Texas

Big news at the Capitol this week is what to do about Medicaid expansion which will be part of the discussion as the House debates the state’s $246B budget proposal. President Biden’s action rescinding the 1115 Waiver authorized reimbursements to hospitals, nursing homes and mental health providers for patients without insurance came as quite a surprise to lawmakers. Texas has the highest number of uninsured in the nation. Among the several Medicaid expansion bills filed, none have been heard.

Also in Texas, the Health and Human Services Committee is seeking candidates to serve on the Value-Based Payment and Quality Improvement Advisory Committee. Anyone interested should review the linked application letter to find out who the committee is seeking as representatives and if you qualify; click on the application linked here to apply to be on the committee.

Also in Texas, the Senate Health and Human Services Committee held a hearing on April 21st on SB 2195 by the Chair Sen. Kolkhorst, legislation NACDS supports that protects patients who receive prescription drug benefits through a commercial health plan subject to Texas Department of Insurance (TDI) oversight. The bill also ensures patient choice, prevents self-dealing, and prohibits clawbacks. The Committee Substitute to SB 2195 was reported favorably by a 6-0 vote.

Lastly in Texas, NACDS launched two RxIMPACT alerts urging members to call members of the House Public Health Committee asking them to vote YES on HB 678 expanding access to immunizations and HB 2049 allowing pharmacists to furnish medications according to the result of a positive CLIA-waived test for acute conditions such as flu and strep throat.

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

2021-04-23T12:17:04-04:00April 23, 2021|Texas|

Washington

The Health Care Authority issued a final rule effective May 1, 2021, requiring providers to agree that all claims for Apple Health clients in fee-for-service and managed care are subject to 340B standards as part of participation in the 340B drug pricing program.

Also in Washington, the Office of the Insurance Commissioner extended two emergency orders until May 16, 2021, that are of interest to pharmacies.

  • Notice extending the Emergency Order 20-01 requiring health insurers to waive copays and deductibles for coronavirus (Covid-19) testing. The order also requires insurers to allow a one-time early refill for prescription drugs; suspend 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.
  • Notice extending Emergency Order 20-06 concerning insurance coverage for COVID-19 diagnostic testing prohibits all health carriers from balance billing for COVID-19 diagnostic testing processed by out-of-network laboratories, when determined to be medically necessary. The order 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.

2021-04-23T12:16:03-04:00April 23, 2021|Washington|

Alabama

Effective May 1, 2021, the COVID-19 related universal prior authorization (PA) number will no longer be accepted for pharmacy overrides related to the three-month maintenance supply program. The universal PA will continue to work for claims associated with COVID-19 in other allowances (other than the three-month maintenance supply program) as described in the March 17, 2020 ALERT which can be found here.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

2021-04-16T10:06:43-04:00April 16, 2021|Alabama|

Alaska

On February 19, the Board of Pharmacy adopted regulation changes in Title 12, Chapter 52 of the Alaska Administrative Code. The final rule of the Board of Pharmacy refines the requirements for registration with the prescription drug monitoring program (PDMP) controlled substance prescription database, clarifies the requirements for registration by pharmacists before dispensing schedule II, III, or IV controlled substances under federal law, in particular clarifying the mechanism for out-of-state pharmacists to obtain a registration exemption and for those same pharmacists to meet registration requirements before dispensing controlled substances in this state and to clarify that a “prescriber” would be required to register within 30 days after initial licensure or registration with the DEA, whichever is later. These changes will be printed in Register 238, July 2021 of the Alaska Administrative Code.  The rule is effective May 6, 2021.

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

2021-04-16T10:05:59-04:00April 16, 2021|Alaska|

Arkansas

The Division of Pharmacy Services issued a final rule effective April 16 adding six opioid substances, four depressants, and two synthetic cathinones to Schedule I. The rule also adds three opioid analgesics to Schedule II, three mood-altering substances to Schedule IV, two substances to Schedule V and modifies Schedule VI removing FDA-approved cannabidiol substances from Schedule V.

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

2021-04-16T10:05:24-04:00April 16, 2021|Arkansas|

California

NACDS and the California Retailers Association submitted a joint letter to the Assembly Business and Professions Committee in support of AB 1328, legislation allowing pharmacists to perform all CLIA-waived tests.

Also in California, the Board of Pharmacy’s teleconferenced Licensing Committee’s April 21, 2021, meeting agenda and meeting materials have been posted along with information to participate.  Also, the teleconferenced Enforcement and Compounding Committee’s April 22, 2021, meeting agenda has been posted along with information to participate.

Also in California, the Division of Workers’ Compensation’s Pharmacy and Therapeutics (P&T) Committee will meet on April 21, 2021, from 12:30 to 2:30 p.m. via video/audio conference only. To attend the meeting via video conference, please use the P&T Meeting Link. To join the meeting via teleconference, please use the call-in phone number: 1 (619) 407-9860 and enter phone conference ID: 520 391 953#.

Also in California, on April 1, the online attestation period opened for fee-for-service Medi-Cal pharmacy providers seeking the higher of two professional dispensing fees as part of the reimbursement for covered outpatient drugs. Medi-Cal pharmacy providers should have received a communication that includes the URL for the online attestation portal, as well as a unique login ID and password, by email, fax, or mail. If you have not received this communication, please call the Attestation Survey Hotline at 1-844-294-9982 or email CODSurvey@mercer.com.  The attestation period for the 2020 calendar year is open until 11:59 pm April 30, 2021, and no attestations will be accepted after that time. The attestation for the 2020 calendar year reporting period determines the professional dispensing fee component of the pharmacy claim reimbursement for claims with dates of service from July 1, 2021, through June 30, 2022. For additional information, providers can refer to the Pharmacy Provider Self-Attestation FAQs or may call the Attestation Survey Hotline at 1-844-294-9982, or email their questions to CODSurvey@mercer.com.

Also in California, Medi-Cal Rx Transition and Resources Training announced three sessions covering important Medi-Cal Rx changes for pharmacy providers and prescribers. For registration, all the training sessions are posted on the Education & Outreach Calendar within the Saba Learning Management System (LMS); you must be logged into the User Administration Console (UAC) to access the Education & Outreach Calendar in Saba.

Lastly in California, the Board of Pharmacy is beginning the development of its new strategic plan and is seeking stakeholder feedback. The Department of Consumer Affairs, SOLID Planning Solutions (SOLID), is assisting the Board with its strategic planning process.  Completed surveys will provide input as to how the Board is doing by identifying strengths, challenges, and current trends to consider for the future direction of the Board. All responses are anonymous. This survey will be open until April 30, 2021. For your convenience, NACDS is providing a PDF file of the survey.

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

2021-04-16T10:04:29-04:00April 16, 2021|California|

Florida

Florida Medicaid will continue to align with the Medicare vaccine administration rates. These rates were updated by the Centers for Medicare and Medicaid Services effective March 15, 2021. COVID-19 vaccines administered with a date of service on or after March 15, 2021, must be paid at the new rates. All guidance applies to both the fee-for-service and Statewide Medicaid Managed Care delivery systems unless otherwise stated.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

2021-04-16T10:03:26-04:00April 16, 2021|Florida|

Iowa

The Board of Pharmacy published the following effective May 12, 2021:

  • Final rule amends and adopts regulations under 657 IAC 3 and 6 related to pharmacy technicians and general pharmacy practice including broader language relating to the delegation of nonclinical pharmacy functions to a pharmacy technician beyond those related solely to dispensing; prohibiting a pharmacy license holder from requiring a supervising pharmacist to delegate functions to a technician against the pharmacist’s professional judgment; changes related to pharmacy technician registration and the renewal period for certified pharmacy technicians; and other related amendments outlined in the posting;
  • Final rule amends and adopts regulations under 657 IAC 5 to require registration of pharmacy support persons before employment in a pharmacy. The rule also aligns the late renewal and reactivation procedures for those with other licenses and registrations, adds a $15 fee for written verification of registration, and expands the delegation of nontechnical pharmacy functions to pharmacy support persons. Additionally, the rule prohibits requiring a supervising pharmacist to delegate functions to a support person against their professional judgment, requires support persons to report any criminal conviction or disciplinary action within 30 days, and adds provisions on the online application process.
  • Final rule amends regulations under 657 IAC 4 to require pharmacist-interns to notify the board of changes in name, address, email, any criminal convictions, or disciplinary action. The rule also requires the submission of a $15 fee for verification of a pharmacist-intern registration or certification of hours and removes the reference to a license surcharge for the Board’s monitoring program.
  • Final rule amends regulations under 657 IAC 37 to require reporting of Schedule V controlled substances to the prescription monitoring program database. The rule also revises the definition of “health care professional.”
  • Final rule amends regulations under 657 IAC 10 to temporarily add oliceridine and remimazolam as controlled substances to conform to federal standards.

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

2021-04-16T10:02:29-04:00April 16, 2021|Iowa|

Maryland

The following bills of importance to pharmacy under both practice expansion and reimbursement have passed both chambers before the Legislature adjourning this week. They are now on their way to Gov. Hogan for signature. NACDS commends the Maryland Association of Chain Drug Stores and the Maryland Pharmacists Association for their work on the ground on these issues.

  • HB 1040 Kelly -D- would mirror pharmacists’ federal authority to provide childhood vaccines to children age 3 years and older effective July 1, 2021 thru June 30, 2023. The bill also requires the Department of Health to complete a study of pharmacist-administered childhood vaccines by December 1, 2022. This would allow time for the General Assembly to extend the authority during the 2023 session before it expires.
  • SB 537 Hershey (R)- Effective October 1, 2021, pharmacists can substitute a therapeutically equivalent brand name drug or device product for the originally prescribed generically equivalent drug or device if it is less expensive. It also requires pharmacists to inform patients of therapeutically equivalent brand name drugs that are the lowest-cost alternative to the originally prescribed generically equivalent and of their cost difference if the information is readily available.
  • HB 135 Young (D) Authorizes pharmacists to administer maintenance injectable medications that treat a chronic disease, condition, or disorder. This would include medication for the treatment of a psychiatric disorder or substance use disorder, contraceptives, and vitamins.  The product must be prescribed by an authorized prescriber; following a standing order issued by an authorized public health official; or under the protocol. The Board of Physicians, Nursing, and Pharmacy must issue regulations by September 1, 2021. Notably, it also requires payment for both patient assessments and the administration of the medication.
  • HB 601 Kipke (R) This bill would regulate the relationship between PBMs and pharmacies in response to the Rutledge Decision and is intended to capture ERISA plans. It includes many provisions including a prohibition on gag clauses and clawbacks; reimbursement parity among certain pharmacies, contracting transparency, credentialing, and audit reform, to name a few. The bill would be effective on January 1, 2022.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

2021-04-16T10:01:41-04:00April 16, 2021|Maryland|

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