Indiana
The Family and Social Services Administration (FSSA) Office of Medicaid Policy and Planning (OMPP) published the Monthly Medicaid Financial Report webpage to provide transparency and information about expenditure, enrollment, and funding data of the Indiana Medicaid program.
Also in Indiana, the Health Coverage Programs (IHCP) issued updates approved by the Drug Utilization Board in April.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2564-MC-FFS Avastin® (bevacizumab) Billing
- INFORMATIONAL LETTER NO. 2575-MC-FFS Updated Respiratory Syncytial Virus (RSV) Vaccine Codes
- INFORMATIONAL LETTER NO. 2576-MC-FFS New Vaccine for Children (VFC) Program Codes
- INFORMATIONAL LETTER NO. 2579-MC-FFS-D Change of Ownership (CHOW)
- INFORMATIONAL LETTER NO. 2584-MC-FFS Pharmacy Cost of Dispensing Survey 2024
- INFORMATIONAL LETTER NO. 2586-MC-FFS-D June 2024 Iowa Medicaid Pharmacy Program Changes
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
The Board of Pharmacy's May newsletter is available online.
Also in Kansas, Gov. Laura Kelly (D) reappointed Erick Axcell, PharmD, and Andy Truong, PharmD, to the Board of Pharmacy for an additional four-year term.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health (LDH) requested the Managed Care Organizations (MCOs) start a new project that will span six months, ending September 30, 2024, requiring each MCO to thoroughly review and make corrections to their network reporting to eliminate inaccurate or outdated information.
Also in Louisiana, the May 14 issue of Pharmacy Facts announced that beginning July 1, 2024, Louisiana Medicaid is revising the Single Preferred Drug List (PDL), shifting both brand and generic versions of these drugs to preferred status. With the implementation of the new PDL, prescribing providers are advised to note "brand name necessary" on prescriptions where they want to ensure pharmacies fill their prescriptions with brand name drugs. Absent this notation, individual pharmacists will make the decision on whether to fill the prescription with brand or generic drugs. The new PDL will be posted online.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
MO HealthNet completed the annual review of the pharmacy preferred drug list and utilization management edits.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Board of Pharmacy posted the agenda for its upcoming meeting on May 20.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Hampshire
On May 15, 2024, the New Hampshire Senate Committee on Health considered HB 1365, a bill relative to the substitution of biological products by pharmacies. The bill intends to allow for the substitution by a pharmacist of an interchangeable biological product for another interchangeable biological product. HB 1365 had been previously approved by the House. NACDS will remain engaged on this legislation.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New York
On May 15, 2024, the State Department of Health held its monthly NYRx, the Medicaid pharmacy benefit program, call for stakeholders in the pharmacy community. The agenda included a wrap up of the state budget, update to over-the-counter COVID-19 testing and pharmacy claims edit.
On May 15, 2024, A9729, a bill related to shared pharmacy services, was approved by the Assembly. Under the bill, "shared pharmacy services" means a system that allows a registered pharmacist or a registered pharmacy, pursuant to a request from another registered pharmacist or pharmacy to process or fill a prescription or order, pursuant to regulations promulgated by the Commissioner of Education. The bill now moves to the Senate where we expect action. NACDS will continue to advocate for the bill's passage.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Oregon
NACDS submitted comments to Prescription Drug Affordability Board (PDAB) urging it to consider NACDS reimbursement principles in any upper payment limits (UPL) methodology established by the PDAB. The letter urged the Board to ensure that pharmacies be paid no less than the UPL in addition to a professional dispensing fee. The Board has circulated a survey to pharmacies in the state requesting feedback on the UPL methodology and will be conducting a series of meetings in the coming weeks to discuss the feedback from the surveys.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The General Assembly adjourned sine die on May 10 as required by South Carolina law. Per the sine die resolution, bills with conference committees appointed can meet to work on conference reports. NACDS' priority legislation, H. 3988 (PREP (Pre exposure Prophylaxis) codification) was amended in the Seante, but the House did not concur with Senate changes, sending the bill to conference committee. Assigned Conferees are Senators Cromer, Martin and Hutto and Representatives Mark Smith, Davis, and W. Jones.
Also in South Carolina, on May 8, the Department of Health and Human Services (SCDHHS) announced it will implement a single, state-directed pharmacy benefit preferred drug list (PDL) for all providers enrolled in the Healthy Connections Medicaid program. This change, which was announced in Medicaid bulletin MB# 24-016, is effective July 1, 2024.
As announced in MB# 24-016, SCDHHS will host two live provider training webinars on May 22 from 7:30 am-9:00 am and from 12:30 pm -2:00 pm. These provider training sessions will be geared toward prescribers and dispensers. The training will include subject matter expert panelists to answer questions about the transition to the single PDL.
Providers can register for the training webinars at this registration link. Providers can submit questions about the transition to the single PDL when registering for one of the webinars.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
The Board of Pharmacy met on May 7 and provided several key regulatory insights:
- BOP CE (Continuing Education) Violations Policy has been updated on the website and will be effective July 1, 2024. The new policy clarifies disciplinary action procedures, including signing an Agreed Citation if found to be in violation of the policy.
- BOP has granted its Executive Director the authority to issue waivers for the rule requiring out-of-state pharmacists to be licensed for 12 months before being eligible for a state license.
- Licensing fees will increase across the board as the BOP works to resolve its budget.
- BOP will use the NABP form for conducting GAP analysis during compounding facility inspections. The updated form will be under "Applications" on the BOP website.
- BOP Town Hall on compounding rules will be August 21. A virtual meeting link will be created, and the public can also attend in-person at 665 Mainstream Drive in Nashville.
The next BOP Rules Review meeting will be held on June 13 from 10:00 am to 2:00 pm CT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS met with Rep. Stephanie Klick (R), Chair of the House Public Health Committee, in her Ft. Worth district. The meeting in her district was a valuable opportunity to reconnect with Chair Klick thanking her for her leadership and support in promoting patient access to healthcare services. (Photo: Left to right: Mary Staples, NACDS – Cody Cribb & Stephanie McConnell, Walgreens – Texas State Rep. Stephanie Klick – Jill Lester & Jeff Loesch, Kroger).
Also in Texas, the Texas Federation of Drug Stores held a pharmacy advocacy training program and its quarterly meeting prioritizing chain pharmacy's 2025 legislative agenda.
Finally in Texas, Speaker Dade Phelan (R) announced the 2024 Interim Charges for the House of Representatives.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Board of Pharmacy posted its May 2024 newsletter.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Washington
The Health Care Authority (HCA) is extending the April 27 implementation of the Pharmacy Point of Sale (POS) Replacement system. The new targeted go live date is June 8.
Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) revised its Ancillary Utilization Plans and the Administration of Drugs and Devices guidance document to include pharmacy assistants with a technician in training endorsement that are enrolled in a commission-approved Pharmacy Technician Education and Training Program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
The Executive Administrator of the Board of Pharmacy, Michael Bowles, provided additional guidance on the new regulations on Pharmacist-in-Charge (PIC) requirements, Indian Health Service (IHS) pharmacies and self-inspection forms.
- Self-inspection forms no longer need to be submitted to the board for renewals of pharmacies or any other facility type. Self-inspections still need to occur, but the form should be maintained at your pharmacy/facility and made available to the board upon request. The attestation mentioned in the regulation below is on the renewal applications.
12 AAC 52.300. LICENSE AND REGISTRATION RENEWAL.
(a) Pharmacy, remote pharmacy, wholesale drug distributor, outsourcing facility, third-party logistics provider, manufacturer, pharmacist, pharmacy technician and drug room licenses must be renewed biennially on or before a date set by the department.
(b) An applicant for renewal of a pharmacy, wholesale drug distributor, outsourcing facility, third-party logistics provider, manufacturer or drug room license must submit on or before the license expiration date
(3) an attestation that a self-inspection of the premises using the form provided by the department was completed within the last two years or since the last time the license was initially issued; the applicant must retain the self-inspection and make it available to the board upon request for the duration of the licensing period in which it was completed.
- The PIC of an Alaska licensed pharmacy located outside of Alaska is required to be licensed in Alaska and have an active Alaska Pharmacist license. This must be the actual PIC of the pharmacy, not a separate staff pharmacist/owner/etc. designated by the pharmacy as “the Alaska PIC.”
- Pharmacies under the IHS that hold an Alaska Pharmacy license must have an active Alaska Pharmacist license. The IHS exemption currently in place through May 18 does not extend to the PIC.
12 AAC 52.020. PHARMACY LICENSE.
(a) An applicant for a pharmacy license shall submit the items required in (b) of this section for review and approval by the executive administrator. An application that does not clearly demonstrate qualifications for licensure must be reviewed and approved by the board.
(b) An applicant for a pharmacy license shall submit
(1) a complete notarized application on a form provided by the department that includes
(F) the name, active Alaska license number and contact information for the pharmacist-in-charge.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
Gov. Katie Hobbs (D) signed HB (House Bill) 2582 (Chapter 123), legislation permitting pharmacists to enter into collaborative practice agreements with a state-licensed certified nurse midwife or a physician assistant.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
A draft emergency rule by the Insurance Commissioner Alan McClain that would require reimbursement for pharmacies for prescription drug or device services at a rate that is no less than 110% of the current National Average Drug Acquisition Cost (NADAC) plus a $10.50 dispensing fee for all generic and branded drug transactions or services has hit a roadblock.
Also in Arkansas, the next meeting of the Board of Pharmacy is on June 4 and 5.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the "Pharmacy Provider Dispensing Fee Self-Attestation." This will be the final opportunity to attest for the upcoming fiscal year 2024-2025. All attestations must be received by May 31 to be accepted. Attestations will not be accepted after closing on May 31; no exceptions.
- Medi-Cal Weekly Wrap-up for April 26-May 2 (May 3)
- Medical Supplies: Updates to the Billing Policy for Contracted Blood Pressure Monitoring Devices and Cuffs (May 2)
- Removal of Appendix H – List of Physician Administered Drugs with Reject Code 816 (May 1)
- Availability of Extencilline on the Medi-Cal Rx Contract Drugs List (May 1)
- Reminder Billing Tips: Non-Covered Medical Supplies (May 1)
- Medi-Cal Rx Monthly Bulletin for May (May 1)
- Changes to the Medi-Cal Rx Contract Drugs List (May 1)
- Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs (May 1)
- Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations (May 1)
- Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes (May 1)
- Updates to the Medi-Cal Rx Provider Manual (May 1)
- Pharmacy Provider Dispensing Fee Self-Attestation (April 30)
- Medi-Cal Rx Weekly Wrap-up for April 19-25 (April 26)
- How to Address Reject Code 80 – Diagnosis Code Submitted Does Not Need to Meet Drug Coverage Criteria (April 23)
- Closure of Latimer's Pharmacy in Los Molinos and Old Time Drugs in Corning, Tehama County (April 19)
Also in California, the Department of Health Care Services posted the following:
- April 2024 Pharmacy Medi-Cal Update Bulletin
- April 2024 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin
Also in California, NACDS and the California Community Pharmacy Coalition, a project of the California Retailers Association, testified before the California Senate Business, Professions & Economic Development Committee in support of SB 1365, legislation expanding the pharmacist to pharmacy technician ratio to 1:6. The bill was amended changing the ratio from 1:6 to 1:4 and passed out of committee.
Also in California, NACDS submitted a support letter for SB 966, PBM reform legislation to the Senate Appropriations Committee in advance of the hearing scheduled for May 13. SB 966 includes provisions that would prohibit the use of "spread pricing". The bill would also provide other vital reforms, including requiring 100% pass-through of manufacturer rebates to plan sponsors to keep patient premiums low, prohibiting the steering of patients to PBM-affiliated pharmacies, and requires PBMs to obtain a license to operate in the state.
Also in California, the Board of Pharmacy proposed modifications to the following:
- Title 16 CCR § 1760, and the Disciplinary Guidelines, incorporated by reference. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning April 29, 2024, and ending on May 14, 2024.
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- Disciplinary Guidelines
- Notice of Modified Text
- Modified Text
- Modified Disciplinary Guidelines
- Title 16 CCR § 1709.1, related to the Designation of Pharmacist-in-Charge. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning April 29, 2024, and ending on May 14, 2024.
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- Notice of Modified Text
- Modified Text
Finally in California, the Board of Pharmacy has released a Notice of Proposed Action to amend Article 4.5, add Articles 4.6, 4.7, and 4.8, and repeal Article 7 of Title 16, Division 17, of the California Code of Regulations related to Compounded Drug Preparations. The Board will accept comments on the proposed text through June 3.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Rerevised SB24-209, legislation filed by the Colorado Retail Council that chain pharmacies support, would expand pharmacy technician duties. The bill was amended and passed by the Senate Health Committee by a vote of 7-2. The bill advanced to the Senate floor for a vote on April 30 and passed the Senate on May 1. It was amended in the House Committee on May 2 and passed a third reading in the House on May 5.
Also in Colorado, SB24-168, legislation providing reimbursement for the use of telehealth remote monitoring for outpatient services for certain Medicaid members, passed the Senate on April 24 and was assigned to the House Health and Human Services Committee.
Finally in Colorado, HB24-1438, legislation concerning the implementation of certain affordable prescription drug programs, passed the House on April 24 and was assigned to the Senate Judiciary Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Gov. Ron DeSantis (R) signed HB 159 into law. The measure allows a pharmacist to screen an adult for HIV exposure and advise the adult to seek medical consultation from a physician and allows a certified pharmacist to order and dispense PEP (post-exposure prophylaxis) drugs under a written collaborative practice agreement between the pharmacist and a licensed physician.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
Gov. Brian Kemp (R) has signed two pieces of legislation impacting NACDS’ priorities, legislation increasing technician ratios at closed door pharmacies (HB 1072) and expansion of the standing order from the Commissioner to include post-exposure prophylaxis (PEP) medications for the prevention of human immunodeficiency virus to be distributed by pharmacists (HB 1028). Both became effective upon signature.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Hawaii
HB 2553, legislation expanding pharmacists’ immunization authority for minors was transmitted to Gov. Josh Green (D) on May 2.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
Gov. Kim Reynolds (R) signed the following bills:
- HF 555, legislation modernizing the Pharmacy Practice Act by implementing a standard of care model reflecting the education and training of pharmacists licensed to practice in the state. Accordingly, various definitions have been amended to reflect a pharmacist's authority to "issue prescription drugs" and to be defined as a "practitioner" in the state. The board of pharmacy, in consultation with the department of health and human services, may develop statewide protocols. There are also some efficiencies gained, e.g., refill authority for non-controlled drugs and therapeutic substitution.
- HF 2099, legislation proposed by the Department of Insurance and Financial Services that oversees PBM (Pharmacy Benefit Managers) practices in the state. The bill deems that PBMs (Pharmacy Benefit Managers) owe pharmacies a duty of fair dealing and good faith, prohibits PBMs from retaliating against a pharmacy filing a complaint to or cooperating with the commissioner, requires PBMs to update the maximum allowable cost list within seven days of a 10% increase in NADAC, and prohibits a PBM from assessing or collecting charges/fees.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
Now that Kansas pharmacists are recognized in state statute as providers, starting on June 1, all KanCare (Medicaid) vaccine billing, including flu shots, will be under the new provider designation "Non-Physician/Pharmacist." The benefit of medical billing is that vaccine administration is billed at Kansas Medical Assistance Program (KMAP) rate of $14.20 instead of $10.50.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
HB 579, the post-exposure prophylaxis (PEP)/pre-exposure prophylaxis (PrEP) bill supported by pharmacies, passed unanimously out of the House. It was amended in the Senate Health and Welfare Committee last week. Next step is to be voted on by the full Senate, and then returned to the House for concurrence.
Also in Louisiana, the Department of Health (LDH) issued a Bulletin acknowledging that they are working to resolve several issues associated with the implementation of the Single Managed Care Organization (MCO) pharmacy benefit manager (PBM), Magellan (MMA). Pharmacists are encouraged to email Medicaid pharmacy staff directly for assistance.
Also in Louisiana, the Department of Health (LDH) issued a revised Medicaid Bulletin on April 15, clarifying 340B reimbursement.
Also in Louisiana, the Board of Pharmacy's quarterly meeting was held at the Board's office on May 7 and 8.
Also in Louisiana, the Department of Health (LDH) posted a plethora of resources for healthcare providers addressing substance use disorder as a treatable medical condition through stigma-free care and ensuring access to treatment options.
Finally in Louisiana, the Board of Pharmacy posted the agenda for a Public Hearing on May 28 for four regulatory projects – Product Integrity, CDS (Clinical Decision Support) Licensing, Open Meetings via Electronic Means and Prescription Monitoring Program Advisory Council Open Meetings via Electronic Means.
For more information, contact NACDS’ Mary Staples at 817-442-1155.