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’ Ben Pearlman at 617-515-2603.
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.
Montana
Gov. Greg Gianforte (R) signed the following bills:
- HB 379 (Chapter Number: 259), extending the prohibition on PBMs to require federally certified health entities to identify 340B drugs from June 1, 2023, to June 1, 2025.
- HB 710 (Chapter Number: 216), permitting a pharmacist to delegate the administration of immunizations to a pharmacy technician or licensed intern, who has completed requirements for education and training. Administration of immunizations by technicians and interns will be supervised by the pharmacist.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services posted the Practitioner Fee Schedule for Injectables effective April 1, 2023. The Department also posted the COVID-19 Fee Schedule effective April 21.
Also in Nebraska, the Department of Health and Human Services published the following:
- Provider Bulletin 23-11: Pandemic Flexibilities That End After June 30, 2023
- Provider Bulletin 23-10: Pandemic Flexibilities That End After May 11, 2023
Also in Nebraska, the Department of Health and Human Services announced the DUR (Drug Utilization Review) Board Meeting scheduled for May 9 has been cancelled. The next meeting will be held on July 11.
Finally in Nebraska, the Department of Health and Human Services announced a public hearing on May 31 to receive comments on proposed changes to Title 471, Chapter 7 of the Nebraska Administrative Code (NAC) – Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies (DMEPOS). The proposed changes set the regulations' scope and authority; update definitions; expand prescription authority; update provider requirements; update service requirements for covered and non-covered services; add glucose monitors as a covered service; update billing and payment requirements; remove unnecessary and outdated language; remove duplicate statutory language from the regulations; update formatting; and restructure the regulatory chapter. Written comments may be submitted no later than the day of the hearing to: DHHS Legal Services, PO Box 95026, Lincoln, NE 68509-5026, (402) 742-2382 (fax) or dhhs.regulations@nebraska.gov, respectively.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On April 27, 2023, Governor Hochul announced an budget agreement with the legislature that held off all efforts to repeal the NYRx, the Medicaid prescription benefit carve out for fee-for-service. As of April 1, 2023, all Medicaid members enrolled in Mainstream Managed Care now receive their prescription drugs through the program.
On April 24, 2023, NACDS participated in a pharmacy lobby day in Albany, in collaboration with the Community Pharmacy Association of New York and the Pharmacist State Society of New York. Members and pharmacists lobbied in support of S3467: CLIA-waived testing, S6337: expanding the Long Acting Injectables law, and for final signature of A 1060: pharmacists administered contraceptives.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Dakota
On April 5, Gov. Doug Burgum (R) signed SB 2378, legislation related to clinician-administered drugs. The new law includes language that prohibits a PBM from requiring "a patient, as a condition of payment of reimbursement, to purchase pharmacist services, including prescriptions drugs, exclusively through a mail-order pharmacy or a pharmacy benefit manager affiliate, or a combination of both."
Also in North Dakota, on April 10, Gov. Doug Burgum (R) signed HB 1095, legislation including comprehensive medication management services in health benefit plans.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oklahoma
Insurance Commissioner Glen Mulready (R) recently filed an administrative action against CVS citing a violation of state law prohibiting patient steering. The administrative hearing is scheduled on May 25, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Department of Human Services began issuing $170 million in Pandemic EBT (P-EBT) food benefits to 434,000 students and young children in late March through May. These additional food benefits are part of the Pandemic EBT (P-EBT) program, a temporary COVID-19 response program meant to provide additional food support for children whose access to food provided through school programs may have been impacted by COVID-19. A P-EBT card containing $391 in food benefits, which is different from a regular electronic benefit transfer (EBT) card, will be sent by mail to each eligible child.
Also in Oregon, the Oregon Health Authority published a final rule effective April 1, amending Prior Authorization Approval Criteria Guide & Preferred Drug List DUR/P&T Actions. (OAR 410-121-0030, OAR 410-121-0040)
Also in Oregon, the Board of Pharmacy published a final rule effective April 4, amending Committee Member Compensation. (OAR 855-010-0016)
Also in Oregon, the Board of Pharmacy posted the following:
- Interns Workgroup – May 3 at 1:00 p.m. – Agenda
- Collaborative Drug Therapy Management / Clinical Pharmacy Agreements Workgroup – May 4 at 1:00 p.m. — Agenda and Meeting Materials
Also in Oregon, the Board of Pharmacy is proposing to adopt the following rules and announced a May 23 public hearing. Written comments may be sent to pharmacy.rulemaking@bop.oregon.gov no later than 4:30 p.m. on May 23.
- Divisions 006/041/043/045/080/139/141 related to Adopted Standards by Reference
- Divisions 019/020 related to Pharmacist Prescriptive Authority
- COVID-19 Monoclonal Antibody & COVID-19 Antiviral Protocols *Repeal
- Continuation of therapy including emergency refills of insulin v. 06/2023
Travel Medications v. 06/2023 - HIV (Human Immunodeficiency Virus) Post-exposure Prophylaxis (PEP) v. 06/2023
HIV Pre-exposure Prophylaxis (PrEP) v. 06/2023 - Contraception v. 06/2023
Finally in Oregon, the Board of Pharmacy adopted the following Temporary Rule, effective May 5: Division 045 – related to USP <795> and USP <797> Adopted Standards by Reference
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 3-years old 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 voted favorably out of the House Public Health Committee on April 26th by a 7-4 vote.
Also in Texas, on April 25th, the House Human Services Committee held a hearing on HB 1293, Rep. Toni Rose’s (D) Medicaid rate floor bill that all pharmacy groups support, would require PBMs’ pharmacy reimbursement to at least cover the pharmacy costs. Committee members questioned Priscilla Parrilla with the Health and Humans Services Commission’s Vendor Drug Program about the concerning fiscal note, and requested VDP (Vendor Drug Program) provide the committee with more information on how that was calculated. The bill was left pending in the committee.
Also in Texas, on April 26th, the Senate Health and Human Services held a hearing on SB 1619 by Sen. Charles Perry (R), legislation supported by all pharmacy groups that would prohibit the Health and Human Services Commission’s Vendor Drug Program from including any discount price offered for the prescription drug, including a discount offered through a third-party discount card when defining the price of a prescription drug for purposes of determining the Usual and Customary (U&C) reimbursement rate for Medicaid. The bill was left pending in the committee.
The Senate Health and Human Services also took testimony on SB 1137 by Sen. Charles Schwertner (R), PBM ERISA (Employee Retirement Income Security Act) reform legislation being led by the Texas Pharmacy Association and the Texas Pharmacy Business Council that is supported by all pharmacy groups. The companion bill by Rep. Tom Oliverson (R), HB 2021, was heard in the House Insurance Committee on March 21st. Both bills were left pending in committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The legislature adjourned on Sunday, April 23, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Wyoming Attorney General (Commissioner of Drugs and Substances Control) issued a proposed rules to additional substances to Schedule I and Schedule IV in the Wyoming Controlled Substances Act of 1971. Comments may be emailed to melissa.rexius@wyo.gov; the comment period ends on June 1, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Alabama Medicaid Agency (Medicaid) is announcing the final extension of the COVID-19 public health emergency (PHE). The new expiration date is May 11, 2023, which correlates with the expiration date of the national emergency. A Provider ALERT will be forthcoming from Medicaid to communicate changes to services related to the COVID-19 PHE.
During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. Providers should include appropriate COVID-19 diagnosis code(s) on claims submitted to help with tracking of COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
Janet Mann is the new Medicaid Director with the Department of Human Services. Mann has over 20 years of experience in health care and finance, including working in Mississippi Medicaid.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy posted the agenda and meeting materials for the April 5 meeting of the Licensing Committee.
Also in California, the Department of Health Care Services posted the following updates:
- On March 29, DHCS received approval from CMS to waive the asset test at redeterminations for members enrolled in Non-Modified Adjusted Gross Income (Non-MAGI) Medi-Cal. The waiver flexibility is effective for renewals retroactive to March 1 through December 31. Asset elimination takes effect on January 1, 2024. This waiver flexibility ensures continuity of coverage for seniors and persons with disabilities who meet all other Medi-Cal eligibility criteria, such as income, and will prevent potential disruptions in their Medi-Cal coverage once redeterminations resume in April 2023. DHCS issued Medi-Cal Eligibility Division Letter (MEDIL) 23-19 to provide counties with immediate guidance on operationalizing the waiver flexibility.
- This week, DHCS posted the Medi-Cal Continuous Coverage toolkit in 17 Medi-Cal threshold languages (in addition to the previously posted English and Spanish). Each toolkit includes materials that can be customized to help DHCS Coverage Ambassadors and partners assist Medi-Cal members with the redetermination process. The content encourages members to update their contact information to ensure they receive important information about keeping their Medi-Cal coverage. On April 6, from 1 to 2 p.m., DHCS will host a Continuous Coverage Unwinding and Communications Campaign webinar (advance WebEx registration required) to discuss the Medi-Cal renewal and redetermination process, communications campaign updates, and how DHCS Coverage Ambassadors and other partners can continue to help assist in this important effort.
- DHCS released a COVID-19 Uninsured Group (UIG) Program toolkit (in English and Spanish) to provide information to more than 500,000 UIG Program members about how to apply for ongoing coverage through Medi-Cal or Covered California before the program ends on May 31, 2023. Due to the COVID-19 Public Health Emergency ending, Covered California will open a special enrollment period for UIG Program members that have their coverage ending. The special enrollment period will end 60 days after May 31, 2023. The toolkit offers vital information for DHCS Coverage Ambassadors to share broadly with their networks about where UIG Program members can find the resources to apply for health coverage, including contact details for their local county offices and how to apply online. More information about DHCS' strategy to unwind the UIG Program is available in the Medi-Cal COVID-19 Public Health Emergency and Continuous Coverage Unwinding Plan posted on the Keeping Medi-Cal Members Covered webpage.
- As of March 24, Phase III, Lift 1 of the Medi-Cal Rx Reinstatement plan has been successfully implemented. Providers are required to submit prior authorizations for new and renewing prescriptions in specific drug classes for members 22 years of age and older.
- On March 29, the California Health & Human Services Agency, Department of Managed Health Care, and DHCS held a webinar to walk through the Governor's proposal to modernize California's behavioral health system. The proposal builds on the Administrations' previous investments and policy reforms to re-envision how the state treats mental health and substance use disorders. More information and the presentation are available on the Modernizing our Behavioral Health Initiative webpage.
Also in California, the Department of Health Care Services (DHCS) posted the following alert on the Medi-Cal Rx Web Portal: Mpox Vaccine No Longer a Family PACT Pharmacy Benefit (March 30).
Finally in California, Medi-Cal posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
HB 215, legislation adding enforcement language to Title 41-349 related to PBMs permitting 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, passed the House (61-9) and Senate (25-8-2). On March 29, it was sent to Gov. Brad Little (R) for consideration.
Also in Idaho, HB 291, legislation establishing the Fair Pharmacy Audits Act and creating standards and criteria for the audit of pharmacies by PBMs or other authorized entities, passed the House (61-7-2) and Senate (27-7-1). On March 29, it was sent to Gov. Brad Little (R) for consideration.
Finally in Idaho, the Board of Pharmacy posted its March 2023 Newsletter including the following items:
- 2023 Summary of Pending Statute and Administrative Rule Changes
- Idaho Telehealth Access Act COVID-19 Guidance Updated
- Announcement and Reminder: Prescription Drug Monitoring Program
- Idaho to License Virtual Wholesalers That Operate in and into Idaho
- Enforcement of Mandatory Checking of the PDMP to Begin April 1, 2023
- Board Executive Officer Awarded the Judy Smetzer Just Culture Champion Scholarship
- Board Sets 2023 Meeting Schedule
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
SB 678 has passed the House and Senate and is on its way to the Gov. Wes Moore’s (D) desk. It will require Medicaid, CHIP and commercial health plans to pay for services provided by pharmacists within their scope of practice.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
On March 2, the Department of Health and Human Services (MDHHS) began mailing beneficiary alert letters to notify beneficiaries that an eligibility renewal packet will be sent soon. Per federal legislation, Michigan will restart Medicaid eligibility renewals for both fee-for-service Medicaid and Medicaid Health Plan (MHP) beneficiaries effective April 1, 2023. MDHHS plans to continue to mail the beneficiary alert letters each month to additional groups of beneficiaries until February 2, 2024. Providers should continue to verify beneficiary eligibility prior to services. Visit the eligibility and enrollment webpage for step-by-step instructions. Eligibility redetermination or renewal dates can be viewed within the CHAMPS eligibility inquiry screen. For more information on how benefits are changing with the COVID-19 Public Health Emergency (PHE), visit Medicaid Benefit Changes.
Also in Michigan, MDHHS issued two bulletins:
- Medicaid Bulletin MMP 23-14 discusses Updates to the MDHHS Medicaid Provider Manual; Medicaid Eligibility Requirements; Federal Public Health Emergency and is issued on March 2, 2023.
- Medicaid Bulletin MMP 23-10 discusses Telemedicine Policy Post-COVID-19 Public Health Emergency and is issued on March 2, 2023.
All Medicaid bulletins can be accessed at www.michigan.gov/medicaidproviders click on "Policy, Letters & Forms".
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Department of Health, Health Economics Program (HEP), released the first set of data from the Minnesota Prescription Drug Price Transparency (RxPT) initiative. This release includes RxPT’s first legislative report and the new RxPT Data Dashboards and downloadable files. The report is the result of the Minnesota Prescription Drug Price Transparency Act of 2020. The Act tasked the Department of Health (MDH) with developing a system for collecting and reporting data from drug manufacturers on high and quickly increasing prescription drug prices. To address some these remaining challenges and provide more actionable data to policymakers, the Governor’s budget propo
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Department of Commerce and Insurance (DCI) extended the COVID-19 vaccine and testing standing orders until May 11, 2023. Revised standing orders may be found at:
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Dept. of Labor and Industry published the following effective March 25, 2023:
- 24.174.101 – The Board of Pharmacy adopts and incorporates the organizational rules of the Dept. of Labor and Industry.
- 24.174.201 – The Board of Pharmacy adopts and incorporates the procedural rules of the Dept. of Labor and Industry.
- 24.174.202 – The Board of Pharmacy adopts and incorporates the public participation rules of the Dept. of Labor and Industry.
Also in Montana, HB 710, legislation permitting pharmacy interns and technicians to administer immunizations, passed the House (90-8) and Senate (44-5). It has not yet been transmitted to the Governor.
Finally in Montana, SB 112, legislation allowing pharmacists to prescribe certain medications with limitations, passed the Senate (34-15). In the House Human Services Committee, the bill was amended and passed (14-7).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Board of Pharmacy has posted the April 4 meeting agenda. Please note they plan to discuss the quota and break proposed rules from the Pharmacy Workforce Advisory Committee.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services published Provider Bulletin 23-08: Guidance on Telehealth.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
PBM reform bill, AB 440, was heard in the Assembly Commerce and Labor Committee on March 31. The Retail Association of Nevada offered several amendments defining specialty drugs, patient steering, patient choice, adequate networks, any willing provider, spread pricing, as well as prohibiting retroactive fees and setting a rate floor.
For more information, contact NACDS’ Mary Staples at 817-442-1155.