Washington
Gov. Jay Inslee (D) hosted a roundtable this week to discuss the fentanyl crisis and laid out his proposals for the upcoming legislative session. The governor’s budget adds over $50 million in new funding to take down opioids for the 2023–25 biennium, augmenting the investments from the state’s $82 million opioid settlements with drug manufacturers and pharmacies responsible in part for the opioid crisis and general fund investments within the 2023–25 biennial budget. The biennial budget allocated over $200 million for substance use disorder (SUD) treatment facility operations, rental subsidies for people with SUD, treatment subsidies, criminal diversion programs, peer support services, Tribal SUD grants and more.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
Please find the latest ALERT for pharmacy providers regarding coverage for adult vaccines, COVID vaccines and their administration. Also, an ALERT regarding coverage of adult vaccines for non-pharmacy providers has been released. Both versions have been released and will be sent to the respective provider lists. Medicaid shared both ALERTs so that individuals were aware there is a specific notice for pharmacy providers as the billing is unique to pharmacy. All ALERTs can be found here.
Also in Alabama, the Center for Medicaid and CHIP Services (CMCS) has approved a community-based mobile crisis state plan amendment (SPA) that allows Alabama to create mobile crisis intervention teams to provide Medicaid crisis services. Alabama will be able to provide these services by connecting eligible individuals in crisis to a behavioral health provider 24 hours per day, 365 days per year. For more information on this approval, please see the full Alabama SPA.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Board of Pharmacy scheduled a special meeting on December 7 to review public comments received for the most recent publicly noticed regulations project, continue the discussion on unexpected closures of pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
The Insurance Commissioner issued a Bulletin #20-2023 defining business days and hours in the Prior Authorization Transparency Act.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services (DHCS) posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the “Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice”; rates will be effective January 1, 2024, and will be posted to the Mercer Med-Cal Rx website no later than December 1, 2023. Also note the “Commercial COVID-19 Vaccine Coverage for Children” alert providing an updated policy whereby COVID-19 vaccines are a Medi-Cal Rx pharmacy benefit for members three years of age and older.
- Medi-Cal Rx Weekly Wrap-up for November 17-30 (December 1)
- Reinstatement Spotlight (December 1)
- 30-day Countdown: Medi-Cal Managed Care Plan Transition (December 1)
- Maximum Allowable Ingredient Cost 30-day Pharmacy Provider Notice (December 1)
- Medical Supplies Updates: Updates to Contracted Pen Needles, Insulin Syringes, and Sterile Syringes with Needles (Non-Insulin), Effective January 1, 2024 (December 1)
- Medical Supplies Update: Updates to Diabetic Testing Supplies, Effective January 1, 2024 (December 1)
- Medical Supplies Update: Updates to List of Contracted Self-Monitoring Blood Glucose Systems (Glucometers), Control Solutions, and Lancing Devices, Effective January 1, 2024 (December 1)
- Updates to the List of Contracted Enteral Nutrition Products, Effective January 1, 2024 (December 1)
- Medi-Cal Rx Monthly Bulletin for December (December 1)
- Changes to the Medi-Cal Rx Contract Drugs List (December 1)
- Updates to the Medi-Cal Rx Provider Manual (December 1)
- Commercial COVID-19 Vaccine Coverage for Children (November 29)
- Paper Remittance Advice: Dollar Sign Placement Update (November 22)
- Reinstatement Spotlight (November 17)
Also in California, the Board of Pharmacy provided this important alert and reminder to licensees about the drug xylazine.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Gov. Jared Polis (D) convened a special session in mid-November to address property taxes.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
The Department of Health Care Finance (DHCF) Quarterly Pharmacy Stakeholders meeting will take place on December 19 and 20. A virtual meeting link is available by RSVP’ing to allison.williams@primetherapeutics.com no later than December 18.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Indiana
The Health Coverage Programs (IHCP) issued a bulletin reminding pharmacy providers to submit claims with the appropriate DAW codes.
Also in Indiana, after four interim legislative hearings, the Health Care Cost Oversight Task Force issued a report with seven recommendations for legislation, including increasing transparency and prohibiting spread pricing by PBMs, third parties and insurers.
Finally in Indiana, the IHCP Bulletin 2023168 provides informational updates on the November Drug Utilization Review (DUR) Board.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health (LDH) issued a report detailing the results of key initiatives and policy goals for five major categories designed to make measurable improvements:
- Improve health and well-being across the lifespan of Louisianans
- Support vulnerable and underserved populations
- Invest in and empower #TeamLDH
- Improve performance, accountability, and compliance
- Strengthen customer service, partnerships, and community relations
Also in Louisiana, LDH issued a bulletin outlining the available options to providers for pursuing claims resolutions and appeals of issues with Medicaid managed care organizations (MCO) and the state’s fee-for-service claims processor, Gainwell Technologies.
Also in Louisiana, LDH issued a revised bulletin with added information on provider enrollment.
Also in Louisiana, LDH announced an 11% decline in new human immunodeficiency virus (HIV) diagnoses over the past five years. As of June 2023, the number of individuals living with HIV in Louisiana stands at 22,920.
Finally in Louisiana, LDH issued a memorandum announcing that diabetic supplies will be added to the Medicaid Single Preferred Drug List to be reimbursed as pharmacy claims only effective December 1, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Maryland Prescription Drug Affordability Board (PDAB) Stakeholder Council will be held remotely at 2:00 PM on Mon. December 18, 2023, and is open to all stakeholders. The agenda and meeting materials will be available on the Stakeholder Council page prior to the meeting. After registering, you will receive a confirmation email containing details about joining the meeting. To register for in-person comments, please refer to the Stakeholder Council page. You can find more information about upcoming and previous meetings of the Board and the Council, and presentation materials on the PDAB website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
The Massachusetts Board of Pharmacy issued the following orders:
- Policy 2023-07: Non-Sterile Compounding: Several modifications regarding the addition of flavoring agents were added.
- Policy 2023-09: Action Level Environmental Monitoring Results: Clarified that highly pathogenic microorganisms will be those determined by a qualified microbiology professional.
- Policy 2020-15: Scope of Practice: Statement that the pharmacist is responsible for the accuracy of the final dispensed prescription was added.
- Compounded Ketamine: Edits to this document include the FDA cautions regarding the use of all compounded ketamine products, not just nasal spray.
- Sterile Injectable Dispensing (Including Testosterone): Reviews how to interpret the proper days’ supply of injectable vials.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
Medicaid issued a bulletin announcing prescription copay change for Healthy Michigan Plan enrollees.
Also in Michigan, The Department of Licensing and Regulatory Affairs (LARA) issued an email communication to pharmacies regarding the new Pharmacy Technician Administrative Rules that were effective on Oct. 2, 2023. They noted they are diligently working on updating relative information on their website to reflect the revision. Please send questions about the revised rules to BPLHELP@michigan.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Secretary of State announced open positions on the Prescription Drug Affordability Board (PDAB) and the PDAB Advisory Council. Applications may be submitted on the Open Positions page. If you are interested in applying, please contact NACDS’ Jill McCormack to coordinate.
Also in Minnesota, the Department of Health (MDH) has opened registration to all manufacturers, wholesalers, pharmacies, and pharmacy benefit managers required to submit prescription drug price transparency reports. Beginning in 2024, prescription drug manufacturers, pharmacies, wholesalers, and pharmacy benefit managers will be required to report quarterly on drugs of substantial public interest identified by MDH. All reporting entities are required to register with MDH’s online reporting system beginning January 1, 2024. MDH’s guide to registering provides more detail on the process.
Upcoming Implementation Steps:
- January 1, 2024: registration requirement goes into effect
- By January 31, 2024: MDH releases the first list of drugs of substantial public interest for reporting
- Thirty (30) or more days after the drug list is posted, MDH will notify reporting entities of their reporting obligations; reporting entities have 60 days after the notification is sent to report
- Early 2024: MDH will release finalized reporting guidance
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy hosted a webinar providing new information on the Prescription Drug Monitor Program (PDMP).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Board of Pharmacy and the Board of Veterinary Medicine posted the Joint Full Board Meeting Agenda for December 7. The meeting will be held by teleconference only; see agenda for details. Information is available on the Board meetings page.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services issued Provider Bulletin 23-31: Hepatitis C Virus (HCV) Antiviral Treatment to notify Medicaid providers of upcoming changes to HCV antiviral treatment requirements.
Also in Nebraska, the Department of Health and Human Services issued Provider Bulletin 32-30: Claims for Reinstated Medicaid Members to inform Medicaid providers of members whose coverage has been reinstated due to recent federal guidance. Additional information on Medicaid member reimbursement is also available online, including copays for prescription drugs paid to pharmacies.
Finally in Nebraska, the Department of Health and Human Services posted the draft minutes from the November 14 Drug Utilization Review Board meeting. The next meeting will be held on January 9, 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
The next meeting of the Board of Pharmacy will be in Las Vegas on December 6 and 7.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
Effective November 29, the New York Department of Health issued updated guidance regarding dispensing of COVID-19 over-the-counter tests at the pharmacy.
NYRx, the New York State Medicaid Pharmacy Benefit Program, sent a release to pharmacy providers on December 6th. The program continues to field questions and concerns from residency program coordinators about pharmacies not able to submit claims to NYRx written by their interns and residents. NYRx asked the following shared regarding submission of claims:
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Board of Pharmacy has issued the following communications:
- Important Dates.pdf
- Quick Reference Guide – Pharmacy Technician Trainee Registration Requirements.pdf
Also in Ohio, the Senate passed SB 144 by a vote of 30-1. This is a priority bill for pharmacy that would permanently authorized pharmacists and both certified and registered technicians to administer all vaccines to patients aged five and older. Action in the House is expected in 2024.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The Bureau of Narcotics and Dangerous Drugs (OBN) alerted the Board of Pharmacy of the ongoing cyberattack regarding Ardent Health Services that is affecting multiple facilities in the state including Hillcrest Health System, Bailey Medical Center, and Utica Park Clinics, among others. The Board issued guidance for pharmacies that receive prescriptions for controlled substances from Ardent Health providers to continue filling the prescriptions received while continuing due diligence in confirming the prescription itself is valid and accurate, regardless of the manner or media received. This is a temporary solution to ensure prescribers can continue patient care until they can obtain OBN prescription pads.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy announced the December 13-15 Board meeting agenda and meeting materials are now available. Please note the consideration of rules for adoption related to vaccines pursuant to the enactment of HB 2486 and HB 2278 this year.
Also in Oregon, the Prescription Drug Affordability Board posted a draft agenda for the December 13 meeting. Board calendar and materials from past meetings are also available online.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
On December 5, Belmont University will host a free, live webinar providing a one-hour Board of Pharmacy update from 6:30-7:30 pm CT. All pharmacists and pharmacy technicians in Tennessee are welcome to register.
Also in Tennessee, TennCare recently released a notice regarding changes to the TennCare pharmacy program, specifically to the morphine milligram equivalent (MME), which will become effective January 1, 2024.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
United Supermarkets’ pharmacist Tim Purser and his wife Charity who is standing next to Gov. Gregg Abbott (R), accompanied NACDS to a Lubbock fundraiser for the Chair of the House Calendars Committee, Dustin Burrows (R).
Also in Texas, Texas Comptroller Glenn Hegar (R) announced the Opioid Abatement Fund Council (OAFC) decisions to approve up to $25 million over the next year of opioid settlement trust funds to be allocated for each grant plan strategy – the distribute Naloxone, the promotion of substance abuse and prevention by raising awareness of students in grades kindergarten through 12th , as well as their parents and caregivers, and bolstering training, recruitment and retention, and certification assistance for the behavioral health workforce. The OAFC had previously approved rules for distribution of $166.7 million of the funds to more than 150 hospital districts over 18 years. Additionally, last March $47.1 million of the Opioid Abatement funds was distributed to political subdivisions.
Also in Texas, the Board of Pharmacy adopted and proposed several new rules at their November meeting.
Also in Texas, the PMP Advisory Committee meeting will be meeting virtually December 14th.
Finally in Texas, Attorney General Ken Paxton (R) is suing Pfizer for “misrepresenting COVID-19 vaccine efficacy and conspiring to censor public discourse, arguing that Pfizer’s claim that the COVID-19 vaccine was 95% effective against infection was “highly misleading.” The lawsuit also charges that Pfizer engaged in a conspiracy to silence dissent by coordinating with social media companies to remove “truth-tellers” from their platforms.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Department of Health’s Pharmacy Quality Assurance Commission (PQAC) filed a rulemaking inquiry to consider possible amending language on prescription transfers requested by the patient.
Also in Washington, the Health Care Authority (HCA) published a new Medicaid program integrity training for providers which includes pharmacy, COVID-related issues and general program integrity overview and activities. The information provided in this educational intervention is not intended to be a comprehensive detailed account of all legal requirements relevant to compliance with Medicaid program integrity laws and regulations and satisfies the law requiring annual training in RCW 74.09.195.
Also in Washington, the HCA updated the Prescription Drug Program Billing Guide, effective for dates of service on and after December 1, 2023. Revisions include added vaccines that can be billed through the point-of-sale pharmacy system, updated pharmacy billing information for vaccines and vaccine administration, and updated professional dispensing fee allowances for pharmacies to align with recently filed emergency rules.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
The Board of Pharmacy is meeting on November 16. The agenda and public packet are available on the Board’s website.
For more information, contact NACDS’ Mary Staples at 817-442-1155.