SB 395 Chapter Number: 501, establishing licensure, reporting, marketing, and advertising, network adequacy requirements, and 340B related provisions for PBMs, was signed by Gov. Greg Gianforte (R) on May 12, 2021.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Effective July 1, 2021, the METAVIR fibrosis score required for coverage by Nebraska Medicaid will be changed to F0. The current prior authorization criteria require a METAVIR fibrosis score of at least F2. These changes mean that patients with a METAVIR fibrosis score of F0 may have their prescribed antiviral medications to treat hepatitis C be covered by Nebraska Medicaid. Prior authorization for Hepatitis C antiviral medications will continue to be in place. See Provider Bulletin 21-11 for additional details.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
This week the full Senate passed their budget bill by a party-line vote. The passed version appropriates $5 million for Fiscal Year 2022 and $10.15 million for Fiscal Year 2023, plus Federal Medical Assistance Percentages to fund the Managed Care Supplemental Dispensing Fee. NACDS worked in partnership with the Ohio Council of Retail Merchants to advocate that funding for this program continue. It is not included in the competing versions of the budget as proposed by the Governor and the House. We will continue to champion this line item as budget negotiations continue over the next two weeks.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
HB 2677, amending the audits and administrative appeals procedures, was signed by Gov. Kevin Stitt (R) on May 4, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board issued several emergency orders to allow for the safe and effective care of patients during an unprecedented pandemic. The Board has continually reviewed these orders and made adjustments as necessary. Effective July 1, 2021, all Board-issued emergency orders are scheduled to be rescinded. Please begin planning now. Those orders pertain to Safe Harbor regarding the reuse of personal protective equipment, pickup kiosks, and remote order entry outside of a licensed facility. Those orders can be here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
NACDS sent a letter to Gov. Greg Abbott (R) urging him to sign HB 1919 into law, legislation that would help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and pharmacy benefit managers from “steering” patients to use any particular in-network pharmacy provider over another. In addition, we have been urging member companies to also contact the Governor’s office.
Also in Texas, the Board of Pharmacy hired a new Executive Director/Secretary Tim Tucker, Pharm.D., replacing Allison Benz who announced earlier this year that she would be retiring on August 31, 2021. The Texas press release can be found here.
Also in Texas, the Board of Pharmacy adopted several rules that became effective June 9, 2021.
Also in Texas, the Health and Human Services Commission has several COVID-related upcoming weekly seminars now open for registration.
Lastly in Texas, the Health and Human Services Commission (HHSC) will resume publication of the quarterly Specialty Drug List in July. Please see the stakeholder notice.pdf for more information
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Health Care Authority issued a final rule changing the time frame in which manufacturers must report new drugs marketed in the state and incorporate the prescription drug pricing transparency program’s nondisclosure agreement.
Also in Washington, effective July 1, 2021, Apple Health (Medicaid) which is administered by the Health Care Authority (agency) will implement changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program. Please view the MAC memo for more details. Additionally, 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, effective for claims with dates of service on and after July 1, 2021, Apple Health (Medicaid) updated the pharmacy Expedited Authorization (EA) List. On the Provider Billing Guides and Fee Schedules Page, scroll to Prescription Drug Program Billing Guides to access.
Also in Washington, the Office of the Insurance Commissioner issued a notice extending the Emergency Order 20-01 requiring health insurers to waive copays and deductibles for COVID-19 testing. The order also requires insurers to allow a one-time early refill for prescription drugs, suspends any prior authorization requirement for treatment or testing of COVID-19, and allows 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.
Lastly in Washington, the Department of Health issued a final rule effective June 18, clarifying dispensers must submit information to the prescription monitoring program as soon as possible, but no later than one business day. The rule also removes the requirement that a facility or entity be a trading partner with the state’s health information exchange to have access to the prescription monitoring program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Health published a notice to announce the removal of the opioid antagonist samidorphan from Schedule II of the Controlled Substances List attached to regulations under AAC 420-7-2. The action is a response to the federal Drug Enforcement Administration removing the substance on April 19. The action is effective May 19, 2021.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
HB 145, modernizing the pharmacy practice statutes, passed both the House Labor and Commerce Committee and the House Health and Social Services Committee earlier this year and will carry over and remain active for consideration as 2021-2022 continues next year. The bill defines patient care activities pharmacists may provide and empowers the Board of Pharmacy to regulate those services; empowers the Board of Pharmacy to more effectively regulate pharmacy support staff; and supports reimbursement for health care services by defining those services and including pharmacists in the state’s provider anti-discrimination statute.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.