Washington
The Department of Health posted its July monthly bulletin “epiTRENDS”.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
The Insurance Commissioner (“Commissioner”) issued Advisory Bulletin 8-2024 to all Insurance Department (“AID”) licensed pharmacy benefits managers (“PBMs”) related to PBM reimbursements to pharmacies at minimum levels to NADAC pricing amounts under Ark. Code Ann. § 23-92-506(b)(5)(A). The Commissioner had received several complaints from pharmacies against PBMs in which a PBM has reversed a payment to reduce or to remove a dispensing fee in the pharmacy’s compensation to equalize the payment to NADAC minimum pricing. Questions concerning this Bulletin should be directed to Legal Division at 501-371-2820 or by email at Insurance.Legal@arkansas.gov.
Also in Arkansas, Tim Griffith, the Attorney General is suing PBMs for their role as a cause of the opioid epidemic in Arkansas.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Servies posted the following alerts, weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal.
- State of Emergency Override Activation: Submission Clarification Code 13
- Medi-Cal Rx Weekly Wrap-up for June 28-July 4
- Medi-Cal Rx Monthly Bulletin for July
- Changes to the Medi-Cal Rx Contract Drugs List
- Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes
- Updates to the Medi-Cal Rx Provider Manual
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Hawaii
Gov. Josh Green (D) signed HB 2553 (Act 104), permitting pharmacists to order and administer ACIP-approved vaccines to persons three years of age or older and authorizing pharmacy interns and pharmacy technicians under the direct supervision of a licensed pharmacist to administer vaccines to persons three years of age or older, if properly trained.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
ACT 246 (SB 276) creates the crime of coerced criminal abortion by means of fraud when a person knowingly and intentionally engages in the use of an abortion-inducing drug on a pregnant woman, without her knowledge or consent, with the intent to cause an abortion, effective October 1, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Board of Pharmacy has given Notice of Proposed Rule-Making. The Board will be hearing public comments on August 1 at 8:30 am online or in-person. These proposed set of rules are in response to several laws enacted by the 131st Legislature:
- setting standards by which a pharmacy technician may qualify to be certified to administer vaccines;
- repeals the 12-item limit for drug outlet vending machines;
- establish standards for authorizing pharmacists to prescribe, dispense and administer HIV prevention drugs, set adequate training requirements and protocols for when there is no prescription drug order, standing order or collaborative practice agreement; and
- implement requirements to increase access to birth control by making certain contraception accessible from a pharmacist.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New Mexico
The Department of Health Care Medical Assistance Division notified Medicaid Pharmacy Providers that some of the Group and PCNs were incorrect. Here’s the updated list:
Presbyterian
- PBM Name: Capital RX
- BIN: 610744
- PCN: CRXMC
- Group: PHPCAID
United Healthcare
- PBM Name: Optum Rx
- BIN: 610494
- PCN: 4941
- Group: ACUNM
Molina
- PBM Name: CVS Caremark
- BIN: 004336
- PCN: MCAIDADV
- Group: RX51EA
Blue Cross Blue Shield
- PBM Name: Prime Therapeutics
- BIN: 011552
- PCN: SALUD
- Group: N72100 – N/A
Fee-For-Service
- PBM Name: Conduent
- BIN: 610084
- PCN: DRNMPROD
- Group: NEWMEXMED
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
NYRx, the State Medicaid Prescription Drug Program, posted a Pharmacy Prior Authorizations Programs Update. This update is effective August 1, 2024.
Also in New York, the Office of Health Insurance Programs of the State Department of Health has approved the release of the May 2024 Medicaid Update. This update includes a pharmacy reminder that Medicaid providers are required to bill applicable third parties that may be liable for a claim before billing Medicaid. Medicaid is always the payor of last resort and federal regulations require that all other available resources be used before Medicaid considers payment.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Ohio
The Ohio Board of Pharmacy issued the following communications:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted the agenda for its next meeting on July 24. Please register in advance of the meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
HB 1993, a PBM reform bill has advanced in the Senate, signaling that there is agreement among the General Assembly and the Governor’s office to pass it prior to summer recess. This week, after intense lobbying by pharmacy, the Senate adopted an amendment to the bill that not only strengthened the PBM provisions from a previous version, but also expanded pharmacy vaccine authority for children, to better align with PREP Act. Specifically, it will allow pharmacists and interns to provide all ACIP-approved vaccines to children aged 8 years and older. It also will authorize Pharmacy Technicians with national certification and vaccine training to immunize children aged thirteen years and older for flu and Covid, effective upon passage; while non-certified technicians will be eligible once the proposed Technician Regulations are approved, and they have registered and received immunization training. NACDS and the Pennsylvania Association of Chain Drug Stores have been working on both issues since the beginning of the Legislative Session in partnership with the Pennsylvania Pharmacists Association and other stakeholders. The bill passed the full Senate and needs a concurrence vote in the House.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
Acting on behalf of Gov. Greg Abbott (R) while he is out of the country on a trade mission, Lt. Gov. Dan Patrick (R) declared a Disaster Declaration for 121 counties impacted by Hurricane Beryl. The Board of Pharmacy’s Executive Director/Secretary Daniel R. Carroll, PharmD, RPh, has again authorized pharmacists in Texas to dispense up to a 30-day supply of medication (other than a Schedule II controlled substance) for patients affected in the counties of the disaster area. Board rule 291.34(b)(8)(E) outlines the procedures for dispensing medication in emergency situations.
Also in Texas, the next hybrid meeting of the Texas Pharmaceutical Initiative Board will be at 1:00 pm on July 16.
Also in Texas, the Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) will perform the semi-annual update of the Medicaid preferred drug list on July 25, based on the recommendations made at two meetings of the Texas Drug Utilization Review early this year.
Finally in Texas, The Texas Drug Utilization Review Board agenda for July 26 is now available. Refer to the Texas Drug Utilization Review Board Handbook for instructions on submitting written materials to the board before the meeting and public testimony on the day of the meeting. People providing written or public testimony must complete the appropriate testimony form and the Public Comment Registration form linked on the agenda.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Pharmacy Quality Assurance Commission (commission) is soliciting public comments on its draft rule language for Mobile Opioid Treatment Program (OTP) Units. The rules workshop will be held at the August 22 Business Meeting. The draft rule language proposes to amend WAC 246-945-060 and WAC 246-945-250 to modify registration and facility requirements pertaining to mobile OTP units and the other controlled substance registration. The Proposed Mobile Opioid Treatment Program Unit Rule Language may change in response to future feedback from the commission and the public. Written comments may be submitted to Haleigh Mauldin, Program Consultant, at PharmacyRules@doh.wa.gov until midnight on August 8. Oral comments may be provided at the August rules workshop.
Also in Washington, Apple Health’s new pharmacy point-of-sale system is a few weeks post go-live and the Health Care Authority’s pharmacy team has scheduled several listening sessions to meet with pharmacy billers to gather feedback regarding experiences with claims and prior authorizations
- July 8, 12:00 pm – 1:00 pm – Webinar ID: 841 8920 3004
- July 24, 11:00 AM – 12:00 pm – Webinar ID: 812 4519 2550
- July 30, 3:00 PM – 4:00 pm – Webinar ID: 862 7121 2
Finally in Washington, the third quarter Washington preferred drug list (PDL) has been posted to the website. The state’s PDL shows which drugs are preferred and which are non-preferred for Uniform Medical Plan and the Department of Labor and Industries.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
The Board of Pharmacy reminded licensees that both pharmacy and facility licensing renewal applications are due by 11:59 pm on June 30 or the license will expire. There is no grace period. Here are the links to the Alaska Board of Pharmacy applications and forms:
- Online Applications: Board of Pharmacy, Professional Licensing, Division of Corporations, Business and Professional Licensing (alaska.gov)
- Paper Applications: Applications & Forms, Board of Pharmacy, Professional Licensing, Division of Corporations, Business and Professional Licensing (alaska.gov)
If you have not registered your corporate entity in Alaska yet, you can find information on how to register your entity at Corporations, Division of Corporations, Business and Professional Licensing (alaska.gov).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for June 14-20.
Also in California, as part of Gov. Gavin Newsom’s (D) Master Plan for Tracking the Fentanyl and Opioid Crises, California will make its own private label branded over the counter (OTC) naloxone hydrochloride (HCL) nasal spray (CalRx®). It will be available for free to eligible organizations through the California Department of Health Care Services (DHCS) Naloxone Distribution Project (NDP) or for sale for $24 per twin-pack. The state is also working on an option for individuals to buy CalRx OTC naloxone nasal spray directly.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Administrative Register has published the following information as the Board of Pharmacy proposes the promulgation of the rules to implement new legislation. These include the following:
- Collaborative Practice Certification: HIV Postexposure Prophylaxis Certification (64B16-31.010)
- Collaborative Practice Certification: HIV Postexposure Prophylaxis Certification Course (64B16-31.011)
- Collaborative Practice Certification: HIV Postexposure Prophylaxis Certification Required Submissions (64B16-31.012).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kentucky
MedImpact, the Commonwealth’s Single PBM, issued a Preferred Drug List update (PDL update) regarding coverage of Humulin N and Novolin N vials.
Also in Kentucky, Medicaid should now be reimbursing pharmacies both an ingredient cost and an administration fee for vaccines provided to children even if the pharmacy is not enrolled in the Vaccines for Children program. Also, due to the passage of HB 274, effective July 15, 2024, pharmacies will be authorized to administer the full range of vaccines starting at age five years (currently age nine years) under a prescriber-approved protocol. If you are experiencing any issues with vaccine reimbursement from Medicaid Fee-for-Service (FFS) or Managed Care, please contact NACDS’ Jill McCormack.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Gov. Jeff Landy (R) signed into law the PEP/PrEP bill, HB 579, sponsored by Rep. Wayne McMahen (R), that will improve critical community access to HIV prevention services. With one of the highest rates of HIV in the country, the Department of Health (LDH) recognized the need for better access. LDH worked with the Louisiana Alliance for Retail Pharmacies (LARP) and other groups advocating for expanding options for at-risk patients to receive timely, convenient and lifesaving care at their local neighborhood pharmacies.
Also in Louisiana, Gov. Landry (R) announced key leadership changes. The Department of Health Secretary (LDH) Dr. Ralph Abraham transitions to the newly created Surgeon General role, Undersecretary Michael Harrington was named as the new LDH Secretary and Chief of Staff Drew Maranto was promoted to Undersecretary of LDH. The Secretary of LDH is responsible for implementing the Surgeon General’s recommendations, overseeing fiscal matters and ensuring the operations of the Department are carried out efficiently and effectively. Both the Secretary and the Surgeon General report directly to the Governor.
Also in Louisiana, LDH announced that Myers and Stauffer will be conducting a pharmacy cost of dispensing survey in August 2024 to evaluate the Medicaid pharmacy reimbursement methodology. A Zoom stakeholder meeting will be held at 9:00 am on July 15. LDH and Myers and Stauffer representatives will discuss the scope of the survey, timeline for completion and address stakeholder questions about the process.
Finally in Louisiana, Medicaid is implementing changes to the Single Preferred Drug List (PDL) on July 1, 2024. The current PDL indicated a preference of some brand name drugs over generic drugs. The revised PDL will shift both brand and generic versions of these drugs to preferred status. The new PDL will be posted online.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Prescription Drug Affordability Board (PDAB) has selected 6 drugs they propose to subject to a cost review process. If members wish to submit comments on any or all the choices, please send them to comments.pdab@maryland.gov with the subject line: Board Selected Drugs (Drug Name) by July 22. For more information on the PDAB or on the comment process, see the PDAB’s Board Selected Drugs Page.
Also in Maryland, Medicaid Fee-For-Service released Advisory #263 in reference to the Generic vs. Brand Status on Medicaid’s Preferred Drug List (PDL) effective July 1, 2024.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On June 25, MassHealth published its regular pharmacy facts update that includes revisions to the MassHealth Drug List.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Minnesota
The Department of Health’s Rx Transparency team recently sent an email to pharmacies and other reporting entities providing further instructions for filing prescription drug pricing information that will be required later this year under law. Additionally, the email reminded pharmacies licensed in Minnesota that they are required to register an account with the Department of Health’s (MDH) Online Reporting Portal and report on the Public Interest Drug lists, stating that “pharmacies that have not yet registered should do so promptly and may use our Registration Quick-Start Guide (PDF) to get started.” For more information, visit: MN Rx Transparency Home Page, Information for Reporting Entities and Public Interest Drug Lists.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Mississippi
On July 1, the Mississippi Division of Medicaid (DOM) will implement a single Pharmacy Benefit Administrator (PBA) to streamline and enhance the processing and management of pharmacy claims for all Medicaid members, including those enrolled in MississippiCAN and CHIP.
Operated by Gainwell Technologies, the PBA will also assume all pharmacy prior authorization responsibilities for drugs submitted on pharmacy claims. DOM will continue to require the use of the Universal Preferred Drug List (PDL). This decision comes after careful consideration and evaluation of various factors aimed at enhancing efficiency and transparency in the Medicaid delivery system.
Medicaid members should notice no disruption in their care if providers are prepared for this change.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Missouri
NACDS sent a letter to Gov. Mike Parson (R) urging him to sign SB 751, legislation expanding the opportunity for pharmacies to participate in the 340B drug program. The bill also prohibits pharmaceutical manufacturers from restricting where patients can access their 340B medications, a restriction not in place before the pandemic. The Governor has until July 14 to act on the bill.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services announced the launch of a new feature on the State Immunization Information System (NESIIS). Beginning June 10, 2024, Nebraskans have the option to securely download their personal (or their child’s) immunization information from NESIIS to their Android or iOS mobile device. This enables the option to share immunization records from NESIIS quickly and easily with healthcare providers, schools or other organizations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The State Department of Health released a notice of reminders to pharmacy providers in case of severe weather events. These include drug storage, vaccines for children, drug delivery and NYRx prior authorizations.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.