California
The Board of Pharmacy is disseminating information that pharmacies are eligible to receive free drug take-back bins and paid disposal service through a federally funded program intended to combat the opioid epidemic and reduce the misuse of medications. The California Statewide Drug Take-Back Program is expected to expand options for consumers to safely dispose of unused, unwanted or expired medications – including controlled substances – for humans and pets. The program is funded by the state Department of Health Care Services (DHCS) and administered by the California Product Stewardship Council (CPSC). California licensed pharmacies, hospitals and other agencies approved by the U.S. Drug Enforcement Administration can apply to receive free collection bins. The program will pay for the cost of the bins, disposal service through 2020, technical assistance and promotion of bin locations. More information, including a program FAQ sheet and instructions on how to apply for a drug take-back bin, is available on the California Statewide Drug Take-Back Program website.
Also in California… In advance of the July 24 Board of Pharmacy meeting, NACDS and the California Retailers Association sent a letter expressing our concerns regarding the proposed regulations related to the “no pharmacist left alone” bill passed last session. (B&P Section 4113.5 /SB 1442, Statutes of 2018).
Also in California… Gov. Gavin Newsom (D) continues to move forward with the implementation of an Executive Order to take on high prescription drug costs. The DHCS announced this week that they will soon begin accepting proposals to implement a significant component of the state’s prescription drug purchasing plan. Under the proposal, DHCS will be transitioning Medi-Cal pharmacy services from its contracted managed care plans to its directly negotiated fee-for-service system, thereby purchasing on behalf of 13 million enrollees, as opposed to the current 2 million.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
NACDS received a response from the Department of Healthcare Policy and Financing regarding NACDS’ comments on the proposed rules pertaining to Medical Assistance Program Integrity. Some of our suggestions were adopted by the Medical Services Board at its July 12 public hearing.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
Gov. Ned Lamont (D) recently signed HB 7363, now Public Act 19-199, placing restrictions on clawbacks and direct and indirect remuneration (DIR) fees by pharmacy benefit managers effective Wednesday, January 1, 2020.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Minnesota
With legislation enacted for the state to comply with CMS’ Covered Outpatient Drugs Final Rule for Medicaid fee-for-service pharmacy reimbursement, next steps include filing a State Plan Amendment (SPA). To this end, the Department of Human Services (DHS) is requesting documentation of pharmacy payment of the state’s 2% wholesaler tax by Wednesday, July 31. The Minnesota Pharmacists Association has created a template to facilitate submission of acceptable documentation. The information may be emailed directly to Chad Hope, PharmD, Deputy Director, Division of Purchasing and Service Delivery at DHS.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Missouri
As part of its ongoing process to comply with CMS’ Covered Outpatient Drugs Final Rule, Missouri HealthNet has issued a cost of dispensing survey. Instructions and information can be found on the Department of Social Services web page. Survey responses are due by Friday, August 16.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nebraska
The Nebraska Health Information Initiative (NeHII) announced it will be changing vendors for the state’s Prescription Drug Monitoring Program. Uploading to the new site will be required by Tuesday, September 3, but will be available as early as Monday, August 5. If pharmacies are interested to be early adopters, please contact NeHII.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Nevada
At the July 18 Board of Pharmacy workshop meeting, the Board considered changing the ratio of pharmacist and pharmaceutical technician (currently 1:3 since 2006) to 1:8 ratio where a pharmacist can supervise up to 8 technicians or up to 5 technicians and 3 technicians-in-training. Unfortunately, board members decided to pursue adopting a 1:4 ratio and removing the ability of a clerk, defined as an individual who is not a pharmacist, intern pharmacist, pharmacy technician or pharmacy technician in training, from performing any task in a pharmacy where they come into contact with any prescription drug that is not packaged for final sale and verified by a pharmacist. This issue will be on the Board’s Workshop Agenda at its Wednesday-Thursday, September 4-5 meeting in Reno.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
Gov. Kate Brown (D) recently signed HB 2185, relating to pharmacy benefit managers, into law. Among the various provisions is language that eliminates retroactive fees, clawed back after payments from PBMs to pharmacies have already been made.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wisconsin
The Pharmacy Society of Wisconsin reminds pharmacies participating in a Pharmacy Examining Board-approved pilot program (i.e. tech-check-tech, technician ratio, or automated technology final check), the one-page reporting form is due to the Pharmacy Examining Board by Wednesday, July 31, summarizing the pharmacy’s pilot participation from July 1, 2018 to June 30, 2019. The reporting form for each pilot can be found here. Once completed, the form should be emailed to DSPSCredPharmacy@dsps.wi.gov with cc to Sharon.Henes@wisconsin.gov.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
California
NACDS and the California Retailers Association (CRA) submitted a letter urging Gov. Gavin Newsom (D) to sign AB 1803, clean-up legislation delaying the implementation of AB 315 (Chapter #905, 2018) and AB 2863 (Chapter #770, 2018) until Wednesday, January 1, 2020. Subsequently, the Gov. Newsom signed the bill into law on July 12, effective immediately. This law will provide pharmacies and health plans the time they need to set up their contracts and computer systems to allow for the cash price information to be shared effectively and efficiently when a patient chooses to pay retail price for the drug because it is cheaper. The patient can then have that amount deducted from their health plan’s required deductible.
Also in California… In response to CalRecycle’s draft regulatory text implementing SB 212 (Chapter #1004, 2018), the drug take-back and sharps law, NACDS and CRA submitted a letter detailing our concerns with the draft language. We will continue to monitor and participate in the rulemaking process.
Also in California… In response to the lawsuit filed last month by the California Pharmacists Association (CPhA) through the Californians for Access to Life-Saving Medicine, the Department of Health Care Services agreed to temporarily stop the Medi-Cal retroactive recoupments on June 14. The agreement came as the attorneys for CPhA and Deputy Attorney General (who represents the State) negotiated over the court hearing date for the judge to consider the motion for a preliminary injunction. With this agreement, CPhA has withdrawn its request for the court to consider the preliminary injunction on the shortened timeframe of July 12. Therefore, the hearing will now occur on Friday, August 30.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kansas
The City of Lawrence Sustainability Advisory Board has voted in support of a 16-cents charge for plastic and paper bags used to carry items purchased at grocery stores and retailers. According to Board’s recommendations, revenue from the bag fee would be allocated to address the business costs associated with the policy, to support local environmental education and initiatives and to support programming for low-income Lawrence residents. The measure will advance to the Lawrence City Commission for possible action. NACDS is providing support to the Kansas Pharmacists Association to exempt out prescription bags.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Missouri
Gov. Michael Parson (R) signed SB 514 into law on July 11. Among its provisions, the law requires e-prescribing of Schedule II-IV controlled substances with exceptions effective Friday, January 1, 2021. The law also updates the pharmacy practice act to include the prescribing and dispensing of any nicotine replacement therapy product. In addition, the law authorizes the Board of Pharmacy to approve, modify and establish requirements for pharmacy pilot or demonstration research projects related to technology assisted verification or remote medication dispensing that are designed to enhance patient care or safety, improve patient outcomes or expand access to pharmacy services. Finally, the law establishes the Ensuring Access to High Quality Care for the Treatment of Substance Use Disorders Act. These provisions specify that medication-assisted treatment (MAT) services will include, but not be limited to, pharmacologic and behavioral therapies. Formularies used by a health insurer or managed by a pharmacy benefits manager and medical benefit coverage in the case of medications dispensed through an opioid treatment program are to include all certain specified medications. All MAT medications required for compliance with these provisions will be placed on the lowest cost-sharing tier of the formulary.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Texas
Medicaid will publish the semi-annual update of the Medicaid preferred drug list on Thursday, July 25.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
A new law (KY Acts ch. 185) allowing pharmacists to dispense emergency supplies of insulin was effective June 27. The law closes a loophole in the state’s current emergency refill statute that excluded insulin because it does not fall into a 72-hour dose category. It also contains language to allow emergency dispensing of inhalers for treatment of chronic respiratory illnesses.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
HB 3273 awaits signature by Gov. Kate Brown (D), establishing a state-wide drug take-back program funded and designed by drug manufacturers. The bill contains local pre-emption, places enforcement and rulemaking in the hands of the Oregon Department of Environmental Quality and allows for both stationary receptacles and mail back programs. The program is scheduled to be operational by Thursday, July 1, 2021.
Also in Oregon… HB 2935 (Chapter 438) was signed into law by Gov. Kate Brown (D) requiring retail pharmacies to provide prescription readers, upon request, to their patients who are visually impaired. The prescription labels will have to be compatible with the prescription readers and be available to the patient for the duration of the prescription. The Board of Pharmacy has rulemaking authority on this law which took effect upon its passage.
Also in Oregon… Gov. Brown has signed into law SB 698 (Chapter 465), requiring all retail pharmacies to provide to patients with limited English proficiency their prescription labels in both English and the language requested. If authorized by the Board of Pharmacy by rule, the informational insert may also be included in the requested language. The state has identified at least 14 languages other than English in which prescription labels will be required to be translated. This law takes effect 91 days after the end of session that occurred on June 30. The Board will meet Wednesday-Friday, August 7-9 in Portland.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
Last week, Gov. Tom Wolf (D) signed legislation requiring commercial insurers to cover medication synchronization programs for patients on maintenance medications. HB 195 (Act No. 46), sponsored by Rep. Eric Nelson (R), passed both chambers unanimously prior to approval by the Governor. Specifically, the law requires insurers to allow coverage for partial fills, prorate patient copays and pay a full dispensing fee. It will be effective Thursday, July 2, 2020.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The Board of Pharmacy has announced a new online system (www.pals.pa.gov) and application process for new pharmacy and non-resident pharmacy applications. They will no longer accept paper applications.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
As a result of collaborative efforts by NACDS and the Washington State Pharmacy Association, Pharmacy Quality Assurance Commission adopted for final passage the elimination of the current 3:1 pharmacy technician-to-pharmacist ratio with an effective date of this fall.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Rachel Michelin, the President of the California Retailers Association (CRA), has recently hired Steve McCarthy as Vice President of Public Policy and Regulatory Affairs and Jacob (Jake) Asare as Legislative Advocate. CRA is NACDS’ in-state partner on pharmacy issues.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Hawaii
The following bills have been sent to Gov. David Ige (D) for signature:
- HB 1272 permits pharmacies to register with the U.S. Drug Enforcement Administration to collect drugs for disposal utilizing either secured collection receptacles or mail-back programs. The law, if enacted, takes effect Monday, July 1.
- SB 203 clarifies pharmacists may administer certain vaccinations and immunizations and requires a record of the immunization be maintained by the pharmacist and be available to the Department of Education and the Department of Health. If enacted, the effective date is Monday, July 1.
- SB 535 authorizes pharmacists, acting in good faith and exercising reasonable care, to prescribe and dispense an opioid antagonist to patients at risks of overdose and family members and caregivers of patients at risk. If enacted, it sunsets on Sunday, June 30, 2024.
- SB 540 allows the Board of Pharmacy to approve pilot and demonstration research projects for innovative applications in the practice of pharmacy so long as it is not construed to expand the definition of the practice of pharmacy.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Minnesota
Gov. Tim Walz (D) signed into law the Health and Human Services (HHS) omnibus bill containing a wide range of provisions notable to pharmacy, including language to comply with the CMS Covered Outpatient Drugs final rule. Effective Monday, July 1, or upon federal approval, whichever is later, Medicaid fee-for-service pharmacy reimbursement will be NADAC plus a professional dispensing fee of $10.48. Cost of dispensing surveys will be required every three years, with the initial survey to be completed by Friday, January 1, 2021. The sunset provision to the 2% wholesaler tax was removed, and the tax was reduced to 1.8%. Gov. Walz also signed legislation establishing funding from manufacturers and wholesale license holders, excluding chain pharmacy warehouses, for addressing opioid additions and creating an advisory group. Other key legislative outcomes included PBM regulation, language to facilitate medication synchronization and expanded pharmacist authority to administer intramuscular and subcutaneous injections to treat mental health and alcohol or opioid dependency.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New Mexico
In response to the recent notice from the Human Services Department announcing a $2.00 increase the professional dispensing fee for “community-based pharmacies” participating in the Centennial Care program effective Monday, July 1, NACDS sent a letter objecting to the proposed differential dispensing fee for a limited group of independent pharmacy providers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Texas
Gov. Greg Abbott (R) signed into law HB 2174, legislation to address opioid abuse and addiction, while providing key safeguards to address the needs of those suffering from chronic pain. By Friday, January 1, 2021, all controlled substances will have to be electronically prescribed. Also, the new law will limit the supply of a patient’s first opioid prescription to 10 days when that prescription is for temporary or acute pain.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
NACDS submitted a letter to the State Board of Pharmacy on proposed rules for pharmacy technicians. In our comments, NACDS sought board clarification on several issues related to the administrative process implementing the recent new statutory requirements for applicants for certification as a pharmacy technician.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health issued two final rules effective May 20, 2019.
- Final rule revising standards for the Pharmacy Benefits Management Program. The rule reinstates federal upper payment limits and conforms the reimbursement methodology for physician-administered drugs in a physician office setting with a CMS-approved state plan amendment.
- Final rule adding numerous diseases to the list of mandatory disease reporting requirements, and a requirement for children to receive meningococcal vaccinations in accordance with the Advisory Committee on Immunization Practice of the United States Public Health Service.
Also in Louisiana… Prior to adjourning on June 6, the legislature approved HR 257, a resolution by Rep. Frank Hoffmann (R) urging the Department of Health to pursue value-based payments in Medicaid to increase access to buprenorphine/naloxone and naltrexone products for opioid use disorder treatment.
For more information, contact NACDS’ Mary Staples at 817-442-1155.