Nevada
The Board of Pharmacy’s agenda for the September 6-7 meeting should be posted here soon. On September 7, there will be a public hearing on a proposed rule requiring a facility for treatment with narcotics to obtain a license and pay a fee to administer opioid agonist treatment medication. It also requires a dispensing practitioner at such a facility to obtain informed consent before reporting certain information.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
The State Ethics Commission reached a settlement agreement between Gov. Michelle Lujan Grisham (D) and the New Mexico Human Services Department over a terminated request in January of 2023 for proposals (RFP) for the Turquoise Care Medicaid program. Five managed care organization contractors responded to the RFP and all but one, Western Sky Community Care, was awarded the RFP.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
The Board of Pharmacy issued updated guidance on immunization authority for pharmacists, pharmacy technicians and pharmacy interns. This updated guidance relates to legislation initiated in the 2023 Legislative Session (SB 206 and HB 190).
Also in North Carolina, please see the August Medicaid Newsletter which contains essential information on expiration of current standing orders (contraceptives, naloxone, tobacco cessation, PEP (Post Exposure Prophylaxis)) as well as information on donation programs, 72-hour emergency supplies and PDL (Preferred Drug List) updates.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
Gov. Greg Stitt (R) appointed pharmacist Greg Huenergardt to the Board of Pharmacy, effective July 1, 2023, replacing Dr. Justin Wilson.
Also in Oklahoma, CMS sent the Health Care Authority (OHCA) Board a SPA (State Plan Amendment) approval letter confirming that Medicaid recognizes pharmacists as healthcare providers and will reimburse for services they provide within their scope of practice pursuant to state law, including but not limited to administration of any vaccinations or immunizations recommended by the Advisory Committee on Immunization Practices (ACIP).
Also in Oklahoma, the Office of the Insurance Commissioner issued Bulletin 4-2023 detailing the new legislative requirements of Step Therapy Protocol and Biomarker testing (HB 1736, HB 2748, and SB 513).
Finally in Oklahoma, Insurance Commissioner Glen Mulready (R) provided an update on the resolution of the Caremark 90-day prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy announced a rulemaking hearing on September 27 where it is proposing to adopt the following rules. Written comments may be submitted via email to pharmacy.rulemaking@bop.oregon.gov by 4:30 p.m. on September 27.
- Division 007 related to Compliance w/OHA COVID-19 rules
- Divisions 019/041/043/044/139 related to Short-acting Opioid Antagonist
- Division 045 related to USP <795> and USP <797> Standards Adopted by Reference
- Division 115 related to Short-acting Opioid Antagonist
- Divisions 115/125 related to RPH Applicability, Definitions, Counseling; COPT/PT Prohibited Practices
Also in Oregon, the Board of Pharmacy adopted the following rules, effective March 1, 2024, at its August 2023 Board Meeting:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The state issued a Provider update. Please find here the link to the August Provider Update.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
Due to recently enacted legislation, South Carolina retailers who sell tobacco products must notify the Department of Revenue (SCDOR) by August 14, 2023. The legislation, signed into law May 16, updates the definition of "tobacco products" to include cigarettes, products made of tobacco, electronic smoking devices, e-cigarettes, e-cigars, e-pipes, vape pens, e-hookah, e-liquid and tobacco items that may or may not contain nicotine. For more information on the definitions of tobacco products, see SC Code Section 16-17-501.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Pharmacy Provider Procedure Manual (PPPM) was updated on August 1, 2023. The revised manual is a comprehensive resource for Medicaid pharmacy providers enrolled with the Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) on benefits, policies and procedures for outpatient pharmacy claims and rebates.
Also in Texas, NACDS sponsored the Texas Pharmacy Association's (TPA) Conference and Expo in Houston, where Rep. Four Price (R-Amarillo), the author of legislation would have made permanent in Texas law the expanded vaccination authority afforded to pharmacists and pharmacy technicians by the federal PREP (Public Readiness and Emergency Preparedness) Act, gave the keynote address. NACDS also sponsored the Passing of the Gavel ceremony where pharmacist Jay Bueche with HEB was sworn in as president of TPA.
Also in Texas, the Board of Pharmacy's monthly newsletter is available here.
Finally in Texas, the Board of Pharmacy's quarterly meeting was held on August 1. The next meeting is scheduled for November 7, election day.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Board of Pharmacy will meet on August 22. The details for participation and the agenda have been posted online. Below are the discussion items.
- 9:00 AM DSCSA (Drug Supply Chain Security Act); Justin Macy, NABP (National Association of Boards of Pharmacy) Director of Innovation
- Vaccine Protocol
- Pharmacist In Charge Responsibilities Review
- Pharmacist Prescribing Epinephrine Auto-injectors
- Transfer of Electronic Prescriptions Schedule 2-5
- Alterations to Schedule II Controlled Substances
- Hormonal Contraception Questionnaire Update
- PEP/PrEP Update
- Next APCEC meeting September 14.
Also in Utah, the Board of Pharmacy distributed its August 2023 newsletter.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Vermont
NACDS joined its members, in-state partners, and representatives from the state medical community to discuss pharmacist and technician scope with members from the Department of Health. Stakeholders also met on July 27 to discuss test and treat legislation for 2024.
Also in Vermont, on July 26, the Board of Pharmacy held its regular meeting, during which it reviewed the emergency declarations and the Executive Order regarding pharmacies. Link to the agenda
Finally in Vermont, the Executive Order allows a one-time 30-day maintenance prescription to be filled, as well as emergency licensing for pharmacists and pharmacy technicians from out-of-state to fill any staffing gaps. This Executive Order lasts for 90 days or if there is a State of Emergency, whichever is shorter. There will be updates to come as things change. The next board meeting is August 23.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alaska
HB 112, signed by Gov. Mike Dunleavy (R), requires that Out-of-State Pharmacies be licensed rather than registered by June 30, 2024.
- If an Out-of-State Pharmacy is currently registered, it will not need to do anything until renewal time, which is scheduled for June 2024.
- If an Out-of-State Pharmacy is not currently registered, they will need to apply to be licensed rather than registered beginning November 27, 2023.
- All Internet-based/Online Pharmacies will fall under the same statutory and regulatory requirements as Out-of-State Pharmacies if they want to provide pharmacy services.
- Beginning November 27, 2023, all licensed Out-of-State Pharmacies must also have a Pharmacist-in-Charge that holds an active Alaska Pharmacist license. Out-of-State Pharmacies that are currently registered and will renew in June 2024 must have a Pharmacist-in-Charge that holds an active Alaska Pharmacist license at renewal time.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
The Board of Pharmacy’s rules, permitting pharmacists to provide patients 18 years of age and older with self-administered hormonal contraceptives via a standing order, were approved and effective immediately. The Arizona Department of Health Services issued the statewide standing order.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
The Joint Committee on Insurance and Commerce held a hearing at the Capitol on July 13. Included on the agenda was Interim Study Proposal (ISP-2023-068) by Sen. Clarke Tucker (D), draft legislation proposing to amend the Law Concerning Maximum Allowable Cost (MAC) Lists to Define a Similarly Situated Pharmacy, Clarify How a Pharmacy Benefits Manager Provided its Maximum Allowable Cost List and Establish a Private Right of Action.
Also in Arkansas, the Insurance Department issued Bulletin 12-2023: "Application of Arkansas Prior Authorization Law to Non-Physician Healthcare Providers."
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Effective July 1, 2023, the Board of Pharmacy and all other Department of Consumer Affairs (DCA) licensing boards and bureaus were required to grant temporary licensure to the spouse or domestic partner of an active-duty military member stationed in the state if the applicate is currently licensed and holds an active and unrestricted license in another state with the same scope of practice as the profession in California for which they would like to practice. This applicant population also receives expedited processing and initial application and license fee waivers. Applications for this temporary licensure are available through the board or bureau with jurisdiction over the type of license being sought. DCA posted the requirements and additional information.
Also in California, as required in Business and Professions Code Section 4301.3, the Board of Pharmacy submitted its report to the Legislature. The report provides summary information of the efforts undertaken to evaluate whether moving to a standard of care enforcement model would be feasible and appropriate. The report offers recommendations, including most notably that the Board concludes that a hybrid enforcement model remains appropriate for the regulation of the practice of pharmacy for consumer protection. The report also provides next steps, including continuing to work with stakeholders to advance patient access to care that achieves health equity for California consumers without compromise to public safety.
Also in California, the Department of Health Care Services (DHCS) posted the following weekly notices and alerts on the Medi-Cal Rx Web Portal:
- Medi-Cal Rx Weekly Wrap-up for July 7-13 (July 14)
- Reinstatement Spotlight (July 14)
- Prior Authorization Submission Processing – System Issue Resolved (July 13)
- Medi-Cal Rx Weekly Wrap-up for June 30-July 6 (July 7)
- Reinstatement Spotlight (July 7)
- 30-day Countdown: Phase IV, Lift 1: Reinstatement of Claims Edits for Age, Gender, and Labeler Code Restrictions for Members 22 Years of Age and Older (July 3)
- Medi-Cal Rx Monthly Bulletin for July (July 1)
- Changes to the Medi-Cal Rx Contract Drugs List (July 1)
- Changes to the Medi-Cal Rx Contract Drugs List – Blood Factors (July 1)
- Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs (July 1)
- Changes to the Medi-Cal Rx Family Planning, Access, Care, and Treatment Pharmacy Formulary (July 1)
- Updates to the Medi-Cal Rx Provider Manual (July 1)
- Medi-Cal Rx Weekly Wrap-up for June 23-29 (June 30)
- Reinstatement Spotlight (June 30)
- 90-day Countdown: Reinstatement of Prior Authorization Requirements for Enteral Nutrition Products for Members 22 Years of Age and Older (June 23)
- Medi-Cal Rx Weekly Wrap-up for June 16-22 (June 23)
Finally in California, Medi-Cal posted the following:
- July 2023 Pharmacy Medi-Cal Update Bulletin
- July 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin
- COVID-19 Medi-Cal Response Page Update and Vaccine Guideline Removal
- 2023 HCPCS Quarter 3 Update
- Simplified Bivalent Vaccine Administration Codes Added for COVID-19
- Pharmacy Medi-Cal Update Bulletin
- June 2023 Update: Discontinuation of the COVID-19 Uninsured Group Program
- National Correct Coding Initiative Quarterly Update for July 2023
- June 2023 Pharmacy Medi-Cal Update Bulletin
- June 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Republican lawmakers asked Gov. Jared Polis (D) to convene a special session to address two issues: rising property taxes and bond eligibility for murder suspects.
Also in Colorado, the Healthcare Policy and Financing (HCPF) is hosting its annual stakeholder online seminar on August 8 to review accomplishments and solicit input on priorities for the next fiscal year.
Also in Colorado, the COVID-19 public health emergency (PHE) ended on May 11. Many of the temporary flexibilities were made permanent. For more information, go to Overview of COVID-19 Emergency Federal Flexibilities Colorado Medicaid, a webpage featuring a chart of what flexibilities were requested, what was used, what policy changes were made permanent and what will be changing at the conclusion of the PHE.
Finally in Colorado, the Board of Pharmacy held a Permanent and Emergency Rulemaking Hearing on July 20 to allow stakeholders a final opportunity to provide testimony before the Board considers adopting the proposed revisions to Rule 5.00.00 on a permanent and emergency basis to implement HB23-1195, automated pharmacy dispensing systems.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Hawaii
Gov. Josh Green (D) signed SB 602 (Act 103), permitting pharmacists to order, perform and report the results of certain CLIA-waived testing including blood glucose, hemoglobin A1C, hepatitis C, HIV, influenza, respiratory syncytial virus (RSV), COVID or streptococcal pharyngitis.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
In 2022, the General Assembly passed Public Act (P.A.) 102-0700, which suspended the state’s 1 percent (1%) low rate of sales and use tax on retail sales of groceries from July 1, 2022, through June 30, 2023. The 1% grocery sales tax suspension ended on Friday, June 30. Retailers are now required to collect and remit the 1% sales tax on groceries.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The state's Health Coverage Programs (IHCP) provided updates on prior authorization (PA) criteria and Preferred Drug List (PDL) as approved by the Drug Utilization Review (DUR) Board at its June meeting. The provisions apply only to Medicaid fee-for-service.
Also in Indiana, a Medicaid state plan amendment (SPA) allowing pharmacists to be enrolled as providers was submitted to the Centers for Medicare & Medicaid Services (CMS). The SPA allows pharmacists to be enrolled as providers and includes provisions that would reimburse for all services pharmacists provide within their scope. Unfortunately, the state rulemaking process could take 18 months to two years to implement once approved by CMS.
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. 2485-MC-FFS – Clarification – 340B Drug Pricing Program
- INFORMATIONAL LETTER NO. 2481-MC-FFS – Spravato ® (Esketamine Nasal Spray) Billing and Coding
- INFORMATIONAL LETTER NO. 2478-MC-FFS – Federal Fiscal Year (FY) 2024 Payment Error Rate Measurement (PERM) Program – Change of Review Contractor
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
The Department of Human Services announced that due to the COVID-19 pandemic and the noticeable increase in vaccinations administered by pharmacy providers in recent years, they will be increasing the current pharmacy vaccine administration fee ($3.30) effective October 16, 2023. The new administration fee will be $27.49 for the first dose in the series. Each subsequent dose will receive an administration fee of $9.80 (if applicable). The effective date of this change is October 16, 2023. Members should expect to receive more information and billing instructions from MedImpact. NACDS reminds members that Medicaid no longer requires pharmacies to enroll in the Vaccine for Children Program (VFC) to be reimbursed for vaccines.
Also in Kentucky, the Board of Pharmacy published a final rule permitting pharmacies to provide COVID treatment to patients. NACDS encourages members to review the rule because it also makes substantive changes to the process for providing test and treat services under ALL Board-approved protocols.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Effective October 1, 2023, Medicaid will reimburse continuous glucose monitors and other diabetic supplies as a pharmacy benefit.
Also in Louisiana, the Department of Health (LDH) and its vendor Magellan Medicaid Administration (MMA) finally held an online seminar on July 17 detailing their plans to migrate to a Single MCO PBM on October 1, 2023. Pharmacy stakeholders were briefed on their plans to open a portal with on-line training videos and a testing window beginning on August 1. All pharmacies need to have a signed contract with MMA. New ID cards will be mailed by mid-September, but the Member's ID number will remain the same, so no crosswalk is needed.
Also in Louisiana, by line-item vetoing certain sections in HB 1, the state's budget bill, Gov. John Bel Edwards (D) restored the $100 million reduction in funding to Louisiana Department of Health (LDH). Had the Governor not acted, the cuts would have caused loss of funding and federal matching funds, totaling between $400 million and $700 million.
Also in Louisiana, Gov. John Bel Edwards (D) vetoed two school vaccine bills, HB 182 and HB 399, that the Governor feared could undermine public confidence in vaccines. The Legislature has an Override Veto Session scheduled to convene on July 18.
Also in Louisiana, the Department of Health posted several provider notices of interest to pharmacies:
- Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective July 1, 2023
- Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement – Effective July 1, 2023
- Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Updates – Effective July 1, 2023
Finally in Louisiana, the Board of Pharmacy published two rules in the Louisiana Register with immediate effective dates.
- Regulatory Project 2022-06 – Nonresident Pharmacies amended the rules for nonresident pharmacies to replace the term "out-of-state" with "nonresident," create parity between nonresident and resident pharmacy requirements, clarify intent and modify the responsibility on the pharmacist-in-charge (PIC) in the matter of policy and procedures. The rule was also amended to remove the requirement for nonresident pharmacies to designate a resident agent and registered office in Louisiana.
- Regulatory Project 2022-09 – Partial Fills of CDS (Controlled Substances) Prescriptions amended Sections 2735 and 2747 of rules relative to prescriptions for controlled dangerous substances (CDS). The change in Section 2735 places a requirement on pharmacies dispensing prescriptions for CDS to use a dispensing information system capable of accurately recording partial fills and refills of such prescriptions. The change in Section 2747 places a requirement on a pharmacist to dispense a partial fill of a prescription for a CDS when requested by the patient or prescriber, subject to the pharmacist's obligation relative to corresponding responsibility.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Prescription Drug Affordability Board (PDAB) released the agenda for the July 24 meeting which will be held remotely at 2:00 p.m. Please register for the meeting in advance. The Board continues to welcome public comment and input on all its work. Please submit comments to comments.pdab@maryland.gov, and they will be provided to the Board prior to the upcoming Board Meeting. Please visit the Board's website for more information about the upcoming and previous board meetings, presentation materials, and to learn more about the PDAB's work.
Also in Maryland, The Department of Health (MDH (Maryland Department of Health)) is currently accepting applications and nominations for physicians and pharmacists to serve on the Medicaid Drug Use Review (DUR) Board in 2024. The DUR Board is comprised of up to twelve (12) licensed and actively practicing physicians and pharmacists in Maryland. Members are appointed by the Secretary of MDH and serve one term of three (3) years from the date of their appointment with the option to serve an additional three (3) year term. All interested applicants are required to submit a formal application by August 1, 2023.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
This week, Gov. Gretchen Whitmer (D) signed SB 219 effective July 19. The bill codifies PREP (Public Readiness and Emergency Preparedness) Act authority, allowing pharmacies to provide all ACIP (Advisory Committee on Immunization Practices) vaccines to patients aged 3 years and older. It also authorizes pharmacists to order and administer CLIA-waived tests for COVID, Flu and RSV and provide drugs that treat those conditions under CDC protocols. Many thanks to members, the Michigan Retailers Association, and the Michigan Pharmacists Association for their work with the Legislature on this critical patient access to care law.
Also in Michigan, the Bureau of Professional Licensing (BPL) within the Department of Licensing and Regulatory Affairs (LARA) sent a communication reminding pharmacy that the new Central Fill and Shared Pharmacy Services rules were effective as of May 19, 2023. The email asks that Licensee review the rules and statute for a complete understanding of all applicable requirements. Questions about the revised rules may be sent to BPLHELP@michigan.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Department of Health’s weekly COVID Vaccine Provider Update reminds immunizers that the COVID-19 Vaccine Provider Agreement is still in effect until the new vaccine formulations are available.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
On July 6, Gov. Mike Parson (R) signed into law three bills enacting the largest pharmacy scope of practice expansion (HB 115 / SB 157 / SB 45 & 90). The bills allow pharmacists to independently administer all vaccines approved by the FDA as of January 1, 2023. The law also expands the services pharmacists can provide through physician protocols, and it creates framework for statewide standing orders for the testing and treatment of COVID, Flu and Strep.
Also in Missouri, effective July 30, MO HealthNet will no longer allow automatic refills or automatic shipments of medications, devices, or supplies. MO HealthNet does not pay for any
prescription without an explicit request from a participant or the participant's responsible party, such as a caregiver, for each refilling event. Participants and providers cannot waive the explicit refill request requirement and enroll in an automatic refill program.
Also in Missouri, MO HealthNet also reported that due to the increase in the Missouri Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Professional Dispensing Fee for Medicaid-reimbursed prescriptions was increased effective July 1, 2023.
Also in Missouri, the Department of Commerce and Insurance's (DCI) Department of Health and Senior Services issued a revised naloxone HCL standing order that now lists the nasal spray generically, allowing pharmacists to dispense the brand name or generic product.
Also in Missouri, starting July 17, MO HealthNet announced that the Pharmacy Help desk's NEW hours for drug prior authorizations will be Monday through Friday, 8:00 a.m. to 7:00 p.m. Central; weekend hours will remain the same 8:00 a.m. to 6:00 p.m.
Finally in Missouri, the MO HealthNet Division recently moved all provider forms regarding MO HealthNet benefits to a new Provider Forms page.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
