In advance of the Board of Pharmacy’s Licensing Committee meeting January 9, NACDS submitted a comment letter providing suggestions for a training program for pharmacist furnishing pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Office of Environmental Health Hazard Assessment’s (OEHHA) Carcinogen Identification Committee (CIC) postponed their December 5 meeting on whether to add acetaminophen (APAP) to the state’s it’s list of carcinogens under the Proposition 65 law until the Spring of 2020. If they decide to add it, that would then require businesses to provide warnings notices to California consumers about exposures to chemicals that cause cancer, birth defects or other reproductive harm.

Also in California … In 2020, DHCS plans to host quarterly Medi-Cal Rx public forums, webinars and in-person meetings to ensure that the stakeholder community is kept apprised of Medi-Cal Rx implementation activities and timelines for the transition back to Fee-For-Service. DHCS posted a FAQ document—“Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-For-Service”—to the Medi-Cal Rx: Transition webpage that provides additional guidance and clarification to Medi-Cal beneficiaries, providers, plan partners, tribal health programs, and other interested parties regarding the transition of Medi-Cal’s pharmacy benefit. 

Also in California… The Board of Pharmacy’s Licensing Committee will be meeting on December 12 to discuss rulemaking implementing SB 159, a new law allowing pharmacists to furnish HIV Preexposure and Postexposure Prophylaxis medications. Also on the Committee’s agenda is a discussion on advanced pharmacy technicians requirements and functions. The following day, December 13, the full Board will be meeting but that agenda is not yet available, but will be posted on the Board Meetings page.

Also in California… the Board of Pharmacy issued a formal statement regarding compounding requirements pending appeals and postponement of USP Chapters 795, 797, and 825. 

Also in California … Advancing and Innovating Medi-Cal (CalAIM) is a multi-year initiative by the Department of Health Care Services (DHCS) to improve the quality of life and health outcomes of the Medi-Cal population by implementing broad delivery system, program, and payment reforms across the Medi-Cal program. Due to the comprehensive scope of the CalAIM initiative, stakeholder engagement is critical – memo. During the month of December 2019, DHCS will convene four workgroup sessions for Population Health & Annual Health Plan Open Enrollment, Behavioral Health – Payment Reform, Enhanced Care Management & In-Lieu-of Services, and Behavioral Health. For more information about CalAIM, please visit the DHCS webpage. 

Also in California … Department of Health Care Services (DHCS) submitted SPA 19-0015 to CMS, with a proposed effective date of July 1, 2020, to establish a new methodology for blood factor reimbursement for Hemophilia Treatment Centers (HTCs) and non-HTC specialty pharmacies.

• For HTCs, the proposed methodology will be the lower of either their actual acquisition cost (AAC), which is invoice price minus discounts, rebates, or chargebacks, plus a $0.14 per unit dispensing fee; or Average Sales Price (ASP) plus 20 percentn.
• Non-HTCs will be reimbursed at the lower of either the AAC for the drug equal to invoice price minus any discounts (excluding a prompt pay discount of no more than 2 percent), rebates, or chargebacks, plus a $0.04 per unit dispensing fee; or ASP plus 20 percent

Implementation of DHCS’ new reimbursement methodology and provider reimbursement will be prospective from the date of CMS final approval. The SPA package is available on the DHCS State Plan webpage. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Department of Health Care Services (DHCS) posted a document titled "Medi-Cal Rx: Transitioning Medi-Cal Pharmacy Services from Managed Care to Fee-For-Service Frequently Asked Questions," to the DHCS' Medi-Cal Rx: Transition webpage. The document provides additional guidance and clarification to Medi-Cal beneficiaries, providers, plan partners, tribal health programs and other interested parties, regarding the Friday, January 1, 2021, transition of Medi-Cal's pharmacy benefit (collectively referred to as "Medi-Cal Rx").  

Also in California… Chain pharmacies interested in filing for the DHCS' retroactive Medi-Cal rate recoupments and the alternative rate recoupment process must submit an application by this Friday, November 22. Applications will not be considered past that date. More information on the application process can be accessed online. For chain pharmacies not participating in the alternative payment rate process, please refer to the Pharmacy Retroactive Claim Adjustments FAQs on DHCS' website – #5 explains the timeframe for recoupments for pharmacies, #7 explains how DHCS will handle the recoupments via different potential scenarios and #17 explains how pharmacies can estimate their outstanding balance due to DHCS.

For more information, contact NACDS’ Mary Staples at 817-442-1155.