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Vermont

On January 24, the Board of Pharmacy held its regularly scheduled meeting. The board welcomed new members, elected a new chair, and provided a legislative update. The next meeting is scheduled for February 28 at 9:00 am virtually via Teams.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 26, 2024|Vermont|

Washington

In advance of the January 24 House Health and Wellness Committee hearing, NACDS registered in support of HB 2116, legislation expanding prescriptive authority for pharmacists. We also submitted the attached support statement for the record.  

Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) is scheduled to meet on February 1. The meeting materials will be available online soon. 

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

January 26, 2024|Washington|

Wisconsin

On January 24, Gov. Tony Evers (D) issued a standing order to ensure BadgerCare Plus members have direct access to over–the–counter emergency contraception. The order allows BadgerCare Plus members to get OTC emergency contraception from any Wisconsin Medicaid-enrolled pharmacy under their state coverage without a prescription from their doctor and with no out-of-pocket cost to them.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 26, 2024|Wisconsin|

Arizona

HB 2183 related to parental rights and medical records will be heard in the House Health & Human Service Committee on January 22 and is listed on the agenda. The bill entitles parents with the right to have access to any electronic portal or other health care delivery platform, including written medical records, for their minor child.  

Also in Arizona, SB 1085, legislation permitting pharmacists, pursuant to a statewide written protocol, to independently order, perform and interpret CLIA-waived tests and initiate treatment to individuals three years of age and older and who test positive for influenza, Group A streptococcus pharyngitis, SARS-COV2 or any other respiratory illness, condition or disease and a condition related to an emerging or existing public health threat identified by the Department of Health Service for which a standing order rule or executive order is issued, was introduced, read for the first time and assigned to the Senate Health & Human Services Committee. The bill also permits the pharmacist to delegate the administrative and technical tasks of performing a CLIA-waived test to a trained member of the pharmacy staff who is under the supervision of the pharmacist and states a health insurer may not deny reimbursement for these services performed within the scope of the pharmacist's license and covered by the insurer if performed by a physician, nurse practitioner or physician assistance. 

Also in Arizona, HB 2450, legislation adding a pharmacy technician trainee to requirements for work at a remote dispensing site pharmacy, has been introduced. 

Finally in Arizona, HB 2582, legislation permitting a pharmacist to enter into a collaborative practice agreement with a certified nurse midwife or physician assistant, was introduced, read for the first time and assigned to the House Health & Human Services Committee.  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 19, 2024|Arizona|

California

The Department of Health Care Services posted the following alerts, bulletins, and weekly notices on the Medi-Cal Rx Web Portal.   

 

 

Also in California, the Department of Health Care Services posted the following:   

 

 

Also in California, the Board of Pharmacy proposed modifications to the following. To view all documents associated with these proposed regulatory actions and other pending regulations, visit the board's "Pending Regulations" webpage.  

 

  • Opioid Antagonist Protocol 

 

  • Continuing Education 

Also in California, the Board of Pharmacy posted its Annual Notice of Availability of Precedential Decisions Index.  

NOTICE IS HEREBY GIVEN that the California State Board of Pharmacy (Board), pursuant to section 11425.60 of the Government Code, the Board maintains an index of precedential decisions, which is annually made available by the Board to the public by email subscription. To join the Board's email list, go to www.pharmacy.ca.gov. The index and the text of the precedent decisions are continuously available on the Board's website at http://www.pharmacy.ca.gov/enforcement/precedential.shtml. 

Also in California, the Board of Pharmacy provided an update to licensees and interested stakeholders regarding the cultural competency continuing education (CE) requirements for pharmacists and pharmacy technicians that become effective on January 1, 2024, pursuant to Assembly Bill 2194 (Ward, Chapter 958, Statutes of 2022).  

As pharmacists and pharmacy technicians seek cultural competency CE courses, the Board has received questions about acceptable courses. 

Business and Professions Code (BPC) section 4231, as operative on January 1, 2024, details the criteria that a cultural competency course must meet, as follows: 

  • The course focuses on patients who identify as lesbian, gay, bisexual, transgender, gender nonconforming, or queer, or who question their sexual orientation or gender identity and expression. 
  • The course is approved by an accreditation agency approved by the Board. 
  • The course covers recognized health disparities faced by Black, Indigenous, and people of color. 
  • The course contains elements demonstrating how sexual identity is directly impacted through intersectionality. 

The Board does not endorse or recommend any specific cultural competency course. As a courtesy to licensees, however, the Board is notifying licensees of two courses that may meet the above requirements: 

Finally in California, the Board of Pharmacy posted the agenda and meeting materials for the following committee meetings: 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 19, 2024|California|

Illinois

The Department of Healthcare and Family Services (HFS) is providing this update regarding buprenorphine dosing for pregnant individuals with a substance use disorder (SUD) diagnosis, who, due to growing fetus and maternal weight gain, are likely to require a higher dosage than the usual 24 mg maximum dose.  

HFS is working on programming to allow a total daily dose of up to 32 mg of all buprenorphine products (monotherapy as well as combination products with naloxone) for pregnant individuals with SUD without a prior authorization, when both diagnoses (pregnancy and SUD) are noted on the prescription.  

These services will be covered under both the fee-for-service (FFS) program and managed care organizations (MCOs) with a target implementation date of February 1, 2024.  

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the appropriate MCO plan.  

Also in Illinois, Public Act 103-1425, which became effective January 1, 2024, requires prescriptions to be issued electronically unless one or more of a variety of exemptions are met.  

Illinois Retail Merchants Association (IRMA) and the Illinois Pharmacists Association (IPhA) are being inundated with complaints from prescribers because paper prescriptions are being denied by pharmacists primarily issued by prescribers who are exempt from having to issue electronically. The complaints are primarily coming from prescribers who will not issue more than 150 prescriptions in the calendar year. In addition to that exemption, below is a summary of the exemptions under the law.  

Importantly, any pharmacist who dispenses in good faith based upon a valid prescription that is not prescribed electronically may be exempt from any disciplinary action. A pharmacist is not required to ensure or be responsible for ensuring the prescriber's compliance, nor may any other entity or organization require a pharmacist to ensure the prescriber's compliance with that subsection.  

IRMA and IPhA have prepared and issued detailed guidance. You are strongly encouraged to distribute or utilize this guidance to ensure pharmacy personnel are fully aware of the exemptions under this law.  

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

January 19, 2024|Illinois|

Indiana

NACDS is a proud sponsor of the Indiana Pharmacy Associations' (IPA) annual Legislative Day at the Indiana State House. The advocacy event allows pharmacists, students and pharmacy technicians to educate legislators about the importance of pharmacies as a convenient, accessible community healthcare destination, as well as an opportunity to promote pharmacists and technicians as vital members of the healthcare team. 

Also in Indiana, the Family and Social Services Administration's (FSSA) Indiana Health Coverage Programs (IHCP) issued Bulletin 2023181 updating billing guidance for Novavax COVID-19 vaccinations. The reimbursement is carved out of managed care benefits. 

Also in Indiana, all pharmacy groups are strongly supporting SB 192, legislation that would allow pharmacists to administer all Advisory Committee on Immunization Practices (ACIP)-approved vaccines to anyone 11 years of age and older under a physician protocol. 

Finally in Indiana, HB 1327, a PBM audit and transparency bill supported by the Employers Group of Indiana, was heard in the House Public Health Committee on January 16.  

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

January 19, 2024|Indiana|

Iowa

The House Commerce Committee held a hearing on January 18 and recommended passage of HSB 536, related to PBMs. This study bill, proposed by the Department of Insurance and Financial Services, expands the PBM’s duty of good faith and fair dealing to pharmacies. It also prohibits retaliation by a PBM against a pharmacy for exercising its rights or remedy or in cooperation with the commissioner. Also, a PBM is prohibited from assessing, charging or collecting any form of renumeration that passes from any pharmacist, regardless of whether the pharmacist in a pharmacy network. The bill also requires a PBM to update the maximum allowable cost (MAC) list within seven days from the date of an increase of 10 percent more in the NADAC of a prescription drug on the list. Finally, it places additional reporting requirements on PBMs. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 19, 2024|Iowa|

Louisiana

The Board of Pharmacy's Regulation Review Committee has posted the agenda for the January 24 meeting in Baton Rouge.  

Also in Louisiana, the Department of Health's (LDH's) vendor Magellan will approve overrides for non-preferred products when the preferred product has a manufacturer shortage. Contact the Magellan Medicaid Administration help desk at (800) 424-1664 to get the override. The prescriber does not need to fill out a prior authorization. The current list of drugs with known shortages are Sabril® 500mg powder for oral solution, generic Concerta®, generic Focalin XR®, Trileptal® suspension and generic Mydayis™. 

Finally in Louisiana, LDH (Department of Health) issued Bulletin 24-1 informing providers that Medicaid is updating the Medicaid Fee-For-Service (FFS) files procedure codes.  

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

January 19, 2024|Louisiana|

New York

On January 16, Gov. Kathy Hochul (D) announced her current year budget proposal. The impactful sections are below:   

  1. Streamline Medicaid Drug Cap – to streamline and remove prior triggers to enable the state to get manufacturer rebates more quickly 
  2. Discontinue Prescriber Prevails – to eliminate prescriber prevails in Medicaid where clinical standards for approval are not met 
  3. Pharmacy Enhancements and Integration Specialty Drug Management – to create new benchmarks for physician administered drug reimbursement similar to pharmacy reimbursement under Medicaid Fee-for-Service (FFS); part of the goal is to bring drugs that do not have a NADAC up to WAC instead of current WAC-3%. Also, it includes requirement for all Medicaid enrolled pharmacies to submit annual cost reports in a form requested by the state Department of Health (DOH).  
  4. Reduce Coverage for Over-The-Counter (OTC) Pharmaceuticals – to enable DOH to modify the list of OTCs covered in the Medicaid program  

 

Also in New York, NYRx, the New York Medicaid Pharmacy Benefit Program, held its regular industry call on January 17. Updates are below; however, two other conversations occurred during the call, including Pharmacy Cost Reporting proposed in the budget and Inspector General (OMIG) audit protocols regularly updated to reflect Medicaid FFS pharmacy policies, e.g., change in signature on deliveries requirement. OMIG will be joining the February Pharmacy Sector call. 

  1. Covid-19 Oral Antivirals: DOH discussed new guidance related to billing for antivirals (Paxlovid™ and Lagevrio™). 
  2. Covid-19 Vaccine Billing for non-VFC (Vaccines for Children) Pharmacies: DOH discussed guidance for billing non VFC and admin code to use for VFC and non-VFC which can be found here. 
  3. 1115 Waiver: 3-year waiver approved totaling $7.5 billion through March 31, 2027.  

NYRx also revised its preferred drug list, effective January 18.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 19, 2024|New York|

North Carolina

During the 2023 Legislative Session, the General Assembly passed, and the Governor signed into law, a statute making gabapentin a drug whose dispensing must be reported to the Controlled Substance Reporting System (CSRS). Gabapentin becomes reportable on March 1, 2024. The Drug Control Unit, which administers the CSRS, has created an FAQ guidance document for dispensers. Pharmacists with additional questions should contact the Drug Control Unit. 

Note that based on an NC Retail Merchants Association amendment, pharmacies are not required to report gabapentin to the CSRS when gabapentin is a component of a compounded prescription that is dispensed in dosages of 100 milligrams or less; see new G.S. 90-113.73(c)(1). 

Also in North Carolina, on January 10, Medicaid released the following concerning pharmacy eligibility to serve as Medicaid providers. All questions should be directed to Medicaid. 

Beginning in May 2021, NC Medicaid started taking additional steps, as outlined in the NCTracks Changes to Provider Verification Process bulletin, to ensure providers meet their contractual obligation to maintain their credentials on their NCTracks provider enrollment record. Multiple bulletin articles were published to notify providers of the change, and providers receive four targeted reminders prior to their suspension notification. Regardless of these efforts to inform and assist providers with this responsibility, we continue to see a fairly large number suspended, and subsequently terminated, from the NC Medicaid program due to their expired credential.

For this reason, and as part of an additional outreach effort, we are notifying NC associations when the number of provider taxonomy suspensions exceeds a defined threshold of unique providers on the report received at the end of each month.

On December 31, 2023, approximately 115 Pharmacist providers were suspended due to an expired credential. These providers have sixty days from the date of suspension to ensure that their license is renewed, and their NCTracks provider enrollment record is updated to avoid termination. Providers may update their NCTracks provider record through the Manage Change Request process. NCTracks User Guides and Fact Sheets offer basic instructions for making the necessary update and any additional questions may be referred to the NCTracks Call Center at 800-668-6696. 

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

January 19, 2024|North Carolina|

Oklahoma

Pharmacists working in multiple locations must have their small wallet card pharmacy license, a copy of their immunization certificate and a copy of their CPR certificate available to produce to the Board’s compliance officers for inspection.

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

January 19, 2024|Oklahoma|

Texas

The next quarterly meeting of the Board of Pharmacy is Tuesday, February 6, at the new Barbara Jordan State office building. The agenda will be posted here when it becomes available. 

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

January 19, 2024|Texas|

Washington

On January 24, pharmacy professionals and students will gather at the Capitol in Olympia for the first of two legislative days which NACDS is proud to sponsor. The advocacy event allows pharmacists, students and pharmacy technicians to educate legislators about the importance of pharmacies as a convenient, accessible community healthcare destination, as well as an opportunity to promote pharmacists and technicians as vital members of the healthcare team.  

Also in Washington, Health Care Authority (HCA) created a new flyer that pharmacies can distribute to help reach Medicaid patients encouraging them to update their contact information and apply for or renew coverage. Pharmacies can order the free flyers in both English and Spanish. 

Also in Washington, the Heath Care Authority's (HCA) first quarter Preferred Drug List (PDL) used by Uniform Medical Plan and the Department of Labor and Industry is available online. 

Finally in Washington, legislation expanding prescriptive authority for pharmacists, HB 2116, will be heard in the House Committee on Health Care & Wellness on January 24. Take action today to register your support for the bill. If you reside in the state, register your support with your legislator by filling out this form. To share your support with all Committee members, use this link to submit a supporting statement or testimony.  

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

January 19, 2024|Washington|

Alabama

To streamline the provider enrollment process, Alabama Medicaid provider enrollment applicants should gather all needed materials before applying. READ MORE for some of the most common reasons why applications are denied. If you have any questions regarding your application, please contact Provider Enrollment at (888) 223-3630.  

Also in Alabama, on January 17, at 2:00 pm CST, the Board of Pharmacy will hold a Practice of Pharmacy Workgroup Meeting, where they will delve into Alabama Administrative Code 680-X-2-.14. This code defines the pivotal roles and duties of pharmacy technicians within the healthcare system. For those who wish to attend in person, the meeting will be held at 111 Village Street, Birmingham, AL 35242. Virtual attendance is available here. Do not miss this chance to be a part of the conversation that shapes the future of pharmacy in Alabama.  

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

January 12, 2024|Alabama|

Alaska

The Board of Pharmacy issued a reminder to pharmacists regarding Collaborative Practice Agreements (CPAs). CPAs are established between medical providers and pharmacists and are housed at the Medical Board, not the Board of Pharmacy. It is important to note that CPAs are established between a physician and a lead pharmacist, not a pharmacy. In the event of a change of pharmacist-in-charge (PIC) at a pharmacy that affects an established CPA, a new CPA must be submitted to the Medical Board for review.

Also in Alaska, pharmacists now have the authority to prescribe immunizations, epinephrine, and emergency drugs. As a result, a Collaborative Practice Agreement is not required to prescribe and administer these items. 

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

January 12, 2024|Alaska|

Arkansas

The Board of Pharmacy met at the Board offices in Little Rock on January 9 and 10.  

Also in Arkansas, the state pharmacist's association received a grant of $78,548. The funds will be utilized in 2024 to educate pharmacists and prescribers about the pharmaceutical supply chain regulatory guidance and oversight mandated by the federal government for drug wholesalers. The training aims to inform them about how this regulation affects patients, physicians, and the local pharmacists.  

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

January 12, 2024|Arkansas|

California

The Department of Health Care Services posted the following alerts, bulletins, and weekly notices on the Medi-Cal Rx Web Portal.   

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 12, 2024|California|

Colorado

The legislature convened on January 10.  

Also in Colorado, an interim committee bill drafted by the Opioid and Other Substance Use Disorders Study Committee addressing medications for opioid use disorder (MOUD) prescribing by pharmacists is expected to be filed soon. 

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

January 12, 2024|Colorado|

Delaware

The Board of Pharmacy will be holding its regular meeting on January 17. The agenda includes Pharmacists Dispensing and Administering Contraceptives Regulation Draft Update, Pharmacists Well-Being Index, Board of Pharmacy Act Revisions and Review and Consideration of Pharmacy License Specialties.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 12, 2024|Delaware|

Florida

Gov. Ron DeSantis (R) released his Focus on Florida's Future Budget recommendations for Fiscal Year 2024-25. The proposed budget comes in at $114.4 billion, which is a $4.6 billion decrease compared to the state's FY 2023-24 budget. Governor DeSantis' Focus on Florida's Future Budget supports more than $1.1 billion in tax relief and the renewal of four traditional sales tax holidays as well as more than $153 million from the nationwide Opioid Settlement Agreement to continue support for the Office of Opioid Recovery, an accredited Graduate Medical Education program to increase the number of psychiatric residents and for other initiatives that support education, treatment and prevention for individuals with substance use disorders. The full budget highlights are available online.   

Also in Florida, the Agency for Health Care Administration (Agency) has filed six (6) new Durable Medical Equipment and Medical Supply Services Coverage Policies for adoption in the Florida Administrative Code (F.A.C.). These new policies took effect on January 10. Please visit the Agency's website at  Adopted Rules – Main Page (myflorida.com) for details on the new Durable Medical Equipment and Medical Supply Services Coverage Policies. 

Finally in Florida, the Agency for Health Care Administration (Agency) has been working on modifying the way diabetic supplies are provided to Floridians served through the State's Medicaid program by transitioning reimbursement for diabetic supplies from the durable medical equipment (DME) fee schedule to the pharmacy point of sale system. The Agency plans to release the Preferred Product List as referenced in proposed rule 59G-4.002, along with a resource toolkit to assist providers with billing for diabetic supplies through the pharmacy point of sale system. Until further direction is given, the Agency will continue to reimburse DME providers for all currently available diabetic supplies listed on the Durable Medical Equipment and Medical Supply Services Provider Fee Schedule using the existing reimbursement process.  

All interested parties should continue to check the Agency's Pharmacy Policy webpage periodically and read all Agency alerts that are sent out regarding these changes. Interested Parties may also email the Agency at PharmacyPolicy@ahca.myflorida.com with any questions.  

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

January 12, 2024|Florida|

Georgia

The Legislature convened on January 8. Legislation regarding reimbursement and scope issues that carried over from the 2023 session are expected to be heard during the 2024 session. 

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

January 12, 2024|Georgia|

Idaho

On April 6, 2023, Gov. Brad Little (R) signed HB 71, the Vulnerable Child Protective Act prohibiting puberty blockers, cross-sex hormones, and sex reassignment surgeries for children under the age of 18 when administered or performed for the purpose of changing the appearance of a child's sex with exemption for medically necessary uses of these drugs and procedures. On December 26, 2023, in a preliminary order, U.S. District Judge B. Lynn Winmill issued an order enjoining enforcement of HB 71 pending the outcome of litigation initiated by families filing a suit challenging the state law; Judge Winmill wrote that the 14th Amendment of the U.S. Constitution's guarantees of equal protection and due process give parents the right to get gender-affirming care for their children.   

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 12, 2024|Idaho|
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