Maine
The state legislature held two work sessions on LD 1829, An Act to Reduce Prescription Drug Costs by Requiring Reference-based Pricing. The measure attempts to prohibit the dispensing, delivery or administration of a prescription drug at a cost that exceeds the maximum fair price during the price applicability period. The bill also attempts to prohibit insurers from purchasing or seeking reimbursement for referenced drugs at a cost higher than the maximum fair price. Lastly, LD 1829 attempts to prohibit retail pharmacies from purchasing or seeking reimbursement for referenced drugs dispensed to a consumer whose health care is provided by an insurer at a cost exceeding the maximum fair price. The bill is still pending before the Committee on Health Coverage, Insurance and Financial Services. NACDS joined other industry groups in a letter of concern with opposition to several aspects of the bill.
Also in Maine, on February 1, the Board of Pharmacy held its regularly scheduled meeting.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts
On February 1, the Massachusetts Board of Pharmacy held its regularly scheduled meeting. Two actions were taken by the board:
- A proposed change to 247 CMR 3.00 will create two different licensing categories for pharmacy technicians. This proposed change is designed to attract more individuals to serve as pharmacy technicians. Once approved, the new regulations will create a Pharmacy Technician 1 (PT1) and a Pharmacy Technician 2 (PT2). The new PT1 applies to persons 16 years of age or older, is of good moral character, and has a high school education or are enrolled in a program that awards that degree or certificate. The PT1 can be licensed by the Board if they meet those qualifications. The PT1 will not be required to participate in a training program, complete a minimum hours on-the-job-training or pass a certification exam. The requirements for PT2 mirror the current regulations the licensing of pharmacy technicians. This proposed regulation must be reviewed and approved by the Governor's office. After the Governor's approval, a public hearing will be held to receive public comments.
- A new policy on non-sterile compounding that provides some exemptions to the current USP (United States Pharmacopeia) mandate was also acted upon.
Also in Massachusetts, MassHealth provided an update to the pharmacy benefit concerning obesity drugs. To maximize the state's ability to collect drug rebates on the following drugs, the Executive Office of Health and Human Services, which oversees MassHealth, is directing Managed Care Entities to not pay for the following drugs if the provider uses 340B stock: Saxenda® (liraglutide), Victoza® (liraglutide), Ozempic® (semaglutide), Rybelsus® (semaglutide), Wegovy® (semaglutide), Mounjaro® (tirzepatide) and Zepbound® (tirzepatide)
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
The Department of Health and Human Services announced that effective December 22, 2023, Blue Cross Blue Shield of Michigan (BCBSM) is no longer a clearinghouse for Medicaid. Beginning February 2024, BCBS will no longer receive the 835/Electronic Remittance Advice (ERA). Providers who currently have BCBS associated and authorized as a billing agent in their CHAMPS provider enrollment information will need to update or modify their enrollment. To continue to receive the 835, providers will need to update their authorized billing agent in CHAMPS. For questions or assistance please
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
MO HealthNet (MHD) issued Bulletin 46-38 announcing that due to the decrease in the Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Medicaid-reimbursed prescriptions was decreased effective January 1, 2024. In-state pharmacy providers receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Missouri Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $12.65. Out-of-state pharmacy providers continue to receive a professional dispensing fee of $8.85. Long-term care pharmacy providers supplying covered drugs to participants in long-term care facilities continue to receive an additional $0.50 dispensing fee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
A new “Opioid Crisis and Pain Management ECHO” program for health professionals aimed at providing information on the safe use of opioids, the risks of opioid overdose and proper pain management will launch on February 8.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
NYRx, the New York Medicaid Prescription Drug Program, made the following changes to the preferred drug list. Effective February 7, the following changes will be made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program:
- Alphagan P® 0.1%, Forteo® and Votrient® will be ADDED to the program.
- Flovent® HFA and Pennsaid® pump will be REMOVED from the program. Note: Pennsaid® pump has been discontinued by the manufacturer.
- Diclofenac 2% topical solution will remain in non-preferred status on the NYRx Preferred Drug List. Prescribers should transition their patients to an alternative preferred product or obtain a prior authorization for the diclofenac 2% solution.
In conformance with State Education Law, a pharmacist shall dispense a less expensive, therapeutically equivalent drug containing the same active ingredients, dosage form and strength as the drug prescribed/ordered. This includes substituting the brand name drug when NYRx has determined it to be the less expensive alternative for the patient. Brand name drugs included in this program:
- Do not require "Dispense as Written" (DAW) or "Brand Medically Necessary" on the prescription.
- Have a generic copayment.
- Are paid at the Brand Name Drug reimbursement rate or usual and customary price, whichever is lower (SMAC/FUL are not applied).
- Do not require a new prescription if the drug is removed from this program.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The Board of Pharmacy will be holding a Pharmacy Compounding Summit on March 6-8 at the Friday Conference Center in Chapel Hill. The agenda and details are available online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Board of Pharmacy published a bulletin regarding Registered Technician license renewals. The renewal period opened on January 31.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The Board of Pharmacy has posted the agenda for the February 6 meeting.
Also in Pennsylvania, a PACE Provider bulletin announcing benefit and corresponding billing code changes to the Pharmacy Naloxone Copay Assistance Program was published. The bulletin announces a new limit of $50 per prescription and a new policy that requires coordination of benefits for insured patients.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
DisposeRx announced a grant opportunity and is looking to identify pharmacies in the state to provide education on safe medication disposal and dispense DisposeRx packets with controlled substance prescriptions, with an emphasis on opioids. In turn, the pharmacies will receive reimbursement for educating the patients and dispensing the packets.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
On January 17, the Pharmacy Podcast Network announced the winners of the 2023 50 Most Influential Leaders in Pharmacy to celebrate “professionals whose thoughts, actions, accomplishments and leadership have helped solve clinical, customer service and financial problems.” Congratulations to TPA Immediate Past President Jay Phipps for earning the number two spot on the list!
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The quarterly public meeting of the Board of Pharmacy will be held on February 6, at the Barbara Jordan State Office Building, Room 2.013. The agenda and meeting materials are posted. Live live-stream information is available on the board's website. Anyone wishing to address the Board regarding an agenda item during the public meeting must submit a Public Comment Request form by 5:00 pm on February 2. Oral comments will be limited to the agenda items.
Also in Texas, Jill Dutton (R) won the January 30 special runoff election, by 107 votes out of more than 13,500 cast, to replace expelled Rep. Bryan Slaton (R) for House District 2. The victory is short-lived as she will face off against the same GOP candidate Brent Money in the March 5 Republican primary election.
Also in Texas, the Health and Human Services Commission (HHSC) drafted a policy to apply a uniform 90-day supply of maintenance medications in Medicaid and the Children's Health Insurance Program (CHIP). The HHSC received pushback from stakeholders expressing difficulty obtaining a 90-day supply of medication. You can submit comments by February 15 to the HHSC Vendor Drug Program (VDP) using the Draft Policy Comment Submission form.
Also in Texas, pharmacists and pharmacy technicians are required to notify the Board of a change of employment within ten days. This information can be found in Board rule §291.3 for pharmacists and Board rule §297.9 for pharmacy technicians.
Finally in Texas, HHSC's VDP (Vendor Drug Program) posted a pharmacy education and opportunities page on its website so that pharmacies know what pharmacy items Medicaid pays for, which products require prior authorization and who to contact with questions about claim processing.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Department of Health briefed pharmacy stakeholders, sharing recent data by age group on COVID vaccinations administered.
Also in Washington, the first of two Pharmacy Legislative Days at the Capitol that NACDS sponsored was held last week and was a huge success. Pharmacists and students were briefed on the priority issues before meeting with legislators.
Also in Washington, changes to the long-acting insulin class on the Preferred Drug List (PDL) go into effect on April 1.
Also in Washington, HB 2116, sponsored by pharmacist legislator Rep. My-Linh Thai (D), was heard in the House Committee on Health Care and Wellness last week and is now dead because it failed to be voted out of the policy committee before the January 31 deadline. This bill would have expanded prescriptive authority for pharmacists.
Also in Washington, the state's Health and Human Services Enterprise Coalition, a group of Washington state health and social service agencies, published an annual update to its Washington State Action Plan for Removing Barriers to Health and Human Services.
Also in Washington, Apple Health (Medicaid) updated several client booklets.
Finally in Washington, effective February 1, the Health Care Authority, Apple Health Fee-For-Service (FFS) is increasing the morphine milligram equivalent (MME) conversion factors used to determine total daily MME under the Apple Health Opioid Policy to the following:
- Hydromorphone MME conversion factor of 5 (increased from 4)
- Tramadol MME conversion factor of 0.2 (increased from 0.1)
The Apple Health MME calculator conversion factors are based on the Washington State Agency Medical Directors' (AMDG) and CDC guidelines for prescribing opioids for pain.
Opioids are limited to 120 MMEs per day. Pharmacy claims for opioids will reject if a single prescription or a combination of prescriptions exceed the MME limit. If a pharmacy claim rejects for exceeding the MME limit, request a prior authorization.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
Gov. Mark Gordon (R) announced the launch of an initiative to address the state’s ongoing mental health crisis. The Governor’s “Mental Health Roadmap” takes steps to advance systemic behavioral health reform. As part of the initiative, the five pillars identified as critical to improving outcomes for those who are battling mental health issues are access to care, affordability of care, quality of care, innovation and suicide prevention and anti-stigma efforts.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Alabama Pharmacy Association is currently accepting nominations for the chain designated seat on the Board of Pharmacy. Please submit nominations to Louise Jones by email at LJones@aparx.org or by fax to 334-271-5423. All nominations must include the name, place of employment, and contact information for both the nominee and nominator. All nominations must be received no later than March 31.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Board of Pharmacy statutes and revised regulations that took effect on January 19 are now posted on the Board’s website.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
The Board of Pharmacy posted its January 2024 Newsletter. See the “Compliance Corner” for important, timely updates.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
SB 339, legislation expanding pharmacist authority to furnish preexposure prophylaxis (PrEP) and providing payment for PrEP and postexposure prophylaxis (PEP) services, passed both chambers and will be sent to Gov. Gavin Newsom (D).
Also in California, the California Pharmacists Association is sponsoring SB 966, related to PBM reform, and sponsored by Sen. Scott Wiener (D). Among the various provisions, the bill would require PBMs to obtain a license from the State Board of Pharmacy and file annual reports with the Board. The Board, in turn, will provide annual reports to the Legislature based on information submitted by PBM licensees. Also, the bill prohibits spread pricing in future contracts and includes provisions related to calculating a patient's cost sharing amount.
Finally in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for January 12-18.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
The Division of Career and Technical Education posted the Idaho Pharmacy Technician Critically Survey seeking input from industry representatives about what is most important for an entry-level employee to know or be able to do. The information will be used to develop program standards for high school pharmacy technician programs in the state.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
The State Veterinary Medical Association asked NACDS to remind members that veterinarians have an exemption from the state’s e-prescribing law for the next two years. Please see HB 1358/Public Act 103-0563 (Section 311.6 (b-5, 10).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
SB 192, broad healthcare legislation that includes a provision allowing pharmacy personnel to provide any immunization recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) to patients 11 years of age and older under a physician protocol, was referred to the Committee on Health and Provider Services.
Also in Indiana, NACDS sent a support letter for HB 1327, legislation that will provide transparency and audit authority needed to make PBMs accountable to the organizations that hire them. NACDS asked the Committee to reject any amendments that would allow PBMs and Third-Party Administrators to charge a "carve out fee" for not using an affiliate pharmacy owned by or invested in by a PBM or Third Party Administer.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
On January 24, the Insurance Commissioner, Doug Ommen, presented to the Senate Commerce Committee various issues including the Insurance Divisions’ work to regulate PBMs. To date, the Division has received 72,000 complaints and nearly $400,000 has been paid to pharmacies. The Division is currently pursuing additional authorities and policies via HSB 536/SSB 3079.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact will host the First Quarter 2024 pharmacy provider online seminar on January 31 from 11:00 am- 12:00 noon. The meeting topic is "provider updates and provider Q & As." You can use one of the following options to join the online seminar:
- Webinar URL
- Entering Meeting ID In Microsoft Teams Meeting ID: 218 939 299 642
Attendee Passcode: omNFva
- Call In (audio only) 1-858-252-2734; passcode138312994# v
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Gov. Jeff Landry (R) starts his first term with a Republican supermajority in both houses. The Governor immediately convened an 8-day special session on January 15 to address three issues – congressional redistricting, reconfiguring the Supreme Court and changing the elections system.
Also in Louisiana, the Department of Health announced that effective February 1, the clotting factor reimbursement methodology will change to an average acquisition cost per unit and a dispensing fee per unit dispensed and will be limited to pharmacy claims only.
Finally in Louisiana, the Board of Pharmacy’s Regulatory Project 2023-02 ~ Temporary Closure of Pharmacy Final Rule went into effect on January 20.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The House Health and Government Operations Committee (HGO) held an informational briefing on January 25 regarding the Department of Health's (MDH) study of establishing NADAC (National Average Drug Acquisition Cost) + Fee-for-Service dispensing fee in the Medicaid Managed Care Program. 3 Axis Advisors presented to the Committee, pointing out the elements that MDH's study did not consider that would impact patient access, costs, and pharmacy viability.
Also in Maryland, on February 1, the House Health and Government Operations Committee will hear testimony on HB 76, a priority bill for pharmacy that would allow the administration of routine childhood vaccines recommended by the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) to children aged 5 years and older. Its companion bill, SB 18, is scheduled for its first hearing in the Senate Finance Committee on February 13. If any members would like to testify on the pharmacy panel at either hearing, please contact NACDS' Jill McCormack
For more information, contact NACDS’ Jill McCormack at 717-592-8977.