Connecticut
On December 4, the legislature started a bipartisan, bicameral Prescription Drug Task Force, dedicated to tackling the rising costs of medications and addressing challenges in prescription drug access and pharmacy care across Connecticut.
Over the coming months, the task force will convene subcommittees to focus on key areas, including:
- Pharmacy Benefit Managers (PBMs)
- Drug shortages and importation
- Patient protection, pharmacy practice, rare diseases and innovation
- Drug pricing and 340B programs
NACDS will continue to participate in and monitor this task force and advocate for PBM reform and our policy principles.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Florida
The Florida Administrative Register has published a proposed rule RE: “Definition of Compounding”; see the lower left and upper right sections of page 4574.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Family and Social Services Administration (FSSA) posted a notice of intent to submit an application to the Centers for Medicare and Medicaid Services under section 1115 of the Social Security Act seeking a five-year extension of the current waiver authorities for the substance use disorder and serious mental illness demonstrations. The current demonstration is authorized through December 31, 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Iowa Pharmacy Association’s Board of Trustees received notice from Kate Gainer that she intends to step down as CEO, effective June 2025. Plans are underway to hire a search firm and appoint a search committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) Medicaid updated the immunization fee schedules reflecting coverage of the influenza vaccines for recipients of all ages and changes related to Vaccines for Children (VFC).
Also in Louisiana, the Louisiana Alliance for Retail Pharmacies (LARP) reported on the November special session on tax reforms that adjourned sine die on November 22. Unfortunately, the attempt to exempt prescription drugs from local sales tax was not successful. The local sales tax collectors claimed their revenue losses from not taxing prescriptions would be much higher than what the state forecasted. Legislators were hesitant to approve the sales tax exemption with such varying estimates of the revenue losses.
Also in Louisiana, LARP attended the Board of Pharmacy’s quarterly meeting and shared this update on regulations:
(1) Legislative Proposal 2025-A ~ Prescription Monitoring Program (PMP) Record Retention (Draft #1)- Approved
(2) Regulatory Proposal 2024-G ~ Pharmacist-in-Charge Requirements (Draft #2)- Approved
(3) Regulatory Proposal 2024-H ~ Emergency Drug Kit (EDK) Permit (Draft #1)- Approved
(4) Regulatory Proposal 2024-I ~ Marijuana Pharmacy (Draft #1)- Approved
(5) Regulatory Proposal 2025-J ~ Pharmacy Technician Certificate Qualifications (Draft #1)- Approved
Finally in Louisiana, effective January 1, 2025, Louisiana Medicaid is implementing changes to the Single Preferred Drug List (PDL). Most of the brand drugs that were previously preferred over the generic versions will be moved to a non-preferred status. Revlimid® brand will remain co-preferred with the generic version.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Board of Pharmacy held its regular meeting on December 5. The agenda included regular business and limited delegation orders that expire at the end of the year.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Maryland
The Prescription Drug Affordability Board (PDAB) posted the agenda for the next Stakeholder Council meeting on December 16 at 2:00 pm. You must register for the meeting to receive the log-in information. More information about the Stakeholder Council and the PDAB are available through their webpage.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The Board of Pharmacy issued the following notices:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Department of Health released the first-ever state mandated financial report on the 340B Drug Pricing Program. As a follow up, Drug Channels published an article summarizing the report’s highlights.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy amended rule 20 CSR 2220-4.010 governing new Board fees, that took effective on October 30.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
Medicaid has contracted with Myers and Stauffer LC to perform a pharmacy cost of dispensing survey. The due date for the cost of dispensing survey will be January 29, 2025. All providers are encouraged to participate. The cost of dispensing survey tool and instructional letters are available online.
Also in Nebraska, the Department of Health and Human Services Drug Utilization Review (DUR) Board posted the November 12 draft meeting minutes. The next meeting will be on January 14, 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
Gov. Kathy Hochul (D) signed A8880A/A1010B, an Act Prohibiting Label Restrictions of Over-the-Counter (OTC) Drugs. The bill makes it illegal to knowingly alter, mutilate, destroy, obstruct or remove by means of a price sticker or otherwise the whole or any part of the label, including where applicable the expiration date displayed thereon, of any OTC drug or cosmetic.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
On October 25, the US Department of Agriculture (USDA) Food and Nutrition Service (FNS) approved the state’s Department of Health and Human Services (DHHS) extension request to waive the statutory definition of “food” under Section 3(k)(1) of the Food and Nutrition Act of 2008, as amended and accompanying regulations at 7 CFR 271.2. This extension waiver approval allows Supplemental Nutrition Assistance Program (SNAP) households statewide, including those with the Eastern Band of Cherokee Indians, to continue to purchase hot foods with SNAP benefits through December 4, in order to increase access to food after power outages as a result of Tropical Storm Helene that began on September 26. Customer questions should be directed to the EBT Call Center at 1-866-719-0141.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Effective January 1, 2025, At-home COVID-19 test kits will no longer be covered under pharmacy benefits for Medicaid fee-for-service (FFS) and managed care members. Any claims received on or after January 1 will result in a rejection. Patients may obtain free At-home COVID-19 test kits and access additional resources for free testing by visiting the Department of Health and Human Services’ COVID testing page. If you have questions, please contact the Gainwell single PBM (SPBM) Customer Service Center at 833-491-0344.
Also in Ohio, the Board of Pharmacy released its 2025 meeting schedule.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The December 11-12, 2024 Board of Pharmacy Meeting agenda and meeting materials are now available. Please note that on December 11, the board will meet in Executive Session immediately after recusal announcements and anticipates resuming Open Session between 4:00 pm-5:00 pm. Also please note that on December 12, the board will meet in Executive Session after roll call and anticipates resuming Open Session at 1:00 pm. The Public may attend the board meeting in person during Open Session. Please see the meeting agenda for additional meeting information. Please be advised that additional meeting materials may be added to the agenda prior to the board meeting. Visit the board website for current meeting materials.
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted an agenda for its December 18 meeting. Please note the “Board discussion and vote on both the policy recommendations for the Oregon Legislature and the annual report to the Oregon Legislature as well as the board’s receipt of the initial, preliminary list of prescription drugs and insulin for affordability review”. You must register in advance to participate.
Finally in Oregon, the Board of Pharmacy published its November 2024 Newsletter to Promote Pharmacy and Drug Law Compliance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The Medicaid Program posted its December 2024 Provider Update. All previous provider updates may be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
Effective for dates of service on or after January 1, 2025, the Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for the physician-administered drugs to ensure use is consistent with the medication’s indication(s) and appropriate clinical guidelines. This change only applies to medications administered to Healthy Connections Medicaid members enrolled in the Medicaid fee-for-service (FFS) program.
The list of physician-administered drugs for which a PA is required when administered to a FFS Medicaid member is available in the Procedure Codes section of the Physicians Services Provider Manual on the SCDHHS website. The list in the manual will be updated with the additional physician-administered drugs requiring a PA beginning January 1, 2025. The list of additional drugs is available online.
Requests for PA and questions about this bulletin should be submitted to Prime Therapeutics at https://gatewaypa.com or by calling (800) 424-8219 between 8:00 am-5:00 pm Monday-Friday.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare released a document summarizing the temporary changes effective September 27, 2024, in counties impacted by Hurricane Helene, aligning with Gov. Bill Lee’s (R) Executive Order No. 105. These changes aim to provide relief to victims of severe weather and flooding and will remain in effect until December 25.
Also in Tennessee, TennCare has made numerous changes to the TennCare Pharmacy Program. Please visit the Optum landing page for these updates. For more information, contact OptumRx’s Pharmacy Support Center at 866-434-5520.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy posted the rules adopted at the November 5 quarterly board meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Department of Health (VDH) issued a clinician’s letter related to an increase in pneumonia and pertussis cases in the Commonwealth. This and other provider communications are also available on the VDH webpage.
Also in Virginia, the Department of Health and Human Services issued a report to the Governor and General Assembly recommending that the state not move forward with a Drug Importation Program. The report is the result of a legislatively mandated workgroup on “The Feasibility of a Wholesale Prescription Drug Importation Program” that found that there was no guarantee of cost savings by implementing an importation program and that the better course of action was to wait and see if other states’ programs move forward with any positive outcomes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The Pharmacy Quality Assurance Commission (PQAC) will meet on December 12. The agenda and meeting materials have been posted.
Also in Washington, the Health Care Cost Transparency Board (Cost Board) is holding its first Public Hearing on December 12. The full meeting packet is available on the meetings and materials page.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following:
- November 2024 Pharmacy Medi-Cal Update Bulletin
- November 2024 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
Also in California, the Department of Health Care Services posted the following alerts and weekly notice on the Medi-Cal Rx Web Portal:
- Mass Adjustment for COVID-19 Vaccine Incentive Fee for Impacted Claims with a Date of Service October 1, 2022, through December 31, 2023
- Medi-Cal Rx Weekly Wrap-up for November 8-14
- State of Emergency Override Activation: Submission Clarification Code 13
Finally in California, the Board of Pharmacy proposed the following rules:
- Discontinuation of Business
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- 45-Day Comment Period: November 15, 2024, to December 30, 2024
- Quality Assurance Programs
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- Notice of Modified Text
- Modified Text
- 15-Day Comment Period: November 15, 2024, to December 2, 2024
- Please send your company’s comments on the modified text to Sandra Guckian by November 25, 2024.
- Compounded Drug Preparations
- Board Requested Format for Submitting Comments
- 30-day Comment Period: November 8, 2024, to December 9, 2024
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
Please see the updated Continuous Glucose Monitor (CGM) Prior Authorization Criteria from the Department of Healthcare and Family Services.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services (HHS), Iowa Medicaid posted INFORMATIONAL LETTER NO. 2641-MC-FFS-D – Ownership and Control Disclosure (OCD) Reminder effective upon receipt.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Board of Pharmacy posted the draft November 4 meeting minutes.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.