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.
New York
Beginning April 1, the State Department of Public Health will be transitioning all Medicaid members to NYRx, the Medicaid Pharmacy Program. The Department will be having a call center available for pharmacies and Medicaid recipients. Please call 1-800-343-9000 if you experience any claims issues. The hours of operation will be Monday through Friday 7:00 am to 10:00 pm and Saturday and Sunday 8:30 am to 5:30 pm, with extended hours to 8:00 pm on April 1. The NYRx program will also be hosting calls for pharmacies regarding implementation on April 3 at 11:00 am.
The next monthly stakeholder call for NYRx will be held April 18 at 1:00 pm. This call will be a webinar about the pharmacy benefit transition. Members, providers and all interested stakeholders are welcome to attend. Registration information will be posted one week prior.
The State Assembly and Senate have both passed bill A1060A, an act relating to the self-dispensing of hormonal contraceptives. The legislation will authorize licensed pharmacists to provide contraceptives pursuant to a non-patient specific order from a physician or nurse practitioner. The legislation once signed by the Governor will take effect in 180 days.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The Board of Pharmacy announced it is pursuing administrative rulemaking concerning "direct-to-patient delivery systems" for pharmacies allowing for technologies where drugs are dispensed directly to patients. The Board will host a public hearing on this issue on June 13, and written comments are due by June 16. Below is more information on this proposed rule which the North Carolina Retail Merchants Association is in the process of analyzing.
PUBLIC HEARING AND COMMENT PERIOD — JUNE 13, 2023 — ON THE FOLLOWING PROPOSED ACTIONS:
ADOPTION OF 21 NCAC 46 .1821 DIRECT-TO-PATIENT DELIVERY SYSTEMS
AMENDMENT TO 21 NCAC 46 .1616 LIMITED SERVICE PERMITS
Reason for Proposed Action:
The Board of Pharmacy proposes to adopt a rule permitting pharmacies to employ certain direct to patient systems, which are technologies that dispense drugs directly to patients. The proposed rule contains provisions to allow pharmacies to comply with the laws governing dispensing drugs, devices, or medical equipment while using these systems. The proposed rule further contains provisions that would ensure that the systems can be used safely and securely, that required records are maintained, that the home pharmacy can adequately supervise and service these systems, and that patients may use these systems while also receiving information, safeguards and counseling that they need to use their drugs, devices, and medical equipment safely. There is an accompanying proposed change to the Board of Pharmacy's limited-service permit rules to provide for permitting of systems that a pharmacy may place in a location other than the home pharmacy's facility.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
Beginning April 1, 2023, the Oklahoma Health Care Authority (OHCA) will begin disenrollment of certain individuals that have been continuously enrolled in SoonerCare (Oklahoma Medicaid program) that no longer meet eligibility requirements. For more information, see Bulletin No. 2-2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy posted the agenda and meeting materials for the next Board Meeting scheduled for April 12-14; see additional details below. Also, please note the following agenda item:
- Div 019/020- Pharmacist Prescriptive Authority – COVID-19 Monoclonal Antibody, COVID-19 Antiviral, Continuation of Therapy including emergency refills of insulin, Contraception, PEP, PrEP, Travel Medications Protocols- #A2, A2a, A2b, A2c, A2d, A2e. See pp 47-103 (inclusive) of the PDF.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Dakota
On March 23, South Dakota Gov. Kristi Noem (R) signed HB 1135; PBM legislation including requirements for PBM licensure, prohibiting retroactive fees except in certain situations and the collection of renumeration fees, and adding criteria for drugs to be placed on the MAC list.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
Walgreens pharmacist Aimee Lusson testified at the House Public Health Committee on March 27 in support of HB 2088 by Rep. John H. Bucy III (D), on emergency insulin supply legislation.
Also in Texas, Rep. Tom Oliverson's HB 1543, legislation establishing a statewide standing order for prescribing an opioid antagonist, will be heard in the House Public Health Committee on April 3.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
Gov. Glenn Youngkin (R) signed SB 1538 into law. This bill, sponsored by Senator Pillion (R), requires the Department of Medical Assistance Services to provide reimbursement when the services provided for by the state plan for medical assistance services are services by a pharmacist, pharmacy technician or pharmacy intern (i) performed under the terms of a collaborative agreement as defined in relevant law and consistent with the terms of a managed care contractor provider contract or the state plan or (ii) related to services and treatment in accordance with relevant law. NACDS supported the efforts of the Virginia Association of Chain Drug Stores and the Virginia Pharmacists Association as it moved through the process.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
West Virginia
Gov. Jim Justice (R) signed the following priority bills into law on March 23:
- Committee Substitute SB 345, a bill that would provide legislative approval of the PBM rule pursuant to the passage of HB 4112 of 2022. Effective from passage – March 10, 2023.
- HB 2754 adopts the immunization authority from the federal PREP Act into state law. It allows both pharmacists and pharmacy technicians to administer all vaccines to patients aged three years and older and removes the long-standing prescription requirement for children. Effective from passage – March 7, 2023.
NACDS thanks our members, Bridget Lambert of the West Virginia Retailers Association, Conrad Lucas of Capitol Resources and the West Virginia Pharmacists Association for their daily engagement on getting HB 2754 across the finish line.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
Stating cost shifting to consumers among his concerns and exercising his line-item veto authority, Gov. Mark Gordon (R) signed SF 151, legislation amending the Insurance Code to further regulate PBMs. The new law includes language that prohibits certain fees and claw backs, prohibits PBMs from restricting or limiting disclosure of information to the insurance commissioner for investigations or review of PBMs, requires contracts between PBMs and pharmacies to include a dispute resolution process, amends MAC and MAC appeals, permits refusal to fill below-cost prescriptions and provides for one-time resources for implementation and administration of this act. The Governor's veto message and the bill with the Governor's vetoes are available online.
Also in Wyoming, the Office of the Attorney General published two final rules amending the lists of Schedule I and Schedule II controlled substances in the Wyoming Controlled Substances Act of 1971, effective March 22, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alaska
The Board of Pharmacy issued Proposed Regulations relating to classifications of licensure, registration, application, license and registration renewal, notification process for changes in name, ownership or physical address of pharmacies, pharmacist-in-charge, pharmacist interns, job shadowing, security, remote pharmacy, return or exchange of drugs, automated distribution kiosks, remodeling, designated representative, drug recalls, facilities, prescription drug monitoring program, and definitions. Written comments deadline is 4:30 p.m. on April 24.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
SB 1283, 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, was heard in the House Regulatory Affairs Committee on March 22 where is was amended and voted (6-1) with “Do Pass Amended”.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services (DHCS) posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal.
- Medi-Cal Rx Weekly Wrap-up for March 17-23 (March 24)
- Prior Authorization Submission in Advance of the Retirement of the Transition Policy – Processing Issue Resolved (March 24)
- Reinstatement Spotlight (March 24)
- Extended Duration Prior Authorizations for Maintenance Medications (March 22)
- 30-Day Countdown – Phase III, Lift 2: Retirement of the Transition Policy for Beneficiaries 22 Years of Age and Older (March 21)
- Medi-Cal Rx Weekly Wrap-up for March 10-16 (March 17)
- Reinstatement Spotlight (March 17)
- Submitting Prior Authorization Requests in Advance of Retirement of the Transition Policy (March 10)
- Reinstatement Spotlight (March 10)
Also in California, Medi-Cal posted the following:
- March 2023 Pharmacy Medi-Cal Update Bulletin (March 16)
- March 2023 Durable Medical Equipment and Medical Supplies Medi-Cal Update Bulletin (March 16)
Finally in California, the Department of Health Care Services (DHCS) has recently initiated efforts to partner with its pharmacy providers in support of a Medi-Cal redetermination initiative for beneficiary outreach, targeted for implementation in early May. DHCS is seeking pharmacies interested in participating. One example of a beneficiary outreach effort would be to affix a DHCS-provided Medicaid renewal message to all Medi-Cal beneficiary prescriptions which would include links and phone numbers to call for eligibility renewal information. If you would like to attend a meeting with DHCS to learn more about this opportunity, please submit the following information to Julie.Cheung@dhcs.ca.gov by March 31. DHCS is targeting early April to hold the first meeting which will include discussion of data-sharing.
- Name of contact to attend meeting
- Email address of contact
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Effective April 3, HHAeXchange will be the statewide subcontractor providing electronic visit verification services (home health and personal care services) for Florida Community Care Medicaid members. If you have questions or need help, please contact Florida Community Care Provider Relations at 1- 866-962-6186. For questions or help with HHAeXchange, please contact HHAeXchange at support@hhaexchange.com or visit hhaexchange.com/info-hub/florida-smmc.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
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 advanced to the Senate where it was reported out of the Senate Health and Welfare Committee with "Do Pass Recommendation".
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 advanced to the Senate where it was reported out of the Senate Health and Welfare Committee with "Do Pass Recommendation".
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
The Board of Pharmacy adopted ARC 6953C, implementing relevant provisions in 2022 Iowa Acts, HFs 771, 2573 and 2169. These amendments implement changes related to licensed nurses engaging in the practice of nursing pursuant to a pharmacist's order and the issuance of a prescription in the name of a school district to obtain a bronchodilator canister, a bronchodilator canister and spacer, or an opioid antagonist.
Also in Iowa, the Department of Health and Human Services published INFORMATION LETTER NO. 2426-MC-FFS-CVD_End of COVID-19 PHE Pharmacy Allowances that includes the following:
- Override for Early Refills/Refill Too Soon
- Days' Supply
- PBM or Program Integrity (PI) Audits
- Patient Signature
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.