New Hampshire
The state legislature adjourned on May 23 after taking up several legislative proposals of interest. Gov. Christopher T. Sununu (R) signed into law SB 332, legislation facilitating medication synchronization, and SB 333, legislation allowing pharmacy interns to administer the same vaccinations for which pharmacists are authorized to administer. HB 1791, legislation permitting substitution of interchangeable biologics and declaring that contracts between insurers/PBMs and pharmacies shall not contain a provision prohibiting the pharmacist from providing certain information to an insured which would prove beneficial in lowering prescription drug costs, and HB 1822, legislation making hormonal contraceptives available directly from pharmacists via a standing order, have passed both legislative bodies and will be considered by the governor. Finally, HB 1418 establishes a commission to study greater transparency in pharmaceutical costs and drug rebate programs. The study report is due by Thursday, November 1.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Nevada
The Board of Pharmacy will be meeting in Reno on Wednesday and Thursday, June 6 and 7. Two public hearings—related to prescription readers and practitioner access to the Prescription Monitoring Program database and related to prescribing and dispensing of controlled substances for treatment of pain—will also be held on Thursday, June 7.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Tennessee
Effective Sunday, July 1, all pharmacies participating in the TennCare or CoverKids pharmacy program must have a valid TennCare issued Medicaid ID. Failure to obtain a valid Medicaid ID may result in rejected claims and disqualification as a provider for these networks. This requirement applies to MagellanRX and Express Scripts and any subsequent pharmacy benefits manager for TennCare or CoverKids. Pharmacies that need a Medicaid ID are required to register through the TennCare electronic registration portal.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Colorado
This week, Gov. John Hickenlooper (D) signed into law SB 18-022 that includes a seven–day opioid prescribing limit.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
The state legislature adjourned after passage of SB 197 (Public Act No. 18-74), permitting substitution of interchangeable biologic products, and SB 246 (Public Act No. 18-77), directing the Commissioner of the Department of Social Services to make recommendations for automatic fills in the Medicaid fee-for-service program. The legislature rejected a proposal requiring the Prescription Drug Monitoring Program database be checked each time an opioid is filled and also rejected a proposal prohibiting prescriptions of Narcan® (an opioid antagonist) to a family member. With the entire legislature up for re-elections, controversial budget issues were punted until after the election.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Iowa
Gov. Kim Reynolds (R) signed into law SF 2322 into law, effective 90 days after adjournment, containing a wide-ranging provisions impacting community pharmacy. The bill authorizes the Board of Pharmacy to develop statewide protocols for naloxone, nicotine replacement products and immunizations. Once the statewide protocol for immunizations takes effect, pharmacists will have independent authority to provide immunizations, meaning a local protocol or a prescription from a physician is no longer required. Pharmacists will be able to administer flu vaccines to patients age six months of age and older (currently eighteen years and above, except in public health emergencies). Pursuant to a protocol to be developed by the Board in consultation with the Department of Public Health, pharmacists will be able to administer the final two doses of HPV vaccination to patients eleven years of age and older. The law also permits technician product verification in the community and hospital settings, charging the Board of Pharmacy with issuing rules for implementation. NACDS acknowledges the Iowa Pharmacy Association for its leadership and advocacy efforts to enact this legislation.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Louisiana
The Department of Health has been working towards developing a single preferred drug list (PDL) to be used for both the Medicaid fee-for-service (FFS) and the Medicaid managed care (MCO) programs, thereby replacing the six different Medicaid drug lists currently in use. Comments on the draft PDL will be accepted via email before Thursday, May 31.
Also in Louisiana…On May 22, Gov. John Bel Edwards (D) convened a two-week special session to address a $648 million budget deficit. This is the sixth special session the Governor has called in the past two years. A balanced budget must be enacted by the start of the next fiscal year on Sunday, July 1.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
NACDS joined the Chain Pharmacy Association of New York State and New York pharmacy community to talk with key state legislators during a lobby day focused on drug take back initiatives. Currently, there are several pending legislative proposals in both the Assembly and the Senate. It remains unclear which of these proposals will advance.
Also in New York…NACDS attended the recent meeting of the New York State Board of Pharmacy. During the meeting, Surescripts led a discussion on the quality improvements in electronic prescribing as part of its prescription accuracy initiatives. Also, several board members suggested a discussion of supervising pharmacists’ roles, requirements and responsibilities as a topic for a future meeting.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
South Carolina
HB 4117, sponsored by Rep. Phyllis Henderson (R), was signed by Gov. Henry McMaster (R) on May 18 and was effective immediately. This measure allows drug control to provide data in the prescription monitoring program to the presiding judge of a drug court pertaining to a specific case involving a designated person.
Also in South Carolina…HB 3826, sponsored by Rep. Chip Huggins (R), was signed by Gov. Henry McMaster (R) on May 17. Effective 60 days after signing, this measure requires all prescriptions for Schedule II through V controlled substances to be written on tamper-resistant prescription pads, unless transmitted by fax, orally or electronically.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
SB 2362, sponsored by Sen. Rusty Crowe (R), was signed by Gov. Bill Haslam (R) on May 21. Effective immediately, this measure specifies that a pharmacy or pharmacist has the right to provide an insured information regarding the amount of the insured’s cost share for a prescription drug. The measure prohibits a pharmacy or a pharmacist from being penalized by a pharmacy benefits manager for discussing such information or for selling a lower priced drug to the insured if one is available.
Also in Tennessee…SB 777, sponsored by Sen. Ed Jackson (R), was signed by Gov. Bill Haslam (R) on May 21. This measure makes several changes related to prescribing and dispensing of buprenorphine.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Florida
Last fall, CMS approved the State Plan Amendment (SPA) for a new Medicaid fee-for-service reimbursement methodology. Subsequently, the Agency for Health Care Administration promulgated a final rule consistent with the approved SPA. Medicaid will begin reimbursing pharmacy providers using the new methodology on Friday, June 15. A subsequent provider alert will outline the plan for scheduling the reprocessing of pharmacy claims retroactive to April 1, 2017 in order to comply with the approved SPA.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
SB 422, sponsored by Sen. Renee Unterman (R) and signed by Gov. Nathan Deal (R) on May 3, exempts pharmacists acting within their scope of practice from the laws requiring registration of a clinical laboratory for all tests, rather than just capillary blood tests.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Maryland
The Maryland Medicaid Pharmacy Program will be conducting a stakeholder meeting on Wednesday, June 13 in Baltimore to discuss the mandatory pharmacy cost of dispensing survey that will be conducted this summer. All providers that participate in the Maryland Medicaid Pharmacy Program are invited to attend.
For more information, contact NACDS’ Sandra Guckian at 703-837-4195.
Texas
On May 15, the House Select Committee on Opioids and Substance Abuse held a hearing focused on the prescription monitoring program and the role of healthcare professionals in preventing overutilization and diversion of addictive prescription drugs. This was one of a series of interim committee hearings studying how to best address the opioid abuse problem. Kroger pharmacist Jeff Loesch led the pharmacy panel educating lawmakers on the NARxCHECK program, and pharmacist Jeremy Ashley with Brookshire Grocery Company discussed mandatory e-prescribing of controlled substances. 5.
Also in Texas…The Health and Human Services Vendor Drug Program announced that there will be a one-day delay in reimbursement payments for Medicaid fee-for-service pharmacy providers, Children with Special Health Care Needs Services Program and Kidney Health Care Program because of the Memorial Day holiday on Monday, May 28. Claims submitted between Friday, May 18 and Thursday, May 24 will be paid Tuesday, May 29, with deposits available Thursday, May 31. Claims submitted on or after Thursday, May 24 will resume on the regular cycle.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
Gov. Phil Scott (R) signed into law SB 175, that proposes to establish a program to allow wholesale importation of prescription drugs from Canada into the state, create a bulk purchasing program for prescriptions drugs through the Department of Health, require manufacturers to provide notice before introducing new, high-cost drugs to the market and direct an evaluation of the overall impact of drugs costs on health insurance premiums. In order for the program to go into effect, Vermont will need federal waivers, a plan design, approval from state’s Agency of Human Service and then additional approval by the Legislature, no earlier than 2019, with a new fee to fund the operational costs prior to implementation. Since Vermont has no funding obligations, National Academy for State Health Policy has offered to fund the design of the template for the proposed system, estimated at $200,000 to $800,000. Currently, federal law generally prohibits commercial importation of drugs from Canada unless the U.S. Department of Health and Human Services Secretary certifies to Congress that such a commercial importation program poses no additional risk to the public’s health and safety and results in a significant reduction in the cost of drugs to the American consumer.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
California
To fill a vacancy on the 13-member Board of Pharmacy, Gov. Jerry Brown, Jr. (D) appointed Shirley Kim of Los Angeles as a public member. Kim has been an associate at Norton Rose Fulbright US LLP since 2016. She earned her law degree at the University of California, Irvine School of Law.
Also in California…New officers were elected at the May 2 Board of Pharmacy meeting. Serving as president is independent pharmacist Victor Law. Public member Greg Lippe is now the vice president and hospital pharmacist Allen Schaad was re-elected to serve as treasurer.
Also in California…NACDS and the California Retailers Association submitted a joint letter to legislators outlining their position on statewide drug and/or sharps take back legislation (SB 212 & AB 444). The associations stated their support for a statewide framework funded by manufacturers. They also affirmed that it is essential that pharmacies’ participation be voluntary with a variety of disposal options that they can offer to meet local convenience thresholds based on the needs of their communities.
Also in California…AB 2741, sponsored by Assemblywoman Autumn Burke (D), passed the Assembly 53-0. If enacted, this legislation would limit doctors from prescribing more than five days’ worth of opioid drugs to minors and includes certain exemptions for situations such as medical emergencies, hospice care and other instances where doctors deem a longer prescription medically necessary. It now goes to the Senate for consideration.
Lastly in California…On May 9, the Assembly Budget Subcommittee No. 1 on Health and Human Services passed a $1 billion healthcare spending proposal on a party-line vote. The $1 billion proposal allocates $330 million to expand coverage in the Medi-Cal program, $50 million to increase healthcare cost transparency, $114 million to expand the healthcare workforce and $500-$550 million to provide healthcare premium assistance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
The state’s Human Services Department issued “Letter of Direction #80—Repeal & Replace“, explaining the Medicaid managed care organization’s (MCO’s) new reimbursement policies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oklahoma
On May 8, Gov. Mary Fallin (R) signed into law HB 2931, legislation mandating e-prescribing for Schedules II-V controlled substances prescriptions by Wednesday, January 1, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
South Carolina
HB 5038, sponsored by Rep. Todd Atwater (R), was signed by Gov. Henry McMaster (R) on May 3 and effective immediately. Among the various provisions, this measure prohibits a pharmacy benefits manager from prohibiting a pharmacist or pharmacy from providing an insured information on the amount of the insured’s cost share for a prescribed drug.
Also in South Carolina… HB 4488, sponsored by Rep. Phyllis Henderson (R), was signed by Gov. Henry McMaster (R) on May 3 and effective immediately. This measure allows a coroner, deputy coroner, medical examiner or deputy medical examiner who is involved in a specific inquiry into the cause and manner of death of a person to have access to data in the prescription monitoring program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Dakota
The Department of Social Services (DSS) issued a notice to all Medicaid providers about changes to the prescription drug benefit concerning opioids, including an early refill threshold and supply limits, targeted for implementation on Friday, June 1 and Wednesday, August 1, respectively. The DSS notice also includes additional policy changes and implementation timelines.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Tennessee
On May 3, Gov. Bill Haslam (R) signed into law HB 1993. The newly enacted law requires that on or after Wednesday, January 1, 2020, prescriptions for Schedule II controlled substances in the state of Tennessee must be issued as an electronic prescription from the person issuing the prescription to a pharmacy. The name, address and telephone number of the collaborating physician of an advanced practice registered nurse or physician assistant shall be included on the electronic prescription. The measure does exclude certain types of prescriptions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commissions’ Vendor Drug Program (VDP) announced that beginning Friday, May 18 prescribing pharmacists will be able to enroll in Texas Medicaid as an ordering, referring or prescribing provider. In accordance with federal regulation 42 CFR 455.410, prescribing pharmacists who write prescriptions for people enrolled in Medicaid fee-for-service must enroll as an ordering, referring or prescribing provider. This requirement does not apply to Medicaid managed care. To allow prescribing pharmacists time to enroll with Texas Medicaid Healthcare Partnership (TMHP), VDP will not deny pharmacy claims when the prescribing pharmacist is not enrolled until Monday, August 20. Please refer to the TMHP website for more information and enrollment instructions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The Pharmacy Society of Wisconsin (PSW) is assisting the state Department of Justice with creating a list of local permanent drug disposal sites. If your pharmacy has a permanent drug disposal box, PSW asks that you email PSW’s Director of Public Affairs, Danielle Womack, with your pharmacy name and address.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Colorado
Letters submitted by NACDS and others opposing HB18-1538, legislation that would require pharmacies to post for the public each pharmacy’s drug prices, was killed in the House Health, Insurance and Environment Committee last week by a surprising 12-1 vote.
Also in Colorado…HB 18-1284, The Patient Drug Cost Savings Act, passed both the House of Representatives and the Senate and was signed into law by Gov. John Hickenlooper (D). Among its various provisions, the newly enacted law states a carrier or PBM acting on behalf of the carrier shall not prohibit a pharmacy or pharmacist from providing a covered person with information about the amount of the covered person’s cost share for the covered person’s prescription drug and the clinical efficacy of a more affordable alternative drug among its various provisions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Illinois
The Department of Human Services announced that, for a second consecutive year, they will receive grant money from the 21st Century Cures Act to fight the opioid crisis. Among its uses, the $16 million grant will enable enhancements to the prescription monitoring program.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.