New York
Gov. Andrew Cuomo (D) issued an emergency order which allows pharmacists to administer flu vaccines to children ages two to 18 years. Subsequently, NACDS worked with the Chain Pharmacy Association of New York State and the New York State Department of Health (DOH) on implementation concerns. Over the weekend, Howard Zucker, Commissioner of DOH, signed a statewide, non-patient specific order for licensed pharmacists with a certificate of administration issued by the New York State Education Department to vaccinate patients ages two years to 18 years against seasonal influenza.
Also in New York…NACDS and the Chain Pharmacy Association of New York State met with state Medicaid staff and were advised that the changes to Medicaid fee-for-service pharmacy reimbursement using NADAC plus a $10.00 professional dispensing fee will be implemented effective Thursday, February 22, on a prospective basis. Staff do not yet know when retroactive adjustments to April 1, 2017, will be made.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Oklahoma
The Board of Pharmacy and the Department of Mental Health and Substance Abuse Services are offering two free continuing education offerings for a full day conference on The Opioid Epidemic: What Pharmacists Need to Know. To register for either the Friday, March 9 meeting at the University of Oklahoma Tulsa-Schusterman Center Perkins Auditorium or the Friday, March 30 meeting at Moore Norman Technology Center South Penn Campus, contact lharrison@pharmacy.ok.gov.
Pennsylvania
SB 542, legislation that would allow a pharmacist to dispense up to a 30-day supply of medication as an emergency refill, passed both chambers unanimously and has been sent to Gov. Tom Wolf (D) for his signature. The bill amends the current statute which only allowed a 72-hour supply to be dispensed.
Washington
NACDS submitted a letter to the members of the Washington State House of Representatives Health Care and Wellness Committee in support of the State Department of Health’s legislation removing a burdensome, antiquated requirement that all e-prescribing systems be approved by the Pharmacy Quality Assurance Commission, formerly the Board of Pharmacy.
Michigan
The Department of Licensing and Regulatory Affairs filed Administrative Rules with the Office of the Great Seal to create a standing order for dispensing opioid antagonists that was effective January 23.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Iowa
The Department of Human Services (DHS) issued an Informational Letter with details about its upcoming cost of dispensing survey. As in previous years, NACDS submitted feedback to DHS about the survey instrument. Surveys will be mailed Tuesday, February 6 with a due date of Friday, March 30.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New York
NACDS joined the New York State pharmacy associations in a Medicaid meeting to discuss details of the Governor’s budget proposal. New details include that the Medicaid Managed Care Medication Adherence provision would allow managed care plans to consider—not mandate—medication synchronization. Of high interest is a new proposal to institute an opioid surcharge of two cents per morphine milligram equivalent on the first sale of opioid prescriptions in the state. At the meeting, the state confirmed that they would target pharmacies as the first sale in the state. The state anticipates this will generate $170 million the first year of implementation. The stated goal of the surcharge is to prevent opioid addiction and prescribing. The budget will be completed by Sunday, April 1.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Medicaid reached out to the North Carolina Retail Merchants Association regarding reports that numerous pharmacies in the western part of the state are reporting little or no inventory of brand name Tamiflu (which is a preferred product on the North Carolina Medicaid Preferred Drug List). The Department has confirmed with Roche that there is no market shortage of brand name Tamiflu and other wholesalers also confirmed there was plenty of inventory with more on the way. Please contact your store operations professionals to check your Tamiflu inventory. North Carolina Medicaid would appreciate any assistance you may be able to provide to make sure your pharmacies throughout North Carolina have adequate inventory of brand name Tamiflu for North Carolina Medicaid beneficiaries.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Gov. Doug Ducey (R) called for a special session in January to combat the opioid crisis. The Arizona Department of Health Services has developed 12 policy recommendations to address the opioid crisis, including “requiring” e-prescribing, ending dispensing of controlled substances by prescribers, and requiring pharmacists to check the prescription drug monitoring program prior to dispensing.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Pharmacy laws passed by the legislature and signed by Gov. Jerry Brown (D) that took effect January 1, 2018, are available on the Board of Pharmacy’s website in Pharmacy Law Changes for 2018 under the “Popular Pages” heading. The online Law Book under “Popular Pages” also has been updated with new laws for 2018.
Also in California…A new pharmacy provider Self-Attestation Claim Volume Process for Medi-Cal fee-for-service started in mid-January and will continue through the end of February. The Department of Health Care Services (DHCS) is implementing a new fee-for-service reimbursement methodology for covered outpatient drugs. Part of this new methodology is a two-tiered professional dispensing fee based on a pharmacy provider’s total (Medi-Cal and non-Medi-Cal) annual pharmacy claim volume ($13.20 if less than 90,000 claims per year; $10.05 if 90,000 or more). Reporting the claim volume is a self-attestation process, which will be submitted electronically. Pharmacy providers seeking the higher of two professional dispensing fees as part of the forthcoming reimbursement changes for covered outpatient drugs should either refer to the Pharmacy Provider Self-Attestation FAQs or call the Telephone Service Center at 1-800-541-5555.
Colorado
The Legislature convened its 2018 legislative session on January 10.
New Mexico
The Legislature convened its 30-day fiscal only legislative session on January 16. For the first time in years, the state has a budget surplus.
Louisiana
Effective January 16, the Department of Health renewed a standing order for naloxone allowing participating pharmacists to dispense naloxone to laypeople including caregivers and family and friends of an opioid user.
Also in Louisiana…Effective January 1, 2018, the final rule of the Department of Health, Board of Pharmacy, amended regulations under LAC 46.LIII, Chapter 9 to require pharmacy technician candidates to demonstrate proof of enrollment in a training program to qualify for the candidate registration was adopted. The rule also requires the training program selected by the candidate to be accredited by a national accreditation organization approved by the board. In addition, the rule requires applicants to demonstrate successful completion of a nationally accredited training program and makes technical changes regarding continuing education records and the scope of practice. Finally, the rule allows for additional board-approved technician certification examinations, clarifies terminations of enrollment, deletes a notification requirement for training programs and revises practical experience requirements for candidates enrolled in training programs.
Idaho
The state legislature unanimously approved the Board of Pharmacy’s rule re-write eliminating over half the Pharmacy Practice Act word count, almost three quarters of the restrictions on practice, and reducing the Act to just six categories of licensure.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oklahoma
In a letter to Speaker of the House of Representatives Charles McCall (R), a growing coalition of stakeholders urged support for legislation that would mandate e-prescribing. The letter also refutes several erroneous claims made recently by the President of the Association of American Physicians and Surgeons.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Texas
Beginning January 9, the Health and Human Services Commission limited the daily morphine equivalent dose (MED) that people enrolled in Medicaid fee-for-service may receive to 300 MED, and will be applied to all opioid prescriptions for all clients, with exceptions for people diagnosed with cancer or those receiving palliative or hospice care.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy, University of California, San Francisco School of Pharmacy and U.S. Drug Enforcement Administration are hosting an educational forum on Saturday, January 27 in San Francisco to train pharmacists on drug diversion trends, pharmacy burglaries, prescription drug abuse and overdose prevention. Pharmacists will receive six hours of continuing education credit for attending the day-long event, plus an additional hour can be earned at the end of the day to meet the requirements of the pharmacist protocol to provide naloxone. Space is limited, and preregistration is strongly encouraged. To register, email your full name and license number to registration@dca.ca.gov.
Also in California…The Board of Pharmacy has added an additional Public Board Meeting on Thursday, January 11 and published a Notice of Meeting Agenda.
Also in California…In a letter sent in December, NACDS, in partnership with the California Retailers Association and the California Pharmacists Association, continues to press the Department of Health Care Services to implement Assembly Bill 1114 (2016, Eggman) to pay pharmacists for providing certain healthcare services.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Colorado
In January 22, the Board of Pharmacy will be seeking stakeholder input on the following proposed draft rules to regulate the practice of pharmacy.
- Rule 5.01.40 and 5.01.50—The purpose of these proposed amendments is to address the minimum hourly operations and security requirements for a pharmacy when a pharmacy does not possess prescription drug or controlled substance stocks.
- Rule 6.00.00—The purpose of these proposed amendments is to address drug therapy management and how this practice may correlate with collaborative pharmacy practice.
- Rule 17.00.00 and Appendix A—The purpose of these proposed amendments is to address collaborative pharmacy practice and how this practice may correlate with drug therapy management.
- Rule 20.00.00—The purpose of the proposed amendments is to allow a fulfillment pharmacy to deliver a prescription directly to the patient in lieu of returning the filled prescription to the originating pharmacy for dispensing to the patient of non-controlled substances.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
NACDS and the Connecticut Association of Community Pharmacy met with Rodrick Marriott, Director, Connecticut Department of Consumer Protection, Drug Control Division, to discuss the January 1, 2018 launch of mandatory e-prescribing for controlled substances Schedules II through V prescriptions. Subsequently, the Drug Control Division published an FAQ that included a statement noting that “a pharmacist is NOT required to verify that a prescriber has a waiver from the requirement to electronically prescribe, or properly falls under one of the other exceptions from the requirement to electronically prescribe. Pharmacists may continue to dispense medications from otherwise valid written, oral, or fax prescriptions that are consistent with current laws and regulations.”
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Illinois
Gov. Bruce Rauner (R) signed into law SB 772, effective January 1, 2018, requiring prescribers to register with the Prescription Monitoring Program (PMP) and, with certain exceptions, to document their check of the PMP before prescribing Schedule II controlled substances.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Michigan
Lt. Gov. Brian Calley (R) signed into law a package of legislation intended to address the opioid epidemic and several bills of which directly pertain to pharmacy. SB 166requires prescribers by Friday, June 1, 2018 to register with the Prescription Monitoring Program and, with certain exceptions, to obtain reports for controlled substance prescriptions of greater than a three-day supply. SB 274 allows pharmacists in certain circumstances to partially fill a controlled substances prescription and prohibits prescribers from prescribing more than a seven-day supply in a seven-day period when treating a patient for acute pain.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
Minnesota
The e-Health Advisory Committee issued its final recommendations to Gov. Mark Dayton (DFL) to address the opioid epidemic. Of note is the recommended goal of increasing electronic prescribing of controlled substances from its current 20% to 80% by 2020 and to develop and implement policy options for enforcement if the goal is not met.
For more information, contact NACDS’ Joel Kurzman at 847-905-0555.
New Jersey
NACDS submitted comments to the Board of Pharmacy urging regulators to reconsider plans to require compliance with USP Ch. <800> by July 1, 2018, ahead of the USP’s December 1, 2019 effective date. At its December meeting, the Board heeded the concerns raised by NACDS and others in the pharmacy community about early implementation and opted to delay compliance until December 2019.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New York
CMS has approved the State Department of Health’s Medicaid State Plan Amendment for cost-based reimbursement plus a $10.00 professional dispensing fee retroactive to April 1, 2017 for the Medicaid fee-for-service program. The new professional dispensing fee is $10.00 per prescription or written order by a practitioner and does not apply to over-the-counter products that do not meet the definition of a covered outpatient drug per section 1927K of the Social Security Act. The following are changes to product reimbursement in the Medicaid fee-for-service program:
- Generic Drugs: The lower of NADAC or WAC-17.5% if no NADAC exists; or the Federal Upper Limit (FUL); or State Maximum Acquisition Cost (SMAC); or the dispensing pharmacy’s usual and customary price charged to the general public.
- Brand Name Drugs: The lower of NADAC or WAC-3 & 3/10% if no NADAC exists; or the dispensing pharmacy’s usual and customary price charged to the general public.
The state will initiate the reimbursement changes in two phases. In the near future, the State intends to give pharmacies two weeks’ notice that the new rate will be initiated on all Medicaid fee-for-service claims. After the successful roll out of the claims processing with the new rates, the State will begin a retroactive adjustment of past claims. The adjustment will be spread out over a period of time.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Oklahoma
During the second special legislative session held in mid-December, lawmakers approved an additional appropriation of $17.7 million to fund the Oklahoma Health Care Authority (OHCA), including the state’s Medicaid program. These funds, coupled with the $22.8 million that was provided when Gov. Mary Fallin (R) approved sections of the appropriations bill on November 17, give the OHCA enough money to operate at current levels until April 2018. To officially withdraw the six percent across the-board Medicaid provider rate reductions that were approved by the OHCA Board on December 1 and scheduled to be effective January 1, 2018, the OHCA held a special board meeting on December 29 to reverse the proposed provider rate reductions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.