliance Specialty Plan is noted below:
RXBIN: 020107
RXPCN: CH
RXGRP: WK3A
Member ID Format: 11-14 digits
For questions regarding future network or contract related inquiries, call IngenioRx at 1-833-235-2030.
Prior to Tuesday, October 1, providers may contact Simply Provider Services for eligibility or prior authorization questions at 1-877-577-9044.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Collaborative Pharmaceutical Care Task Force submitted its recommendations to the General Assembly as required by Public Act 100-0497. That will inform future efforts to update the Practice Act.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
Effective September 15, Medicaid Fee-for-Service (FFS) Pharmacy Program began reimbursing enrolled pharmacies for influenza vaccines and administration of the vaccines for Medicaid recipients who are nineteen years of age and older when the administering pharmacist is an enrolled Medicaid provider. The cost of the vaccine will not be reimbursed for recipients under the age of nineteen as these vaccines are available through the Louisiana Vaccines for Children (VFC) program. If Medicaid FFS is billed for a recipient 18 years of age or younger, only the administration fee will be reimbursed for these recipients.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Gov. Gretchen Whitmer (D) signed an Executive Order to create a Michigan Opioids Task Force within the Michigan Department of Health and Human Services.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Missouri
The Board of Pharmacy created the Rx Cares for Missouri Medication Destruction and Disposal Program, which will provide resources for approved entities to collect medication for disposal. Approved participants will be provided a collection receptable and required inner liners at no cost.
Also in Missouri… The summer newsletter of the Bureau of Narcotics and Dangerous Drugs details information about the implementation of SB 514, including its provisions to require e-prescribing of controlled substances by Friday, January 1, 2021.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
California
NACDS and our in-state partner, the California Retailers Association, submitted a joint letter to Gov. Gavin Newsom (D) urging him to sign into law AB 690, legislation that we successfully amended containing a provision allowing a pharmacy damaged or destroyed during a natural disaster to relocate without changing its pharmacy license.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
South Carolina
The South Carolina Department of Health and Human Services (SCDHHS) is beginning 2019 provider revalidation. In the bulletin dated April 20, 2015, providers were informed their enrollment information must be revalidated, per the Centers for Medicare and Medicaid Services (CMS). To avoid risk of termination in the SCDHHS Healthy Connections Medicaid program, impacted providers must complete and submit an enrollment application 30 days from the date of their official revalidation notification letter. Providers should not begin the revalidation process until they receive notification. The notification contains pertinent information needed to start and complete the revalidation process.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
In response to a request from the Texas Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP), NACDS submitted a 10-page letter detailing Medicaid cost-saving suggestions. The VDP was charged with the responsibility of evaluating strategies and submitting a report with findings and recommendations for achieving cost savings to the Senate Finance Committee, House Committee on Appropriations, Legislative Budget Board, Governor and permanent standing committees in the House of Representatives and Senate with jurisdiction over HHSC by Tuesday, September 1, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health reminded Medicaid providers that the Emergency Overrides Hurricane season continues through Saturday, November 30. When severe weather causes residents to evacuate and businesses to close early, pharmacy providers are allowed to fill a prescription with a minimum three-day emergency supply. Controlled substances and specialty drugs are NOT included in the emergency fill provision. The current Medicaid Immunization Coverage for Fee-for-Service and Managed Care Organizations chart includes information on vaccines and how they are covered.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oklahoma
The Health Care Authority (OHCA) that oversees the Medicaid SoonerCare program, appointed Melody Anthony chief state Medicaid director and chief operating officer. She has previously served as deputy state Medicaid director.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Pennsylvania
The Department of Health has posted guidance on Act 96 of 2018, which will require all controlled substance prescriptions (with some exceptions) to be electronically prescribed effective Thursday, October 24.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
Washington State Health Officer Dr. Kathryn Lofy signed a statewide standing order allowing naloxone to be purchased at pharmacies in the state without a prescription.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The coalition formed by the California Pharmacists Association (CPhA), the Community Pharmacy Advocacy Group was notified on August 27 that the Californians for Access to Life-Saving Medicine’s Medi-Cal NADAC court hearing scheduled at the U.S Courthouse in Oakland on Friday, August 30 was cancelled. More than 92 pharmacies had submitted declarations stating how the clawbacks and continued flawed NADAC methodology will affect their pharmacy operations and patient access. Next step is that the court is expected to issue a written decision.
For more information, contact NACDS’ Mary Staples at 817-442-1155.