Louisiana
The Council on Medicaid Pharmacy Reimbursement met on July 30 to receive updates from the Department of Health (LDH) on the state’s single PBM, the Medicaid PDL and the Myers and Stauffer dispensing cost survey that will be distributed to pharmacies in early August.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Maine Board of Pharmacy held its regular scheduled meeting on August 1, 2024. The agenda included proposed rulemaking on:
- Chapter 7: Licensure and Employment of Pharmacy Technicians (Amend)
- Chapter 41: Sale of Nonprescription Drugs Through Vending Machine Outlets (Amend)
- Chapter 43: Prescribing, Dispensing and Administering HIV Prevention Drugs (New)
- Chapter 44: Pharmacist Authorization to Make Certain Contraception Accessible (New)
The next meeting will be a rulemaking subcommittee meeting on August 19, 2024.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts
The Massachusetts Board of Registration in Pharmacy posted its August newsletter. Included in this newsletter is information about pharmacy license renewals.
Also in Massachusetts, the formal legislative session ended early in the morning on August 1. The legislature failed to pass a conference report for S2520, an Act relative to pharmaceutical access, costs and transparency. The bill would have included reporting to the Health Policy Commission, PBM licensure, audit regulations, prohibition of spread pricing and other fees and required drug rebates returned to consumer. As both chambers have unanimously passed their versions of the bill, there is a slight chance the legislature could advance the bill during informal sessions; however, only one member of a chamber is needed to prevent floor action. NACDS will continue to advocate for PBM policy principles in Massachusetts during the informal legislative session for the remainder of the year and prepare for the new session in 2025.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
The Board of Pharmacy posted the August 14 full Board and Disciplinary Subcommittee meeting agendas.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Department of Human Services announced that the new pharmacy adjudication system implementation date has been delayed until November 4, 2024.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
Effective August 1, 2024, MO HealthNet (Medicaid) no longer covers DisposeRx packets.
Also in Missouri, if a pharmacy does not have a drug take-back receptacle, the Board of Pharmacy provides one for free through its Rx Cares for Missouri Medication Destruction and Disposal Program.
Finally in Missouri, the Board of Pharmacy adopted rules expanding pharmacy technician duties published in the August 1, 2024 Missouri Register (20 CSR 2220-2.715).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
The Board of Pharmacy posted a hearing notice for the September 5 Public Hearing in Las Vegas on proposed new onerous counseling documentation requirements.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
NYRx, the New York State Medicaid Pharmacy Program, provided an update to its prior authorization program, effective August 1, 2024.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Gov. Roy Cooper (D) declared a State of Emergency effective August 5, 2024, and it will remain in effect for 30 days. The Order activates the State Emergency Operations Plan and allows for the Department of Transportation and the Department of Public Safety to take the appropriate action to ensure the expeditious movement of utility vehicles to eliminate power outages, vehicles carrying essential supplies such as food, medicine and fuel or transporting livestock, poultry and crops. This order also triggers the Price Gouging Law.
Also in North Carolina, effective August 1, 2024, Medicaid beneficiaries may obtain the over the counter (OTC) oral contraceptive Opill without a prescription and at no cost. While Medicaid encourages establishing care with a medical home, coverage without a prescription allows Medicaid beneficiaries easy access to the product and reduces barriers such as having to make an appointment to get a prescription, needing transportation to the appointment or even a lack of health care providers in the community. Medicaid beneficiaries will be able to get Opill from pharmacies enrolled in Medicaid who will be able to submit the claim for reimbursement. A $5.00 fee will be included in the reimbursement amount paid to the pharmacy. A dispensing fee will not be paid. Beneficiaries are allowed to obtain up to a 3-month supply of Opill with each request, without a prescription, with a maximum of 13 packs per year. Opill is a progestin only contraceptive. Pharmacists should counsel beneficiaries that Opill is most effective when taken once a day at the same time each day.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Effective August 12, 2024, OAC 4729:5-2-05 requires all outpatient pharmacies located in Ohio to submit notification to the Board of Pharmacy of the types of language translation services, hearing impairment services and vision impairment services they offer patients using the Board’s accessible services reporting webpage. Pharmacies are required to use this webpage to notify the Board of these accessible services. NOTE: The website (www.pharmacy.ohio.gov/ASreport) will go live on August 12, 2024; however, the requirement to submit notification of accessible services does not take effect until November 10, 2024. Chains can bulk report for all their locations but can only make changes moving forward by individual locations. The Board will issue a notification about the program to pharmacies on August 12. For now, only draft guidance is available.
Also in Ohio, the Department of Health is working with Innovation Horizons, a health consulting organization, to build up programs for diabetes prevention and management by increasing the number of pharmacies providing National Diabetes Prevention Program (DPP)/ Diabetes Self-Management Education and Support (DSMES) services to their patients. To better gauge the resources needed and capacities for pharmacies in the state, they created a survey for pharmacies to complete. Pharmacies are encouraged to complete the survey, if appropriate, as it may lead to further opportunities for patient care.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted the draft agenda for its next meeting on August 21. Please note the presentation by Myers and Stauffer titled “SB 192 Upper Payment Limit Deliverable” on the draft agenda. You must register in advance of the meeting to participate.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Department of Human Services published a bulletin to make providers aware of upcoming changes to its domain and URLs in the PROMISe payment system.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
Gov. Henry McMaster (R) issued Executive Order 2024-16, declaring a State of Emergency in preparation for the potential effects of Tropical Storm Debby. Tropical Storm Debby is expected to produce rainfall totals of 10 to 20 inches, with maximum amounts of 30 inches, across portions of coastal South Carolina through Friday morning. This potentially historic rainfall may result in areas of catastrophic flooding. For power outages and shelter information, visit the S.C. Emergency Business Resources Dashboard. If your business sustains any damage during the storm, please be prepared to notify ESF-24 with as much detail as possible. ESF-24 will provide updates when assistance becomes available or business recovery centers open.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare announced the list of covered UPCs for its upcoming diaper program. Luvs, Pampers, Huggies and Cuties are the primary brands that will be covered. If your pharmacy plans to participate and wants to be featured on the TennCare website as a participating location, complete this survey.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS Mary Staples, Walgreens pharmacist Aimme Lusson, and Kroger pharmacist Jeff Loesch, met with State Sen. Bryan Hughes (R) and State Rep. Candy Noble (R), two champions for PBM reform legislation, at the Texas Pharmacy Association’s annual meeting in Allen, Texas.
Also in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) delayed the semi-annual Medicaid preferred drug list update until August 8, 2024.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Vermont
Medicaid has updated its contact information due to the transition of Change Healthcare (CHC) to Optum.
| Contact | Old | New | |
| Help Desk | PBA_VTHelpdesk@changehealthcare.com Physicians: (p)1-844-679-5363 (f) 1-844-679-5366 Pharmacies: (p)1-844-679-5362 | VermontHD@optum.com Note: Phone and Fax numbers remain the same | |
| Provider paper billing address | 1 Green Tree Drive South Burlington, VT | 45 Commerce Dr, Suite 5 Augusta, ME 04330 | |
| PA Fax | Remains the same: 1-844-649-5366 | ||
Also in Vermont, the Department of Vermont Health Access (DVHA) continues a phased recovery following the outage that occurred in February 2024, due to the national cyber security issue affecting Optum/Change Healthcare. Beginning August 7, 2024, edits for Reject-75, Prior Authorization Required, will return to normal functioning in the pharmacy claims system.
- Claims for non-preferred items on the Preferred Drug List (PDL), including medications obtained during the outage, that do not have an active Prior Authorization on file, will now begin to reject. This also includes preferred medications subject to clinical review and medications requiring step therapy. Please refer to the PDL for medication specific coverage criteria.
- An emergency fill can be dispensed when a required prior authorization has not been secured, and the need to fill the prescription is determined to be an emergency. If the prescriber cannot be reached to obtain the required prior authorization, the pharmacist may dispense an emergency supply to last up to 72 hours.
Please continue to refer to the Preferred Drug List to review preferred and non-preferred medications. Providers requiring assistance with submitting a prior authorization may contact the Optum Pharmacy Helpdesk at VermontHD@Optum.com, the Prescriber Helpdesk at (1-844-679-5363) or the Pharmacy Helpdesk at (1-844-679-5362).
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Arizona
Gov. Katie Hobbs signed SB 1211 (Chapter 232), legislation allowing pharmacists to dispense naloxone hydrochloride or any other opioid antagonist approved by the US Food and Drug Administration without a signed prescription; removing the requirement that a pharmacist who dispenses naloxone hydrochloride or another opioid antagonist report outlined prescription information, including the name, strength, quantity, dosage and national drug code number of the drug; and removing the requirement that the Board of Pharmacy establish protocols for the dispensing of naloxone hydrochloride and other opioid antagonists.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
The Insurance Department (AIO) issued a Bulletin_10-2024 reminding insurers that Arkansas Health and Opportunity for Me (ARHOME) is the payor of last resort.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
NACDS submitted a letter to the Assembly Appropriations Committee in support of SB 966, PBM reform legislation, including provisions prohibiting the use of spread pricing, requiring 100% pass-through of manufacturer rebates to plan sponsors, prohibiting the steering of patients to PBM-affiliated pharmacies and requiring PBMs to obtain a license to operate in the state.
Also in California, the Department of Health Care Services (DHCS) announced it will host its quarterly Hearing Aid Coverage for Children Program (HACCP) webinar for medical providers and hearing professionals on August 15 from 12:00 noon to 1:00 pm PDT. For more information and to pre-register, please visit DHCS' HACCP webpage.
Also in California, the Department of Health Care Services posted the following:
Also in California, the Board of Pharmacy posted the agenda and meeting materials for the Full Board Meeting being held July 31-August 1. Please note the inclusion of compounding regulations.
Finally in California, the Department of Health Care Services posted the following alert on the Medi-Cal Rx Web Portal: Reminder: Quantity Limit Restrictions for Anti-Obesity Preparations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Health Care Policy and Financing (HCPF) is hosting a webinar on August 27 to review HCPF major initiatives for Fiscal Year (FY) 2023-2024, priority initiatives for FY 2024-2025 and public health emergency (PHE) unwind insights and opportunities going forward.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy proposes the promulgation of the rules below regarding compounding and to implement new legislation.
Notice of Development of Rulemaking
Department: Department of Health
Division: Board of Pharmacy
Rule No.: 64B16-27.700
Purpose: The Board proposes the rule amendment to update language regarding compounding.
Notice of Proposed Rule
Department: Department of Health
Division: Board of Pharmacy
Rule No.: 64B16-31.010, 64B16-31.011, 64B16-31.012
Purpose: The Board proposes the promulgation of the rules to implement new legislation.
Also in Florda, effective July 1, 2024, employers who hire minors 14-17 years of age are required to post the Florida Child Labor Law Poster that includes changes to employment restrictions for minors.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Inspections, Appeals & Licensing (DIAL) announced a meeting of the Pharmacy Health Committee on July 31. The agenda and information to access the meeting are available in the DIAL Public Meeting Calendar.
Also in Iowa, the Department of Health and Human Services, Iowa Medicaid posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
The Board of Pharmacy published its July 2024 newsletter.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
MedImpact, the Medicaid Single PBM, issued a bulletin along with the statewide Naloxone protocol to clarify that the statewide protocol can be used to prescribe the drug in the absence of a physician protocol.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Board of Pharmacy is holding a Public Hearing on August 26 to solicit comments and testimony on proposed regulatory changes on prescription transfers, durable medical equipment (DME) change of ownership, pharmacy technicians and stocking automated dispensing systems.
Also in Louisiana, the Board of Pharmacy published Bulletin No. 24-02 listing the new laws impacting the practice of pharmacy or Board operations adopted during the Louisiana Legislature's 2024 Regular session that ended in June.
Also in Louisiana, the Board of Pharmacy published its July 2024 newsletter.
For more information, contact NACDS’ Mary Staples at 817-442-1155.