On November 14, NYSDOH (New York State Department of Health) hosted its monthly NYRx industry call regarding the Medicaid Fee for Service program. Following agenda items were discussed: 

• RSV (Respiratory Syncytial Virus) vaccination update: Discussion on recent statewide standard orders from NYSDOH including the most recently issued order for pharmacists to give RSV to pregnant individuals. These resources and others can be found at a dedicated RSV page on NYSDOH’s website. 
• PrEP (Pre exposure Prophylaxis) testing by pharmacies: Request was made for NYSDOH to partner in enabling pharmacies to provide such testing through needed statutory changes/authorizations. 
• Pharmacy billing guidance for new generic launches: NYSDOH walked through its process to add generic coverage once a generic becomes available and after that move certain brands to this program. 
• Refill period: Request made to expand refill period similar to MMC for over the counter (OTC) products (11 refills). NYSDOH discussed their policy and processes in response. 
• Reminder of Pharmacists as Immunizers 
• Office of Medicaid Inspector General (OMIG) update: presentation on NYS OMIG’s Recipient Restriction Program and how pharmacies can fill their prescriptions including a number of limitations and additional requirements. Prescriptions cannot be transferred to other pharmacies under the program.  

NYRx also published billing guidance for brand name drugs with new generic launces.  

On November 15, the formal printing of the withdrawal of the PBM regulations by the Department of Financial Services was published. Within the publication are: 

• Notice of Withdrawal of Rule on Definitions, Licensing of PBMs, Contracting with Network Pharmacies, Acquisition of PBMs, Consumer Protections, and Audits; and 
• Notice of Adoption regarding Pharmacy Benefits Bureau; Pharmacy Benefit Manager Assessments; Filings and Other Requirements for Issuance 

The New York State Board of Pharmacy held its regular meeting on November 8. Relevant to chain pharmacies, the meeting included the following: 

• During the Report of the Chair: referenced the State Plan Amendment was approved in August related to Medicaid reimbursement for pharmacist authorized services within their scope, claims to be paid to pharmacies. 

• During the Report of the Executive Secretary: Central Fill regulations will not be pursued based on comments received and instead plan to address within the broader context of Shared Services. The Long Acting Injectables bill is pending the Governor’s action, plus new self-administered contraceptives in pharmacy law takes effect in 2024. 
• Discussion on Pharmacy Workplace Issues: The Board discussed the USA Today article on recent events with pharmacy workplace issues/walkouts. The Board discussed how to promote the profession to youth/students to encourage them to go into the profession given enrollment declines, shortages, and related challenges. The Executive Secretary reported receiving requests that the Board should take up regulations to address this like regulating quotas, but noted its regulations follow statutory changes providing authority, which has not happened. One member of the board noted receiving feedback that there are pharmacist shortages, so pharmacies are being forced to close causing access issues.  

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