California
The Department of Public Health (CDPH) released its inaugural "California State of Public Health Report". The 2024 Summary Report utilizes multiple health measures and data sources to highlight major trends and disparities in health outcomes across the state. Although there have been major improvements in health and well-being over the past 20 years, California continues to strive to address issues through a myriad of initiatives including intervention at the earliest stages of life; prevention, especially primary prevention; upstream strategies to improve social determinants that create healthy conditions for all, with a priority focus on advancing health equity; and strengthening public health readiness and resiliency in the face of emerging threats and challenges such as climate change.
Also in California, the Department of Public Health issued a summary report on the work of the AB 1341 Workgroup, created by Gov. Gavin Newsom (D) after he vetoed the bill in 2022. With a focus on the state's youth, this report summarizes policy recommendations from academic and medical experts related to educating and safeguarding the public against the potential risks associated with the use of dietary supplements for weight loss and over the counter (OTC) diet pills. It is unknown how this report may impact weight loss supplement legislation currently under consideration by the state legislature.
Also in California, last week, Attorney General Rob Bonta, Gov. Gavin Newsom (D), State Board of Pharmacy President Seung Oh, and Department of Managed Health Care Director Mary Watanabe acted to reaffirm an individual's rights to contraceptive care in the state. Among the actions taken were alerts to all California pharmacies reminding them of their obligation under California law to provide minors access to emergency contraception and alerts to all State Board of Pharmacy licensees reminding licensees of their obligations under state law to provide minors with the ability to access emergency contraception without a prescription or parental consent.
Also in California, the Board of Pharmacy proposed modifications to amend section 1760 of Title 16, Division 17, Article 5 of the state's Code of Regulations related to disciplinary guidelines; see details below. The 45-day comment period ends on April 12. To view all documents associated with the Board's proposed regulatory actions and other pending regulations, visit the board's "Pending Regulations" webpage.
Finally in California, the Department of Health Care Services posted an alert, "National System Outage Impacting Prescription Drug Claims". (February 23)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
HB24-1045, legislation pharmacies support that expands access to medications for opioid use disorder (MOUD), provides funding for startup and training in select locations and ensures fair payment for the medical services provided, passed the House Health and Human Services Committee, and was referred the House Finance Committee for a hearing on March 7.
Also in Colorado, the state submitted an amended Canadian drug importation application to the FDA (FOOD AND DRUG ADMINISTRATION) this week which included a scaled-back list of twenty-four drugs it plans to import at a lower cost, including the new blockbuster weight loss drugs.
Finally, the Colorado Pharmacists Society had a great turnout at the Day at the Capitol on February 28 to promote pro-pharmacy, patient care legislation.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Georgia
The Board of Pharmacy released its latest newsletter which includes information regarding CE (continuing education) requirements for pharmacy technicians, a GDNA (Georgia Drugs and Narcotics Agency) update and President Michael Azzolin’s outgoing message.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
This week, HB 596, related to PBM reform, was reported out of the House Health and Welfare Committee with a “Do Pass Recommendation”. This legislation would add new definitions; outline requirements that make contracts with pharmacies transparent and fair; require PBMs (Pharmacy Benefit Managers) to provide transparent pricing on drugs and require PBMs to report to the Department of Insurance in a transparent way.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
The Health Coverage Programs (IHCP) issued Bulletin 202419 on adjustments and reprocessing claims for COVID-19 vaccines and administration codes.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
On February 26, HF 555 passed the Senate with a unanimous vote (46-0). It returns to the House for concurrence with the Senate amendments.
Also in Iowa, the Department of Health and Human Services, Iowa Medicaid posted the following:
- INFORMATIONAL LETTER NO. 2563-MC-FFS-D RE: Pharmacy Provider Resources
- INFORMATIONAL LETTER NO. 2562-FFS RE: Pharmacy System Issues
- INFORMATIONAL LETTER NO. 2545-MC-FFS RE: Pharmacists Visits at FQHC (Federally Qualified Health Centers)
- INFORMATIONAL LETTER NO. 2542-MC-FFS-D RE: Iowa Medicaid Pharmacy Program Update – Buprenorphine Age
- INFORMATIONAL LETTER NO. 2540-MC-FFS RE: January 2024 Pharmacy Billing Reference
Finally in Iowa, the Board of Pharmacy adopted and filed ARC 7617C to amend Chapter 10, "Controlled Substances". The amendment temporarily places five substances (novel psychoactive substances of the benzodiazepine class, also known as "designer benzodiazepines") to Schedule I of the Iowa CSA (Controlled Substances Act) in response to similar action taken by the federal Drug Enforcement Administration. The amendment is effective March 13.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact issued a communication to pharmacies regarding reprocessing managed care claims for Lagevrio. Prescriptions dispensed using the commercially distributed product for Managed Care members prior to February 8, 2024, may be reversed and reprocessed to include the ingredient cost in the final paid amount. They will automatically reprocess claims that pharmacies have not resubmitted within the next 60 days. This does not apply to fee-for-service claims.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Medicaid issued a Pharmacy Facts program update alerting pharmacies that the Single Pharmacy Benefits Manager (PBM) for Managed Care Organizations (MCO) Magellan, will contact network Pharmacy Services Administrative Organizations (PSAO), chains and independent pharmacies, to agree to the new level of effort (LOE) compound fee schedule effective April 1, 2024.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
On February 27, MaineCare announced it is now authorizing 30-day prescriptions to continue to assist pharmacies in fulfilling MaineCare member prescriptions in response to the Change Healthcare network interruption. This is a change from MaineCare's temporary authorization of the use of a three-day override as noted in its February 23 e-message.
The Department will pay all eligible claims submitted once the system is operational. It is working on the details for when and how such payments will be made and will release the details as soon as possible. Change Healthcare has not issued a timeline for resolution yet. The Department will communicate a timeline for resuming normal payments as soon as possible.
Pharmacies should continue to process claims as usual. Pharmacies should check eligibility for MaineCare members during this period by calling MaineCare Provider Services at 1-866-690-5585 or checking the HealthPas online portal.
We are continuing to waive all prior authorization (PA) mandates for pharmacy. With this change to authorize 30-day prescriptions, we expect pharmacies to return to following the MaineCare Preferred Drug List (PDL).
Consistent with state and federal requirements, pharmacies may not bill, demand, or otherwise seek payment from MaineCare members (or a representative of the member) for any MaineCare covered service.
The Department stands ready to assist pharmacies in assessing MaineCare eligibility and facilitating coverage during this extraordinary period and thanks pharmacies and their staff for their help in ensuring access to medications for MaineCare members.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts
The Massachusetts Joint Legislative Committee on Financial Services has reported H4066, a bill to expand pharmacist’s scope of practice, favorably out of the committee. Specifically, the bill directs the Board of Pharmacy to establish protocols for pharmacies to test, screen and initiate treatment or therapy for qualified health conditions: Influenza, Streptococcal infections, COVID-19, HIV, and any other conditions approved by the Board. H4066 also allows pharmacists to delegate the tasks of performing a CLIA–waived test to pharmacy technicians acting under the supervision of the pharmacists. Lastly, the bill requires insurance carriers to make available provider and consult codes for pharmacy compensation which shall be at the standard contracted rate that they reimburse for the same services by any other healthcare provider. H4066 will now be assigned to a committee of second jurisdiction. NACDS will continue to partner with the Massachusetts Chain Pharmacy Council to advocate for final passage of the bill.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
On March 4, the House Health and Mental Health Committee will hold a hearing on HB 1627, legislation pharmacies support that would bring some much-needed PBM reforms. The Missouri Pharmacy Association is organizing a rally at the Capitol on Monday, urging pharmacists and technicians to show up at 11:00 am to tell legislators that "Enough is enough" with PBM abuses.
Also in Missouri, the Board of Pharmacy's February 2024 newsletter was posted on the Board's website.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Board of Pharmacy posted a revised agenda for its March 4 meeting. The board also posted the draft minutes from the January 8 and the February 6 meetings.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
The Board of Pharmacy posted the agenda for the March 6 & 7 meeting in Las Vegas.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
On February 27, the State Department of Health Office of Health Insurance Programs approved the release of the January 2024 Medicaid Update.
- eConsults (Cover)
- NY State of Health Public Health Emergency Unwind Fact Sheet for Providers Now Available
- Zynteglo® (betibeglogene autotemcel): Medicaid Practitioner Administered Drugs Update
- Reminder: New York State Medicaid Covers Nirsevimab, Abrysvo and Arexvy for the Prevention of Respiratory Syncytial Virus
- Updated Fees for Family Planning Services
- Medicaid Managed Long Term Care Transportation Carve Out Begins March 1, 2024
Also in New York, the State Board of Pharmacy will be holding its regular meeting on March 7 at 10:00 am in New York City. The Board advises that members of the public wishing to observe the Board of Pharmacy's public session must email their full name to the Pharmacy Board office (pharmbd@nysed.gov) at least 48 hours in advance. Failure to notify the Board office may result in delayed entry to the meeting. For security purposes, a valid Government issued ID will be required for admittance.
Also in New York, S8545, was introduced last week at the request of NACDS and the Community Pharmacy Association of New York State. This legislation would (1) remove the limitation on where "registered pharmacy technicians" can practice in the state to all pharmacy settings; (2) add vaccine administration authority to the duties of registered pharmacy technicians; and (3) provide greater flexibility in the supervision standard for pharmacists overseeing registered pharmacy technicians from a "direct personal supervision" standard to being immediately available. An Assembly companion bill will be introduced soon.
Also in New York, on February 13, the State Department of Health issued a new non-patient specific prescription for naloxone with pharmacy dispensing protocol effective February 13, 2024, through February 12, 2026.
Finally in New York, the State has expanded its existing efforts at monitoring and understanding prescription drug prices by enacting legislation addressing prescription drug price transparency. Effective June 19, 2024, S599-A/A1707 amends the New York Insurance Law to require prescription drug manufacturers to report certain price increases before they occur.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Board of Pharmacy has published a schedule of 2024 board meetings.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The Oklahoma Pharmacists Association’s (OPhA) Legislative Day at the Capitol is on March 5. Michael Leake, Deputy Attorney General and Director of the PBM unit, will update on efforts to oversee the enforcement of the Patients Right to Pharmacy Choice Act and the Audit Integrity Act.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
SB 1506 (Enrolled) passed the House and will be sent to Gov. Tina Kotek (D). This bill would allow a pharmacist to test and prescribe, dispense, and administer treatment for SAVS-CoV-2 consistent with protocols adopted by the State Board of Pharmacy by rule. It would also permit a pharmacist to delegate to a pharmacy technician or an intern under the pharmacist’s supervision the administrative and technical tasks of performing a SARS-CoV-2 CLIA-waived test. Finally, the bill would require payment for these services effective October 1, 2024, with a sunset date of June 30, 2026.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Dakota
HB 1147 (Enrolled), legislation addressing discriminatory acts against entities participating in a 340B drug pricing program, was delivered to Gov. Kristi Noem (R) on February 27.
Also in South Dakota, Heather Petermann is Medicaid Director for the Department of Social Services. Heather previously led the Health Care Research and Quality division within the Minnesota Department of Human Services.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
Tennessee Pharmacy Association (TPA) asked pharmacy technicians to complete TPA’s pharmacy technician survey Survey topics include responsibilities, advanced technician roles, direct patient care roles, well-being, and certifications. Participation will help TPA gain insight into the roles that pharmacy technicians hold within different settings of pharmacy practice.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The State Board of Pharmacy (TSBP) adopted and proposed several new rules at the February quarterly meeting.
Also in Texas, the TSBP publishes a monthly newsletter aimed at informing interested parties about law and rule changes and news relating to the practice of pharmacy in the state.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
Effective February 21, Change Healthcare started to experience network issues expected to continue throughout the weekend. To ensure Medicaid members receive necessary prescriptions and pharmacies have necessary guidance the agency offered the following:
- Claim Processing/Prescription and Emergency Fills: Claims are not processing currently. Existing federal law requires that a 72-hour emergency supply of a prescription drug be dispensed to Medicaid patients when the medication is needed without delay. Claims will be processed once the Change Healthcare system issues have been resolved. It is expected that providers will adhere to the provider agreements, which prohibit billing members when Medicaid will pay for services. Please refer to the provider manual for the limitations on billing members Vermont Medicaid Provider Manual (vtmedicaid.com).
- Eligibility: Eligibility must be verified through the automated Voice Response System (VRS), 800.925.1706, option 1 and then option 1 again or by utilizing online Transaction Services (https://vtmedicaid.com/#/home). For those members indicating new enrollment as of February 23, please call Maximus at 855-899-9600 during business hours and for afterhours please call the automated Voice Response System (VRS).
- Pharmacy Procedures: Many pharmacies have established internal procedures to handle such situations and we encourage dispensing medications to affected members to ensure continuity of care.
- Prior Authorizations: The outage is impacting the ability to issue prior authorizations. Therefore, prior authorization will be retroactively reviewed and applied for prescriptions filled during the system outage. Pharmacies must review the PDL to ensure the criteria is met prior to issuing new medications. Preferred Drug List (PDL) & Clinical Criteria | Department of Vermont Health Access
- Refills should be issued as requested based on the member's history and clinical judgement. These claims will also be subject to a retroactive review.
- Controlled substance prescriptions: Please review the Vermont Prescription Monitoring System (VPMS) system as required.
- Helpdesk Access: Due to the outage, pharmacies are temporarily unable to contact the pharmacy helpdesk via phone or fax. Change Healthcare has indicated that the cause of the outage has been identified and they are working actively to restore normal operations. For questions, contact the Department of Vermont Health Access Pharmacy team at 802-879-5000 or ahs.dvhaph@vermont.gov.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Washington
The PBM reform bill that passed the Senate earlier this month was amended in the House and continues to advance E2SSB 5213 through the legislative process despite the false claims that this bill would cost the state of Washington almost $239 million in excess drug spending in year one, and as high over $2.7 billion over the next 10 years. The bill is on the House calendar and must be voted out by 5:00 pm on March 1. If that occurs, the bill will be returned to the Senate for concurrence with amendments added in the House Health and Wellness Committee last week.
Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) posted the agenda for the March 7 meeting.
Also in Washington, register now for the Apple Health quarterly online seminar on March 7 aimed at providing HCA (Health Care Authority) partners with information about current Apple Health (Medicaid) programs and program updates.
Also, in Washington, responsible pharmacy managers or equivalent managers of pharmaceutical firms must conduct an annual self-inspection in March and within 30 days of naming a new responsible pharmacy manager. The self-inspections are to be completed on Pharmacy Quality Assurance Commission provided worksheets.
Finally in Washington, the Department of Health Prescription Monitoring Program is hosting a rulemaking workshop on March 19 to clarify the rules defining the concepts of "sold", "dispense", "filled" and "distributed".
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
SF 0100 (Engrossed), legislation related to prompt payment of clean pharmacy claims, passed the Senate, and was introduced in the House and referred to the Corporations, Elections & Political Subdivisions Committee.
Also in Wyoming, Gov. Mark Gordon (R) sent the Senate his list of nominees for numerous state offices, boards, and commissions. These nominees are subject to confirmation by the Senate. Among the nominees are Summer Hanson, DVM.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Medicaid Agency created a new form titled "Notification of Request for Medical Records from Provider." This form should be used by all Medicaid providers to notify Medicaid that recipients have requested copies of their medical records. For more information, click here.
Also in Alabama, the Alabama Pharmacy Association is excited to announce the introduction of its podcast, "Off Script" hosted by Dr. Garrett Aikens. Through "Off Script", they hope to provide important and timely updates about the ever-changing world of pharmacy. Go follow us on Spotify then listen to the intro and expect the first episode later this week as Louise and Danielle recap this week's Board of Pharmacy meeting.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The broad PBM reform bill pharmacies are supporting, AK SSSB 121 was amended and referred to both the Senate Labor and Commerce and the Finance Committees for action.
For more information, contact NACDS’ Mary Staples at 817-442-1155.