Michigan
The Department of Licensing and Regulatory Affairs and the Department of Health and Human Services updated the Michigan Opioid Laws Frequently Asked Questions (FAQs) last week on June 1.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Mississippi
The Board of Pharmacy issued a statewide standing order allowing pharmacists to dispense by request naloxone without a prescription. Pharmacists are required to maintain proof of completion of a board-approved training program, to maintain a copy of the standing order, to fill and file the prescription as a legend drug and to provide proper counseling on the use of naloxone.
Also in Mississippi…The Division of Medicaid was instructed by CMS to change the way it reimburses for medical supplies, equipment and appliances and subsequently published a news notice. The agency is actively working with CMS and other stakeholders to address compliance with the rule while ensuring that non-physician providers continue to serve as a vital access point for patients enrolled in the Medicaid program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
With the enactment of TN Together (SB 2257/ HB 1831), there are several new prescribing and dispensing limits that will become effective on Sunday, July 1 for new patients receiving prescriptions for opioids. The Tennessee Pharmacists Association is offering a one-hour webinar, “Updates on Dispensing of Opioids in Tennessee” on Wednesday and Thursday, June 13 and 14. Webinar registrants will also receive reference materials, flow charts and opioid conversion tables to help guide implementation of the new law. This is a knowledge-based CE activity that benefits pharmacists and pharmacy technicians who provide care to patients through the dispensing of opioids. There is a fee for this program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alabama
The Medicaid Agency is pursuing a new initiative to transform the Medicaid delivery system through a flexible and more cost-efficient effort which builds off the Agency’s current case management program structure. A meeting to discuss this initiative will be held on Wednesday, June 13. The meeting is for providers, recipients, advocates and others with an interest in Medicaid.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
The Board of Pharmacy will be meeting in Little Rock on Tuesday and Wednesday, June 5 and 6. The following regulatory changes will be considered at a public hearing on Wednesday, June 6:
- REGULATION 5 – LONG-TERM-CARE FACILITIES: Proposed changes will update language regarding destruction of unused drugs for long-term care facilities to remove outdated language, update emergency kit guidelines for use in long-term care and establish a list of emergency medications that can be used in Crisis Stabilization Units.
- REGULATION 7 – DRUG PRODUCTS/PRESCRIPTIONS: Proposed changes will reduce regulatory burdens when transferring prescriptions between pharmacies and add language to specify that a pharmacist cannot dispense more of a Schedule II narcotic medication than a prescriber can prescribe.
- REGULATION 8 – WHOLESALE DISTRIBUTION: Proposed changes will clarify language in Regulation 8 to match statutory language in 17-92-108 and will also allow an outsourcing facility to operate under a single permit if they do not provide medications directly to patients.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
HB 18-1313, legislation chain pharmacy supported that clarifies that pharmacists are practitioners for the purposes of prescribing under statewide protocols, passed both Houses and was sent to Gov. John Hickenlooper (D) for his consideration.
Also in Colorado…The Board of Pharmacy is convening a stakeholder meeting on Monday, June 11 to solicit input on the following proposed draft rules before commencing the formal rulemaking process.
- Rule 3.05.00 – Would establish a new rule acknowledging pharmacist’s ability to issue a prescription for and dispense OTC medications to recipients under the Colorado Medical Assistance Act.
- Rule 6.00.00 – The purpose of any proposed amendments to Board Rule 6.00.00 is to address the requirements of drug therapy management.
- Rule 14.00.40 and 14.00.80 (telepharmacy)
- Proposed draft changes to Rule 14.00.40 would require any telepharmacy that dispenses more than 50,000 dispensing units in a calendar year to register with the Board as a prescription drug outlet.
- Proposed draft changes to Rule 14.00.80 would establish an inspection and visitation timeline based on dispensing volume for consultant pharmacists with responsibility over telepharmacy sites.
- Rule 17.00.00 (collaborative pharmacy practice), Rule 17.00.00 Appendix A (statewide protocol for dispensing hormonal contraceptive patches and oral contraceptives) and Rule 17.00.00 Appendix B (statewide protocol for dispensing tobacco cessation products):
- Proposed draft revisions to Rule 17.00.00 outline the specific education / training to participate in statewide protocols as part of collaborative pharmacy.
- Proposed draft revisions to Rule 17.00.00 Appendix A replace references for “prescribing” contraceptives pursuant to the statewide protocol with references to “dispensing” contraceptives pursuant to the statewide protocol
- Proposed draft revisions to Rule 17.00.00 Appendix B replace references for “prescribing” smoking cessation products pursuant to the statewide protocol with references to “dispensing” smoking cessation products pursuant to the statewide protocol
- Rule 25.00.14 – Would allow and address the corresponding expectations of involved pharmacists in the packaging and labeling of medication for a specific patient by an automated device at a specialized prescription drug outlet.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
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.