In The States – Page 242 – Weekly news about states

California

The COVID-19 Vaccine Administration Frequently Asked Questions (FAQs) page previously found on the Medi-Cal Provider website has been divided into separate FAQs for providers and beneficiaries. These documents are available on the COVID-19 Medi-Cal Response webpage under the FAQs section. As a reminder, the Coronavirus (COVID-19) Uninsured Group FAQs are also available along with the providers and beneficiaries FAQs.

Also in California, the Department of Health Care Services launched its series of ongoing releases of enhancements, updates, and changes to improve and enhance its website navigation and user experience. A complete list of the enhancements, updates, and additional website changes can be viewed within the Medi-Cal Provider Website Release Change Log. Providers are also encouraged to subscribe to the free Medi-Cal Subscription Service (MCSS). The MCSS allows each subscriber to choose and tailor both the subject matters and types of communications they wish to receive from the Medi-Cal Program.

Lastly in California, the Board of Pharmacy recently distributed the following to licensees and stakeholders:

Updated draft versions of self-assessment forms for pharmacies and wholesalers are now posted in addition to currently adopted versions on the Board of Pharmacy website. The Board is in the process of approving the draft versions through formal rulemaking. Board regulations require pharmacies and wholesalers to complete adopted versions of self-assessment forms. However, completion of either adopted or draft versions is acceptable. The Board believes updated draft versions provide a more helpful assessment of pharmacies and wholesalers. The drafts include references to statutory and regulatory changes that occurred between 2012 and the revision date of each draft form. Self-assessments must be performed before July 1 of every odd-numbered year. Completed self-assessment forms must remain at the facility unless the Board requests submission of the form. To find the forms, go to pharmacy.ca.gov. Under the “Licensees” tab, click on Facility License Information/Renewal and scroll down to the link for Self-Assessment Forms.
The California State Board of Pharmacy extends its gratitude to all its licensees working to address the COVID-19 pandemic, including the most recent vaccination efforts underway in many pharmacies. As vaccine supplies continue to increase and vaccine eligibility expands, the Board would like to encourage pharmacies to plan appropriately when electing to provide COVID-19 vaccination services. Such planning should include:

- Ensuring sufficient staffing to maintain other pharmacy services while balancing vaccination services.
- Ensuring sufficient space to provide vaccinations safely, and sufficient space and chairs for patients to remain seated during the recommended period of observation.
- Ensuring appropriate staff is observing patients following administration of the vaccine.

Ensuring vaccination appointments can safely be accommodated with the staffing resources available.

In light of Governor Gavin Newsom’s declaration of emergency and the national declaration of emergency, and consistent with Business and Professions Code (BPC) section 4062, the California State Board of Pharmacy (Board) or the Board president through delegated authority has issued the following waivers.
- Mass Vaccination Sites
  - Amended and Reissued: April 21, 2021
  - Expiration: July 18, 2021

- Supervision of Pharmacy Interns
  - Effective: April 22, 2021
  - Expiration: July 20, 2021

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2021-04-30T09:19:53-04:00April 30, 2021|California|

Colorado

On April 24, the Pharmacy Sunset legislation pharmacies support that expands our scope of practice unanimously passed the Senate and is now pending further action in the House where we will push to have it scheduled in committee as soon as possible.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2021-04-30T09:16:36-04:00April 30, 2021|Colorado|

Indiana

House Bill 1405 PBM reform legislation NACDS supported led by Meijer passed the General Assembly and was sent to Gov. Eric Holcomb (R). There were multiple provisions important to pharmacies including (1) prohibitions on quantity or refill limits, (2) weekly MAC list updates, (3) notification to all pharmacies on successful MAC appeals and adjustments, and (4) established a formal complaint process for addressing MAC appeals and contractual issues.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Michael Silber2021-04-30T09:15:36-04:00April 30, 2021|Indiana|

Louisiana

The new Medicaid Provider Enrollment Portal designed to meet Centers for Medicare and Medicaid Services (CMS) requirements for screening and enrolling Medicaid providers and must be used by all Medicaid providers, including those who do not participate in fee-for-service will launch in June of 2021. The fiscal intermediary and current provider enrollment vendor, Gainwell Technologies, will send providers an invitation to the mailing address on file when it is time for them to visit the portal and complete the enrollment process. Providers can find additional information and submit questions on the provider enrollment webpage and in the Informational Bulletin 21-5: New Louisiana Provider Enrollment Portal

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Michael Silber2021-04-30T09:13:58-04:00April 30, 2021|Louisiana|

Nevada

AB177, legislation pharmacies strongly oppose that mandates language translations be on the prescription vial passed the Assembly and is pending action by the Senate Health and Human Services Committee on April 29. The bill requires retail pharmacies to provide the information required to be included on the label of a prescription drug in English and, upon request of a prescribing practitioner, patient, or an authorized representative of a patient, any language prescribed by regulations adopted by the Board.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Michael Silber2021-04-30T09:13:02-04:00April 30, 2021|Nevada|

Oklahoma

SB 4, legislation by Sen. Greg McCortney (R) establishing conditions when a pharmacist may substitute an interchangeable biological product for a prescribed biological product was signed into law by Gov. Kevin Stitt (R). The new law will take effect on November 1, 2021.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2021-04-30T09:12:00-04:00April 30, 2021|Oklahoma|

Texas

On April 26, the House Public Health Committee approved both the immunization bill, CSHB 678 by Rep. Phil Cortez by a vote of 10-0 and the test and treat bill, HB 2049 by Rep. Donna Howard reported favorably without amendments by a vote of 9-0. NACDS members are urged to contact members of the Texas House of Representatives asking them to VOTE YES on both HB 678 and HB 2049. More information can be found here.

Also in Texas, last week, the Texas House passed its proposed two-year, $246 billion state budget after spending hours on controversial issues such as Medicaid expansion and school vouchers.

Lastly in Texas, the Board of Pharmacy is hosting a quarterly virtual meeting on Tuesday, May 11^th at 9 AM. The agenda and conference information is available here – Texas State Board of Pharmacy

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Michael Silber2021-04-30T09:11:07-04:00April 30, 2021|Texas|

Washington

The State Pharmacy Association’s (WSPA) bill, HB 1445 by Rep. My Lihn Thai (D), clarifies that the reconstitution and mixing of nonsterile products according to FDA labeling and according to a prescription, often referred to as simple compounding, is not compounding. The bill was signed by Gov. Jay Inslee and will go into effect on July 25, 2021.

Also in Washington, Gov. Jay Inslee (D) signed into law the Second Substitute to HB 1161 which modified the requirements for the manufacturer’s drug take-back programs under the Department of Health.

Also in Washington, Apple Health (Medicaid), administered by the Health Care Authority will implement changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program. on June 1, 2021. The full SMAC list can be found on the agency’s Provider billing guides and fee schedules website under the Prescription Drug Program and applies to claims billed FFS.

Also in Washington, HB 1127 by Rep. Vandana Slatter establishes privacy and security standards for COVID-19 health data passed both houses and was sent to Gov. Jay Inslee (D) to sign into law.

Also in Washington, the Health Care Authority (HCA) sent a Provider Alert informing providers about updates to the COVID-19 vaccine clinical policy regarding the roster billing for COVID-19 vaccine administration. When billing for vaccines for fee-for-service clients, there are three options:

Bill each individual claim.
Use batch 837.
Template billing.

HCA is no longer requests that you bill the vaccine with the vaccine administration code. If you do submit a claim with both codes, HCA will not pay for the vaccine but will pay for the administration of the COVID-19 vaccine. These policies apply to both fee-for-service (FFS) providers and HCA-contracted managed care organizations (MCOs). For more information go to Apple Health (Medicaid) COVID-19 vaccine clinical policy under Reimbursement information and billing guidance.

Lastly in Washington, the Office of the Insurance Commissioner extended two Emergency Orders until May 16, 2021:

Notice requires health insurers to waive copays and deductibles for coronavirus testing. It also requires insurers to allow a one-time early refill for prescription drugs; to suspend any prior authorization requirement for treatment or testing of Covid-19, and to allow enrollees to be treated by out-of-network providers within a reasonable distance at no additional cost when the insurer does not have enough in-network medical providers.
Notice concerning insurance coverage for coronavirus diagnostic testing, prohibiting all health carriers from balance billing for Covid-19 diagnostic testing processed by out-of-network laboratories, when determined to be medically necessary. It also requests that insurers notify the agency if out-of-network laboratories submit claims but have not published a cash price or fail to accept such a price.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Michael Silber2021-04-30T09:10:13-04:00April 30, 2021|Washington|

Arizona

On April 9, Gov. Doug Ducey (R) signed into law SB 1356 (Chapter 217, Laws 2021) prohibiting PBMs, from directly or indirectly, holding a pharmacist or pharmacy responsible for a fee related to the claims adjudication process, including adjudicating a pharmacy benefit claim, processing or transmitting a pharmacy benefit claim, developing or managing a claims processing or adjudication network or participating in a claims processing or adjudication network. Pharmacies may file a complaint of a violation, and a PBM that commits a violation is subject to penalties.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Michael Silber2021-04-23T12:30:43-04:00April 23, 2021|Arizona|