Texas
While the 89th legislature will convene at Noon on January 14, 2025, lawmakers have already begun prefiling bills this week. Several bills of interest to pharmacies include:
- Pete Flores (R) re-filed legislation (SB 254) that would allow pharmacists independent authority to order and administer immunizations to anyone three years of age and older without a prescription order.
- John Bucy (D) re-filed clean-up legislation (HB 632) on dispensing emergency insulin.
- Donna Howard (D) re-filed a bill (HB 845) that would allow pharmacists under a written protocol to furnish treatment without a prescription to a patient after a positive CLIA flu or strep test.
- Matt Shaheen (R) re-filed legislation (HB 1027) removing restrictions on operating telepharmacies.
Also in Texas, the House Republican Caucus is scheduled to meet December 7, 2024, to endorse a candidate for Speaker.
Also in Texas, the Department of State Health Services (DSHS) Diabetes Prevention and Control Program updated materials, including two diabetes educational brochures — Could You Have Diabetes? and Could You Have Prediabetes? These brochures provide information regarding diabetes and prediabetes risk factors and symptoms, helping individuals determine their risk.
Finally in Texas, at the Drug Utilization Review Board’s late October meeting, the board recommended clinical prior authorizations, changes to the preferred drug list and retrospective drug utilization criteria. The next quarterly meeting will be held on January 31, 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
Democrats won all nine executive offices and gained additional seats within the state Legislature. Bob Ferguson (D) will serve as the next governor of Washington state, replacing termed-out Gov. Jay Inslee (D). A friend of pharmacy State Senator Patty Kuderer (D) was elected to become the next state Insurance Commissioner.
Also in Washington, the Department of Health (DOH) Office of Immunizations is hosting a webinar on November 21, 2024, featuring Dr. Eva Meekins, a nurse educator with the Centers for Disease Control and Prevention (CDC), to discuss the current vaccine recommendations and strategies to prevent common vaccine administration errors.
Finally in Washington, in observance of the Thanksgiving holiday, state offices will be closed on November 28 and 29, 2024. Provider payments for the week of November 25, 2024, will be made on November 27, 2024. Claim submission deadlines have been moved up to ensure that providers can receive payment and Remittance Advice (RA) documents on November 27, 2024. The deadline for submission of claims to ProviderOne for payment during the week of Thanksgiving will be November 24, 2024, by 5:00 pm. The deadline for submission of pharmacy claims to the Point of Sale (POS) during the week of Thanksgiving will be November 23, 2024, by 5:00 pm.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The Department of Health Services released a campaign to encourage residents to get vaccinated, e.g., flu, COVID and RSV. To find and schedule a vaccine, Wisconsin residents are encouraged to check with their primary care provider, local or Tribal health department, community clinic or visit vaccines.gov. Wisconsinites can also call 211 or 877-947-2211 for help scheduling a vaccine appointment. If they do not have health insurance, or their health insurance does not cover vaccines, there are programs that can help, including the Vaccines for Children program and Vaccines for Adults program.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
California
A licensee is required to notify the Board of Pharmacy when ceasing to act as a pharmacist-in-charge (PIC), designated representative-in-charge (DRIC) or responsible manager (RMG). Disassociation forms are available on the website and intended to assist licensees in providing the required notification to the Board. No fee is required for the notification of disassociation. Completed forms may be submitted to the Board via mail or e-mail by using the email address provided on the form.
Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy is distributing this list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. The Board of Pharmacy is making this information available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers. Names with a strikeout indicate the restriction is no longer effective. Names in bold indicate there has been an update to the action the Medical Board of California took. Questions or comments about the prescribers listed should be directed to the Medical Board of California.
Also in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for October 18-24.
Finally in California, the Board of Pharmacy posted the agenda for its Full Board Meeting on November 6-7, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
The Department of Revenue (IDOR) released an Informational Bulletin to all retailers and servicepersons. For sales and use tax and other related returns due on or after January 1, 2025, the retailers’ discount amount is limited to $1,000 per month. The retailers’ discount is an amount that retailers and servicepersons may claim only if the return is filed on or before the due date and only for a percentage of the taxes paid on or before the due date. The discount is allowed as a reimbursement for the expenses incurred in keeping records, preparing and filing returns, remitting the tax and supplying data to the IDOR on request.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The General Assembly’s Health Care Cost Oversight Task Force held a meeting on October 8 on PBM oversight and contracting. Two years ago, legislation was adopted that funded a state audit. RxConnection was hired to review five years of data from the state’s major PBMs. Unfortunately, the data the auditors obtained was incomplete due to an ongoing lack of transparency surrounding the specific details regarding PBM contracts with the state’s medical plans and the terms of the rebate systems negotiated by PBMs, which prompted the Office of the Attorney General to file civil investigative demands.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Inspections Appeals and Licensing issued the Professional Health Committee – Pharmacy meeting notice for November 6, 2024, at 11:00 am. Agendas are subject to change and may be revised up to 24 hours before the start of the meeting. Please check the DIAL Public Meeting Calendar to ensure you are viewing the current version. The next meeting for the committee will take place on December 4, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact issued an updated bulletin to pharmacies clarifying the coverage limits on naloxone 4 mg nasal spray. This applies to both brand and generic covered NDCs.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Gov. Jeff Landry (R) announced a special session on November 6 focused on revamping the state's tax structure. Governor Landry hopes to overhaul the state's current tax system by reducing income tax and charging sales tax on additional items. If the legislature approves tax reforms, voters will need to ratify the proposals in March 2025 so they can become law.
Also in Louisiana, the Board of Pharmacy provided the Prescription Monitoring Program's Advisory Council with the third quarter update on the program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Prescription Drug Affordability Board (PDAB) is soliciting comments informing the development of draft regulations to implement its plan to determine upper payment limits for drugs of concern. The General Assembly's Legislative Policy Committee approved the plan last week, clearing it to move ahead to the regulatory stage. Comments should be submitted to comments.pdab@maryland.gov by November 8, 2024.
- Farxiga, Jardiance, Ozempic and Trulicity (Clinical input on Upper Payment Limits Plan for each drug)
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Consolidated Health Care Plan (MCHCP) issued an Emergency Rule clarifying member eligibility and responsibility for charges, effective January 1, 2025.
Also in Missouri, the Department of Commerce and Insurance Board of Pharmacy posted a list of fee increases that went into effect on October 30, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Board of Pharmacy posted the revised #2 agenda (October 25, 2024) for the November 4 Board of Pharmacy Meeting.
Also in Nebraska, the Department of Health and Human Services Drug Utilization Review (DUR) Board posted a list of the DUR Board Members. Also, the agenda for the next DUR Board Meeting on November 12, 2024, has been posted.
Finally in Nebraska, the Department of Health and Human Services announced plans for an upcoming pharmacy cost of dispensing survey. Cost of dispensing surveys are anticipated to be distributed to pharmacies that participate in the Medicaid program on December 4, 2024. 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 will be posted on this page by December 4, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Jersey
On October 29, 2024, the Senate Committee on Health, Human Services and Senior Citizens approved S1981, an Act to expand authority of pharmacy technicians in administering drugs and vaccines and permits pharmacists and pharmacy interns, externs and technicians to administer the COVID-19 vaccine. The bill was moved with an amendment, which now moves to the Senate floor for action. The Assembly had previously approved the same bill, A1899. The bills will need to be reconciled before final passage. NACDS will continue to advocate for passage of legislation that expands vaccine authority and recognizes pharmacy technicians.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New York
On October 25, 2024, the State Department of Health updated its “Pharmacists as Immunizers” Fact Sheet. The fact sheet includes updated billing codes, reminder that Medicaid is the payor of last resort and highlighting the change that immunizations of children ages three to 17 years will no longer be authorized as of December 31, 2024.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The United States Department of Agriculture (USDA) has approved a request by the state to extend the hot foods waiver in response to Hurricane Helene. The hot foods waiver will now run until December 4, 2024, to allow families to purchase hot foods for the Thanksgiving holiday. Please make sure your point-of-sale (POS) systems are updated with the new expiration date. As a reminder, the hot foods waiver applies statewide to accommodate those who have been displaced by Hurricane Helene.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Board of Pharmacy posted the November 7, 2024, Board Meeting agenda and meeting materials online. The board will meet in the Executive Session after discussing General Administration item (d.). The Public may attend the board meeting in person during the 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.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The Department of Health and Human Services (SCDHHS) published a Medicaid Bulletin (MB# 24-063) related to “Ongoing Provider Revalidation”. Please recall flexibilities offered by CMS to all state Medicaid agencies during the federal COVID-19 public health emergency (PHE), allowed for the temporary suspension of the Medicaid provider enrollment revalidation process. With the conclusion of the federal PHE in 2023, the SCDHHS is required to resume the provider revalidation process. The SCDHHS restarted this process in June 2024. A list of providers scheduled for revalidation will be published on the SCDHHS website as each cohort’s revalidation period begins.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
According to the Department of Commerce and Insurance (TDCI) Rule 0780-01-95-.10(1)(b) and 0780-01-95-.10(2)(b), the deadline to submit an attestation of low-volume status and proof of actual prescription volume to your contracted PBMs is December 1, 2024. Volume status is based on your pharmacy's actual prescription volume from July 1, 2023, to June 30, 2024.
Also in Tennessee, the Tennessee Pharmacy Association (TPA) is hosting a Pharmacy Technician Conference on November 16 from 9:00 am to 4:15 pm. Pharmacy technicians are invited to register at one of four locations across Tennessee to advance their careers, earn continuing education (CE) credit (including pharmacy law and patient safety) and develop valuable connections.
Finally, register for the TPA and the Tennessee Pharmacists Consortium for Education's (TPCE's) training program, the PBM Playbook: Mastering MAC Appeals in TN. The three-session training program will be presented by Tyler Dougherty, an esteemed expert in PBM reform and compliance. The sessions are on November 6, November 20 and December 4. Please register in advance.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commission (HHSC) posted the biannual specialty drug list.
Also in Texas, the Department of State Health Services (DSHS) combined the individual weekly influenza, respiratory syncytial virus (RSV) and COVID-19 surveillance reports into one report called the Texas Respiratory Virus Surveillance Report. A new Respiratory Illness Interactive Dashboard contains respiratory illness data including emergency department visits, hospitalizations and deaths associated with flu, RSV and COVID-19.
Also in Texas, the DSHS offers an Immunization Toolkit with educational resources to help Texans understand the importance of protecting themselves and others with the flu vaccine.
Also in Texas, the quarterly meeting of the Board of Pharmacy will be on November 5. The Board posted the agenda and will livestream the meeting.
Finally in Texas, the Board of Pharmacy posted the October newsletter.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
Gov. Mike Dunleavy (R) signed a bill into law that aims to ensure consumers have access to affordable prescriptions and level the playing field for pharmacies by regulating pharmacy benefit managers (PBMs) House Bill 226 – CHAPTER 61 SLA 24.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts, weekly notice, and monthly bulletin on the Medi-Cal Rx Web Portal:
- Activation of Reject Code 16 – Medi-Cal Rx Program Integrity Update
- Medi-Cal Rx Claim and Prior Authorization Request System Outage – Issue Resolved
- Update: Medi-Cal Rx Claim and Prior Authorization Request System Outage
- Medi-Cal Rx Claim and Prior Authorization Request Submission Outage
- Medi-Cal Rx Weekly Wrap-up for October 11-17
- Commercial JYNNEOS® Vaccine Reimbursement
- Medi-Cal Rx Weekly Wrap-up for October 4-10
- Reminder: Verification of Member Name on Medi-Cal Rx Claims
- Revolved: Medi-Cal Rx Provider Portal Prior Authorization Attachments
- Justice-Involved Reentry Initiative Now Implemented in Inyo, Santa Clara, and Yuba Counties
- Coming Soon: Commercial JYNNEOS® Vaccine Reimbursement Correction
- State of Emergency Override Activation: Submission Clarification Code 13
- Medi-Cal Rx Weekly Wrap-up for September 27-October 3
- Deactivation of Override Code “55555” for All Drugs/Products – Medi-Cal Rx Program Integrity Update
- Medi-Cal Rx Monthly Bulletin for October
- Changes to the Medi-Cal Rx Contract Drugs List
- Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations
- Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes
- Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs
- Changes to the Medi-Cal Rx Family Planning, Access, Care, and Treatment Pharmacy Formulary
- Updates to the Medi-Cal Rx Provider Manual
Also in California, effective September 17, the opioid antagonist protocol was amended. The approved regulation text with changes has been posted by the Board of Pharmacy.
Also in California, starting January 1, 2025, personal license renewal applications will no longer be mailed and licenses that are eligible for renewal will be processed online.
Finally in California, the Department of Health Care Services posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Agency for Health Care Administration will ensure reimbursement for all services provided in good faith to eligible Florida Medicaid recipients residing in the Florida counties affected by Hurricane Milton.
For providers within the State of Florida, along with out-of-state providers who are not enrolled with Florida Medicaid and who provided services to our displaced Florida residents, Florida Medicaid created a provisional provider enrollment process. Florida Medicaid has waived some initial requirements for providers to submit normally required information and documentation when applying for provisional enrollment. Details have been published in the “Florida Medicaid Health Care Alert” issued-on October 15, 2024.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services (HHS), Iowa Medicaid posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
The Health Coverage Programs (IHCP) issued a Medicaid provider bulletin BT2024166 reminding providers to use the new Gainwell Technologies addresses.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
The Department for Medicaid Services (DMS) and MedImpact issued a bulletin to pharmacies promoting the administration of Human Papillomavirus (HPV) vaccines at pharmacies. Through December 1, 2024, pharmacies will receive a point-of-sale message when billing claims for Medicaid patients that DMS identified as HPV vaccine naive. Pharmacies may bill Medicaid for the product, the administration fee and counseling. NACDS serves on Medicaid’s Pharmacy Technical Advisory Committee (PTAC) that worked with DMS and the health plans to develop and advance the program. Fee-for-service and MedImpact contact information as well as the protocol have been provided to pharmacies.
Also in Kentucky, Medicaid and MedImpact issued bulletins related to MAC appeals and a reminder to pharmacies of their auto refill prohibition policy.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.