Kentucky
The Department for Public Health recently updated the Yellow Fever Vaccination Center Application to allow pharmacists to apply to participate. Further detail can be found on the Office of Epidemiology webpage.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
HB 471 by Rep. Barbara Freiberg (R) authorizing pharmacists to order and administer and pharmacy interns and pharmacy technicians to administer immunizations to children aged seven years and older is scheduled for a hearing in the House Health and Welfare Committee on May 10. The Louisiana Alliance for Retail Pharmacies is urging chain pharmacies to take action to preserve patient access to children and families for lifesaving vaccines at pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
Gov. Wes Moore signed the following bills into law:
- HB 693– Allows pharmacist to delegate administration of certain vaccines to pharmacy technicians: – to adults 18 years of age and older: COVID, flu, pneumonia; and RSV or shingles to patients 50 years of age and older; allows techs to perform remote data entry under supervision. Effective upon signing, April 4, 2023.
- SB 678 – Requires Medicaid, CHIP and commercial insurers to reimburse pharmacies for services within their scope of practice if the plan would otherwise cover. Effective October 1, 2023; signed May 5, 2023.
- HB 374– Pharmacy audits – clarifies that the state's audit law applies to PBMs contracted with Managed Care Plans; adds new auditing thresholds and requirements that apply to all insurers and Managed Care; and requires PBMs to provide a secure electronic method of communication between the pharmacy and the PBM for sharing auditing information by October 2025. Provides that the Department of Insurance may promulgate rules. Effective January 1, 2024; signed May 5, 2023.
- HB 382 -Requires the State Department of Health and Prescription Drug Advisory Board to complete a study on MMC claims for calendar years 2021 and 2022 and on the costs of implementing a pharmacy reimbursement cost-based rate floor in MMC. The study is due to the General Assembly in October 2023. Effective upon signing, April 4, 2023.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
In advance of the May 11 Public Health Emergency ending, the Massachusetts Board of Pharmacy announced the following on May 4:
- In response to the continued public health need for vaccinations, the Board will not be enforcing the supervisory ratios set out in 247 CMR 8.06(3) at licensed pharmacies that are providing vaccination services provided that the following conditions are met:
- A maximum ratio of one pharmacist to six support staff is not exceeded; and
- at least three support staff are interns and / or certified, licensed pharmacy technicians.
- Due to continued staffing shortages, the Board does not intend to take enforcement action against pharmacies that perform and reconcile perpetual inventory counts at least every 15 days as long as back-counts are performed after each prescription is filled.
- Pharmacists, interns and pharmacy technicians may administer vaccines to individuals who are 5 years of age and older in accordance with Policy 2023-02: Vaccine Administration.
- COVID-19 Control Measures, including COVID-19 tests, may be dispensed or administered in accordance with Policy 2023-03: COVID-19 Control Measures.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
The Department of Insurance has posted a draft rule pursuant to the PBM Licensure and Regulation Act. NACDS is currently reviewing the rule and intends to file comments by the June 9 deadline. If there are comments you'd like us to include in the letter, please send them to Jill McCormack by close of business on May 26,, 2023.
Also in Michigan, the Board of Pharmacy will hold a public hearing on Pharmacy – General Rules NOH 6.2.2023.pdf on June 2, 2023 at 9:00 a.m.. Written comments can be submitted to BPL-BoardSupport@michigan.gov. The open comment period ends June 2 at 5:00 p.m.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Conference Committee on SF 2995, the Health Budget Bill, has been appointed and is currently meeting to produce a final bill. The Conferees include Senators Boldon, Kupec, Wiklund, Abeler and Morrison; and Representatives Keeler, Liebling, Pinto, Schomacker and Bierman. Several key pharmacy provisions are in the mix including:
- Pharmacy benefit carve-in to Fee-for-Service
- Pharmacy Technician immunization authority
- Payment for pharmacy services
- Requirement for on-going Cost of Dispensing surveys
NACDS has been working with the Minnesota Retailers Association, the Minnesota Pharmacy Association and members to help advance and support these provisions throughout the session. Once the conference committee report is finalized, the bill will go before the General Assembly for approval.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Montana
On May 1, Gov. Greg Gianforte (R) signed SB 112 (Chapter Number: 322), legislation allowing pharmacists to prescribe certain medications with limitations. In the coming months, the Board of Pharmacy will promulgate rules.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
SB 57, legislation that includes PBMs in the definition of administrators and creating licensing requirements, passed the Senate on April 25 was heard in the Assembly Commerce and Labor Committee on May 3.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
On May 2, Gov. Kathy Hochul (D) signed A 1060: pharmacists administered contraceptives into law.
On the May 1 weekly NYRx Medicaid Pharmacy Benefit transition call, the State Department of Health reminded pharmacies that for the billing process for immunizations, there are different codes to use when billing for multiple vaccines and administration in the same day. Please see the following guidance.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Dakota
The North Dakota Department of Health and Human Services Infectious Diseases and Epidemiology Unit and the North Dakota State University Department of Public Health are excited to announce an opportunity for approximately 15-18 North Dakota pharmacists to complete the Antimicrobial Stewardship Certification Program through the Society of Infectious Disease Pharmacists. Please see the document linked here for more information regarding the certification program curriculum and how to apply. Interested pharmacists must complete the application (PDF Form or Word document) and return it to Emily Perry by 5:00 p.m. on June 30. If you have any questions, please contact Emily Perry, Antimicrobial Stewardship Lead at NDSU's Center for Collaboration and Advancement of Pharmacy, at 701-552-2784 or by emailing Emily.Perry@ndsu.edu
Also in North Dakota, Gov. Doug Burgum (R) signed SB 2041, legislation that caps cost-sharing for insulin and medical supplies for insulin dosing and administration for enrollees in the public employee retirement system. It does not limit out-of-pocket costs on an insulin pump, an electronic insulin-administering smart pen or a continuous glucose monitor.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Board of Pharmacy is accepting comments for various rule sets up for the five-year rule review process. Comments are due to the Board on May 31 and should be posted here.
Also in Ohio, the state's SBPM, Gainwell, announced the launch of their call center's virtual agent, GABBYTM. GABBYTM is an interactive voice response system that offers several self-service functions, including checking claim statuses, member eligibility and prior authorizations. You can watch GABBYTM in action using this link.
Finally in Ohio, Gainwell will begin phase 5 of the re-implementation of Prior Authorization (PA) on May 9, 2023, on specific drug classes. Of note, the PA reimplementation only applies to new, initial authorizations, and it does not apply to those patients who have previously taken the drug supported by recent claims history prior to May 9. Phase 5 includes the following drug classes:
- Analgesic Agents: NSAIDS
- CNS Agents: Anti-Migraine Agents (Acute, Cluster Headache, Prophylaxis), Anticonvulsants, Antidepressants, ADHD Agents, Atypical Antipsychotics, Parkinson's Agents, Restless Legs Syndrome, Sedative-Hypnotics (Non-Barbiturates)
- Compounding Agents (Bulk Chemicals/Powders, Vehicles, Bases)
- Gastrointestinal Agents: Anti-Emetics, Crohn's Disease, Hepatic Encephalopathy, Irritable Bowel Syndrome (IBS) with Diarrhea, Ulcerative Colitis, Unspecified GI
- Infectious Disease Agents: Antibiotics – Cephalosporins, Macrolides, Quinolones, Tetracyclines
- Infectious Disease Agents: Antifungals
- Infectious Disease Agents: Antivirals – Herpes, HIV
Please reference the Unified Preferred Drug List (UPDL) posted on the SPBM portal to see products that require a PA. PAs may be submitted via phone, fax, mail and the SPBM portal. Additional PAs are planned for reimplementation in a similar, incremental fashion during the second quarter of 2023. Please direct questions to the Gainwell Help Desk at 1-833-491-0344.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Oregon Health Authority issued a meeting notice for the Immunization Policy Advisory Team on June 1 from 12:00 noon to 2:00 p.m. The meeting will be conducted via Zoom and requires registration in advance using this link. Registrants will receive a confirmation email with additional information to join the meeting. The draft agenda appears below and the final agenda will be available by sending an email request to imm.info@oha.oregon.gov three days before the meeting date. It will also be available during the Zoom meeting. See additional details in the notice below.
Agenda: Draft items include:
- Public comment
- Athletes and COVID-19 vaccine
- Immunization uptake
- Data analysis – small numbers policy
- 2022 population-based rates for 2-year-olds
- 2023 school immunization update
- COVID-19 vaccine and therapeutics commercialization
- COVID-19 vaccine updates
Also in Oregon, the Oregon Health Authority published a Notice of Proposed Rule Making amending Prior Authorization Approval Criteria Guide & Preferred Drug List DUR/P&T Actions. Written comments may be sent to hsd.rule@odhsoha.state.or.us no later than 5:00 p.m. on June 21.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
HB 1105 by Rep. Four Price (R), legislation that lowers the age to three years and up for pharmacists, pharmacist interns and certified pharmacy technicians to administer all vaccines and immunizations without a patient specific prescription or medical order, was approved on the full House second reading on May 4th by a vote of 113 to 28. The bill is up for third reading on April 5th.
Also in Texas, HB 4990, Rep. Greg Bonnen's (R) Texas Pharmaceutical Initiative, establishing a state PBM aimed at lowering costs and providing access to prescription drugs and other medical supplies for state employees, dependents and retirees of public higher education systems and institutions, Employees Retirement System members, Teacher Retirement System members, persons confined by the Texas Department of Criminal Justice or the Texas Juvenile Justice Department, recipients of Medicaid, and enrollees of the Children's Health Insurance Program. It was amended in the House and passed on May 2 by a vote of 128-12-1. The companion bill filed by Sen. Lois Kolkhorst (R) was heard in the Senate Health and Human Services Committee that she chairs on April 19 and was left pending.
Finally in Texas, HB 1283, legislation NACDS supports that would maintain the single formulary and preferred drug list for Medicaid, passed the House on May 3rd by a vote of 146-0.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The legislature adjourned on April 23 after failing to approve a controversial bill setting drug possession penalties. This week, Gov. Jay Inslee (D) announced that he will be calling a special session on May 16 to pass legislation on drug possession and reform.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
On April 18, Gov. Katie Hobbs (D) signed SB (Senate Bill) 1382 (Chapter 74), legislation requiring PBMs to obtain a certificate of authority to operate and outlining the role, responsibilities and authority of the Department of Insurance and Financial Institutions.
Also in Arizona, the Board of Pharmacy scheduled Oral Proceeding/Public Comment RE: Prescribing a Self-Administered Hormonal Contraceptive on May 16 from 9:00 a.m.-10:00 a.m.
Finally in Arizona, the Board of Pharmacy Oral Proceeding/Public Comment RE: Technician Immunization Authority on May 22 at 9:00 a.m.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services (DHCS) posted the following alerts, weekly notices, and monthly bulletin on the Medi-Cal Rx Web Portal:
- Policy Reminder: Limitations on Coverage of Certain Drugs or Classes of Drugs (April 24)
- NCPDP Reject Code 76: Continuous Glucose Monitor (CGM) Supplies (April 21)
- Medi-Cal Rx Weekly Wrap-up for April 14-20 (April 21)
- Reinstatement Spotlight (April 21)
- 30-day Countdown – Phase III, Lift 3: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older (April 19)
- Medi-Cal Rx Weekly Wrap-up for April 7-13 (April 14)
- Reinstatement Spotlight (April 14)
- Changes to the Family PACT Pharmacy Formulary (April 12)
- Medication Abortion: Coverage of Misoprostol-Only Regimen (April 11)
- Medi-Cal Rx Weekly Wrap-up for March 31-April 6 (April 7)
- Reinstatement Spotlight (April 7)
- Mpox Vaccine: Change in Reimbursement Rate (April 5)
- Updated: Patient Counseling Signature Requirements in Provider Manual (April 1)
- Medi-Cal Rx Monthly Bulletin for April (April 1)
- Changes to the Contract Drugs List (CDL) (April 1)
- Changes to the Contract Drugs List (CDL) – Authorized Drug Manufacturer Labeler Codes (April 1)
- Updates to the Medi-Cal Rx Provider Manual (April 1)
- Medi-Cal Rx Weekly Wrap-up for March 24-30 (March 31)
- Reinstatement Spotlight (March 31)
- Mpox Vaccine No Longer a Family PACT Pharmacy Benefit (March 30)
Also in California, Medi-Cal posted the following:
- Medi-Cal Update – Pharmacy – April 2023 – Bulletin 1037 (April 14)
- Medi-Cal Update – Durable Medical Equipment and Medical Supplies – April 2023 – Bulletin 571 (April 14)
- Policy Update of Mpox Vaccines as a Medi-Cal Benefit (April 5)
- Update: Discontinuation of the Coronavirus (COVID-19) Uninsured Group Program on May 31 (April 3)
Also in California, the Board of Pharmacy posted the agenda and meeting materials for the Standard of Care Ad Hoc Committee meeting on May 3.
Finally in California, the Board of Pharmacy is accepting written comments on the following:
- Title 16 CCR § 1715.1 – Self-Assessment of an Automated Drug Delivery System
- Notice of Additional Modified Text
- Modified Text
- Modified Self-Assessment Form
- Deadline for Written Comments is May 6.
- Title 16 CCR § 1706.6 – Temporary Licenses for Military Spouses/Domestic Partners
- Notice of Proposed Action
- Initial Statement of Reasons
- Proposed Text
- Deadline for Written Comments is May 30.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Legislation NACDS supports that would establish a registration process for PBMs and give the Insurance Commissioner authority to deny or revoke registration if the PBM violates laws or does not follow the prescribed process. Additionally, the bill would add maximum allowable cost (MAC) pricing protections, including specific provisions related to the appeals process. The bill passed the House and is pending in the Senate. (CO23-HB1227)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Idaho
On March 31, Gov. Brad Little (R) signed HB 215 (Session Law Chapter 232, effective July 1, 2023), legislation adding enforcement language to Title 41-349 related maximum allowable cost (MAC). The new law permits the director [Department of Insurance] to act, issue penalties and make remedies for PBMs who violate the law in accordance with authorities in the Idaho Code.
Also in Idaho, on March 31, Gov. Brad Little (R) signed HB 291 (Session Law Chapter 233, effective July 1, 2023), legislation establishing the Fair Pharmacy Audits Act and creating standards and criteria for the audit of pharmacies by PBMs or other authorized entities.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
Legislation authorizing pharmacists to prescribe hormonal contraception passed both houses and was sent to Gov. Eric Holcomb (R) to be signed into law. (HB 1568)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Iowa Pharmacy Association, in coordination with the Iowa Medical Society (IMS), Iowa Department of Health and Human Services (HHS), Iowa Hospital Association (IHA), and the Iowa Primary Care Association (Iowa PCA), leads the Iowa Healthcare Workforce Strategic Planning and Stakeholder Engagement Initiative.
Iowa communities are facing challenges recruiting and retaining across the healthcare workforce population. These partner organizations are working together to assess and evaluate the current landscape and future of the healthcare workforce in Iowa. From these meetings, the statewide action plan will evolve to address current workforce challenges and opportunities.
Over the next few months, regional meetings will be held across the state. All locations will have two sessions available in the day (either 9:00 am – 11:00 am or 1:00 pm – 3:00pm). Click the following links to register.
Upcoming regional townhall meetings:
Des Moines on Friday, April 28th
Waterloo on Wednesday, May 10th
Also in Iowa, the Department of Health and Human Services published the following:
- INFORMATIONAL LETTER NO. 2443-MC-FFS – Monkeypox Vaccine and Testing
INFORMATIONAL LETTER NO. 2446-MC-FFS – Provider Messaging and the Continuous Coverage Requirement Unwind
INFORMATIONAL LETTER NO. 2445-MC-FFS-CVD – Monoclonal Antibodies Update - INFORMATIONAL LETTER NO. 2434-MC-FFS – COVID-19 Public Health Emergency (PHE Unwind – Out-of-Network Enhanced Provider Payment Expiring
- INFORMATION LETTER NO. 2426-MC-FFS-CVD – End of COVID-19 PHE Pharmacy Allowances
- INFORMATIONAL LETTER NO. 2432-MC-FFS – End of Federal PHE Flexibilities
Finally in Iowa, the Board of Pharmacy posted the agenda and related materials for its May 2 meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
Pharmacies can now bill Medicaid for vaccines administered to children enrolled in the Medicaid program, regardless of the pharmacy’s participation in the Vaccines for Children (VFC) program. The change is a result of a rule recently adopted and effective as of March 9, 2023. The rule revised the VFC program regulatory requirements by deleting the language in Section 2 of 907 KAR 1:680 that had previously expressly prohibited Medicaid from “making] payment to a provider for the cost of a vaccine available through the Vaccines for Children Program.” Please reference the As Amended Proposed Rule to see the changes as engrossed in the FInal Rule.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Legislature convened their 60-day fiscal session on Monday, April 10th. The House Health Committee has scheduled a hearing on May 10th on HB 471, legislation the Louisiana Alliance of Retail Pharmacies (LARP) initiated that lowers the age to 7 and older for pharmacies to administer all ACIP immunizations and vaccines without a patient specific prescription or medical order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The General Assembly adjourned Sine Die this week. The following priority bills for pharmacy are on their way to Gov. Moore (D) for his signature:
- HB 693– Allows pharmacists to delegate the administration of certain vaccines to adults to Pharmacy technicians and allows technicians to perform remote data entry. This "emergency bill" will be effective upon signing.
- SB 678 – Requires Medicaid, CHIP, and commercial insurers to reimburse pharmacies for services within their scope of practice if the plan would otherwise cover. Effective Oct 1, 2023.
- HB 374– Clarifies that the statutory audit provisions in current audit law applies to PBMs (Pharmacy Benefits Managers) contracted with Managed Care Plans; adds new requirements that apply to all insurers and managed care; and requires PBMs to provide a secure electronic method of communication between the pharmacy and the PBM for sharing auditing information by Oct 2025. Provides that MIA (Maryland Insurance Administration) may promulgate rules. Effective Jan 1, 2024.
- HB 382 -Requires the MDH (Maryland Department of Health) (Maryland Department of Health) and Prescription Drug Advisory Board to complete a study on MCC claims around the costs of implementing a pharmacy reimbursement cost-based rate floor in the Medicaid Managed Care program. The study is due to the General Assembly in Oct 2023.
NACDS thanks our state partners and members for their work to get these bills across the finish line.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On April 27, 2023, the MassHealth Pharmacy Program announced that “effective May 1, 2023, through March 31, 2024, MassHealth members, including those in managed care plans, do not have to pay copays for prescription drugs. This also applies to Health Safety Net (HSN) patients during this period.”
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
Pharmacy technicians immunizing under the Board's statutes and rules must complete an initial and annual documented competency assessment. A sample Technician Immunization Assessment Checklist template is intended for guidance purposes only to assist licensees and should be modified as appropriate for your practice setting.
Also in Missouri, the 2023 Practice Guide contains updated compliance tips and information on recent statutory/rule changes, including, new/revised sections on Pharmacy Working Conditions, Technician Supervision & Expanded Technician Activities, Electronic Final Product Verification by Pharmacists, Technology-Assisted Product Verification by Interns & Technicians, and Quality Assurance.
Finally in Missouri, the 2023 Missouri Pharmacy statutes and rules law book is available here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.