Pennsylvania

Senator Judy Ward (R) introduced SB 1210, legislation that would allow pharmacists to perform independent COVID-19 point of care tests authorized by the FDA by suspending the laboratory work experience required by state law. NACDS drafted the language and is working jointly with the Pennsylvania Association of Chain Drug Stores (PACDS) to push this measure forward.

Also in Pennsylvania. HB 941 sponsored by Rep. Doyle Heffley (R) was amended and reported out of the Senate Health Committee. The bill contains PBM transparency provisions, as well as language intended to set reimbursement rates in managed care. The committee indicated there is more work to be done on this measure over the summer. NACDS will be supporting PACDS efforts to make the reimbursement language more definitive during this process.

Also in Pennsylvania. SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate. Commonly referred to as a “gag clause” prohibition, the amended bill is now eligible for concurrence in the House.

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

2020-07-09T23:03:15-04:00July 9, 2020|Pennsylvania|

South Carolina

Effective July 15, 2020, South Carolina Department of Health and Human Services will update the standard basis of payment for the FFS pharmacy benefit to provide payment at the lowest of:

  • The actual acquisition cost (AAC) plus a professional dispensing fee (PDF) of $10.50;
  • The state’s maximum allowable cost plus a PDF of $10.50; or,
  • The usual and customary charges to the general public.

The AAC is defined as the National Average Drug Acquisition Cost (NADAC). In those instances where the NADAC does not exist, the AAC is defined as the wholesale acquisition cost. For more information, click here.

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

2020-07-09T22:57:07-04:00July 9, 2020|South Carolina|

Texas

The Drug Utilization Review Board announced that they will be performing a clinical review anticonvulsant, antihemophilic, antineoplastic, antiretroviral, and medications used to treat multiple sclerosis at the October 23, 2020 meeting. These are protected drug classes not currently reviewed on the Texas Medicaid Preferred Drug List. All medications within these drug classes will be preferred and continue to be available without prior authorization. For more information, contact vdp-formulary@hhsc.state.tx.us.

Also in Texas. Health and Human Service Commission’s Vendor Drug Program plans to publish the semi-annual update of the Medicaid preferred drug list on July 27, 2020. The new preferred drug classes are Glucagon Agents, Immunomodulators, Asthma and Sickle Cell Anemia Treatments.

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

2020-07-09T22:55:12-04:00July 9, 2020|Texas|

Wisconsin

ForwardHealth reminds providers that they are to resume collecting co-pays starting July 1st.  Please see the ForwardHealth Update for more information.  Please recall the temporary copay suspension was introduced in the December 2019 Update.

For more information, contact NACDS’ Joel Kurzman at 847-905-0555.

2020-07-09T22:54:38-04:00July 9, 2020|Wisconsin|

Alabama

All previously published expiration dates related to the Coronavirus (COVID-19) emergency are once again extended by the Alabama Medicaid Agency (Medicaid). The new expiration date is the earlier of July 31, 2020, the conclusion of the COVID-19 National emergency, or any expiration date noticed by the Alabama Medicaid Agency through a subsequent ALERT. A listing of previous Provider ALERT and notices related to the health emergency is available on the Agency’s COVID-19 page.

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

2020-06-25T09:31:05-04:00June 25, 2020|Alabama|

California

In advance of the start of the new fiscal year on July 1, 2020, Gov. Gavin Newsom and the Legislature reached an agreement on the budget this week. Below are highlights of two budget trailer bills of interest to pharmacies. 

(AB 89/SB 121) contains language related to federal funding for contact tracing.  Specifically, it allows Department of Finance (DOF) to allocate those funds as directed by California Department of Public Health (CDPH), as long as the funds are not used by any state or local entity for applications that collect information relating to a person’s location and movement.  Please see below: 

SEC. 104. 

 Section 11.95 is added to the Budget Act of 2020, to read: 

SEC. 11.95. 

 (a) Federal legislation enacted between March 6, 2020, and April 24, 2020, is providing funding to the state to support testing and contact tracing in response to the COVID-19 public health emergency. The Department of Finance may allocate these funds to support testing and contact tracing as directed by the State Department of Public Health, provided that funds are not used by any state or local entity for applications that collect information related to an individual’s location and movement. This subdivision does not preclude a contact tracer from using a program to store, organize, or analyze any data otherwise affirmatively provided to the contact tracer by an individual. All testing and contact tracing must be conducted in compliance with applicable federal and state privacy laws. 

(b) Funds described in subdivision (a) may be allocated to offset or reduce appropriations in the 2019−20 and 2020−21 fiscal years that support the COVID-19 response between March 1, 2020 and June 30, 2021. If no item for a department currently exists to allow for adjustments for the additional federal funds allocation or additional reimbursements to be allocated, then an item may be created for this purpose. 

(c) The Department of Finance may adjust any item in Section 2.00 to account for additional federal funding or any additional reimbursements to support testing and contact tracing. If no item for a department currently exists in Section 2.00 of this Act to allow for adjustments for the additional federal funds allocation or additional reimbursements to be allocated, then an item may be created for this purpose. 

(d) Changes to any item in Section 2.00 may be authorized not sooner than 10 days after written notification to the Joint Legislative Budget Committee of the changes to the planned expenditures to support testing and contact tracing. The chairperson of the Joint Legislative Budget Committee or the chairperson’s designee may shorten the 10 days by written notification. 

AB 80/SB 102 does not include the proposed pharmacy reimbursement cuts for services such as providing self-administered hormonal contraceptives, vaccines, nicotine replacement products, travel medications, naloxone directly to patients and PEP/PrEP for HIV prevention. 

  • Requires CalOSHA to establish the Health Care Payments Data Program to implement and administer the Health Care Payments Data System, including health care data submitted by health plans and insurers, cities or counties that offer plans and other mandatory or voluntary submitters. Provisions require the office to use the data to produce reports, analyses, studies, etc. to support goals for improving public health, reducing disparities, and reducing health care costs and specifies that personally identifiable data submitted are exempt from disclosure. 
  • Authorizes CDPH to subsidize up to 30 days of PrEP and PEP medications without regard to whether a person was a victim of sexual assault. 
  • Contains several pharmacy provisions, including removing the Rx copay in Medi-Cal and requiring DHCS to implement a supplemental payment pool for non-hospital 340B clinics.   
  • Contains the “best price” language, specifically defining “best price” to mean the negotiated price for any specified entity, including entities both within and outside the USA.  
  • Authorizes DHSC, upon approval of DOF, to seek the necessary federal approvals to establish and administer a drug rebate program to collect rebate payments from drug manufacturers for drugs furnished to select populations of CA residents who are ineligible for full-scope Medical.  
  • Repeals the provision that limits prescribed drugs under the Medi-Cal program to not more than 6 drugs per month, unless prior authorization is obtained. 

Also in California... Legislation of interest to chain pharmacies passed the Assembly and was referred to the Senate Health Committee for further consideration. 

  • AB 2077 (Ting) Hypodermic needles and syringes – NACDS supports 
  • AB 2203 (Nazarian) Insulin cost-sharing cap – NACDS neutral 

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

2020-06-25T09:29:58-04:00June 25, 2020|California|

Colorado

In a letter submitted on June 19th , NACDS and the Colorado Retailers Association urges Gov. Jared Polis to sign into law HB20-1061, legislation increasing access to care by authorizing pharmacists to prescribe and dispense Human Immunodeficiency Virus (HIV) prevention medication to patients. 

Also in Colorado... NACDS met with the Department of Regulatory Agencies (DORA) to provide additional information on statutes and rules related to the modernization of the practice of pharmacy, responding to questions raised regarding the alignment of Colorado state law with the federal Drug Supply Chain Security Act (DSCSA) and the non-discretionary duties of pharmacy technicians. 

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

2020-06-25T09:28:17-04:00June 25, 2020|Colorado|

Florida

Notice announces the intention of the Department of Health to amend regulations under FAC 64D-3 to add the coronavirus (COVID-19) to the list of reportable diseases and conditions. A comment due date is not specified

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

2020-06-25T09:26:34-04:00June 25, 2020|Florida|

Louisiana

Legislators are continuing to meet in a special session convened earlier this month attempting to negotiate a balance budget agreement prior to the star of the new fiscal year on July 1, 2020. 

Also in Louisiana... Two COVID-19 emergency rules have been extended until November. 

Emergency rule of the Department of Health, Bureau of Health Services Financing, adopts regulations under LAC 50:I, Chapter 5, to establish provisions for the delivery of telemedicine during a declared disaster under the Medical Assistance Program. The rule provides that services may temporarily be provided through the use of an interactive audio telecommunications system, without the requirement of video, if such action is determined to be necessary. The rule, which is issued in response to the coronavirus (Covid-19) pandemic, extends a March 16th emergency rule. The rule is effective July 15, 2020, and expires Nov. 12, 2020. 

Emergency rule of the Department of Health amends regulations under LAC 51:II, Chapter 1, to add coronavirus disease 2019 (Covid-19)/infections with SARS-CoV-2 to the list of reportable diseases. The rule also requires laboratories and health care facilities to report testing results. The rule is effective July 5, 2020 and expires Nov. 2, 2020.  

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

2020-06-25T09:25:06-04:00June 25, 2020|Louisiana|

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