HB 1993, a companion bill to SB 1000, a comprehensive commercial and Medicaid PBM reform bill has been introduced by Rep. Jessica Benhem (D). Both bills have strong bi-partisan co-sponsorship and support. NACDS continues to work collaboratively with the Pennsylvania Association of Chain Drug Stores and the Pennsylvania Pharmacy Coalition and legislators to advance these bills.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Department of Commerce and Insurance (TDCI) shared a rule filing regarding PBMs. The TDCI regulations on audits of PBMs were approved and will take effect on June 26, 2024.
Also in Tennessee, congratulations to Dean Bill Gentry of South College School of Pharmacy, who announced his upcoming retirement effective July 2, 2024.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Texas Pharmaceutical Initiative (TPI) three-member Board held a hybrid meeting on April 9. Five of the largest state agencies on the Advisory Council (TIPAC) provided testimony, addressing issues such as prescription drug pricing, the potential for savings with a single PBM, specialty pharmacies drug pricing, the most expensive prescription drugs prescribed, drug shortages and rebates. HB 4990 passed during the 2023 Regular session requires TPI to present a plan for the legislature by October 1, 2024. The Board also has the authority to explore a distribution network and partnerships to launch a manufacturing facility for generic or biosimilar drugs. The Health and Human Services Commission (HHSC) recommended that the prescription drug importation program law aimed at providing lower cost prescriptions by importing them through Canada (HB 25-2023), also be addressed by TPI.
Also in Texas, the Gainwell point-of-sale claims system, the VDP (Vendor Drug Program) Provider Portal and the VDP eCOI (Electronic Certification of Information) Portal are now active.
Finally in Texas, the Board of Pharmacy posted proposed rules for prescription drug deliveries and non-sterile compounding in the March 22 Texas Register (see pages 1852-1863). Written comments on the proposed rules may be submitted to Eamon D. Briggs, Deputy General Counsel, Texas State Board of Pharmacy, 1801 Congress Avenue, Suite 13.100, Austin, Texas 78701-1319, FAX (512) 305-8061. Comments must be received by 5:00 pm on April 30, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Gov. Glenn Youngkin (R) vetoed companion bills (HB 570 / SB 274) that would have created a Prescription Drug Affordability Board (PDAB) in the state. This move comes as three other states actively conduct affordability reviews of prescription drugs nationwide. NACDS will be monitoring the final outcome of the bill when the Legislature returns later this spring for its veto session. NACDS joined other organizations in expressing opposition to the bill to Gov. Youngkin.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
NACDS applauds the enactment of ESSB 5213, a new law signed by Gov. Jay Inslee (D) on March 25 that will hold PBMs accountable. Although the law exempts the Employment Retirement and Security Act (ERISA) plans, it enhances the Insurance Commissioner’s enforcement authority, establishes an appeals process, opens the network, includes anti-steering and mail order provisions, prohibits spread pricing and expands Maximum Allowable Cost appeals to all prescriptions, not just generic drugs. The bill sponsor, Sen. Patty Kurderer (D), who is running for the office of Insurance Commissioner in November, plans to enforce this new law and actively seek further PBM reforms, if elected.
Also in Washington, the Heath Care Authority asked NACDS to alert pharmacies that recently they have seen delays from its switch vendors and/or software vendors in applying changes for testing. Sarah Stewart said these changes to the BIN number and other information on the payer sheet for its POS (point of sale) replacement system are going live on April 27, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Centers for Medicare & Medicaid Services (CMS) approved an extension effective March 26, 2024, through December 31, 2028, for a 1115 “Behavioral Health Reform” demonstration project. This approval continues the state’s existing authority to receive federal financial participation (FFP) for providing clinically appropriate substance use disorder (SUD) treatment services for short-term residents in residential and inpatient treatment settings that qualify as an institution for mental diseases (IMD), as well as provides additional services to enhance the comprehensive and integrated behavioral health system for children, youth and adults with serious mental illness (SMI), severe emotional disturbance (SED) and/or SUDs (Substance Use Disorders).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
On March 29, Gov. Katie Hobbs (D) signed SB 1165 (Chapter 51), legislation outlining specified provisions an auditing entity must comply with when conducting a wholesale invoice audit and prohibits an auditing entity from retroactively reducing the amount of a claim unless specified criteria apply.
Also in Arizona, on April 2, Gov. Katie Hobbs (D) signed SB 1021, legislation removing the requirement that health professional groups proposing to increase the scope of practice of a state-regulated health profession must complete a statutory sunrise review.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Insurance Commissioner issued Directive 1-2024 suspending for 60 days the technical filing requirements, audits and recoupments related to claims for providers impacted by the Change Healthcare data breach.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Board of Pharmacy posted the following to its website:
Also in California, the Board of Pharmacy is conducting an occupational analysis (OA) of the pharmacy technician profession in California. The survey is a part of the OA, which identifies competencies that will provide the basis for developing future licensure examinations in California. The survey weblink will be available 24/7 and must be completed by April 15.
Finally in California, the Department of Health Care Services posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.