Wisconsin
Effective immediately, Dr. Jasmine Zapata is the new Wisconsin physician signing the Statewide Standing order for Naloxone. You must use Dr. Zapata’s prescriber number going forward as Dr. Jon Meiman’s prescriber number can no longer be used. In addition, the Wisconsin Department of Health Services (DHS) has updated its web pages.
Under this new standing order, there are new resources available through the enhanced Dose of Reality Initiative. Patient education regarding overdose recognition and naloxone administration can be found on the following web pages:
- Review common questions about opioids and address risk factors that can put someone at increased risk of overdose: Dose of Reality: Get the Facts on Opioids
- Provide an overview of how to recognize an overdose and the proper procedure to respond to an overdose: Dose of Reality: Overdose
- Discuss how to administer naloxone and when: Dose of Reality: Safer Use
- Discuss how to safely dispose of opioids and other unused prescription medication: Dose of Reality: Safe Disposal
If you have questions, reach out to: DHSOpioids@dhs.wisconsin.gov
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Arkansas
Gov. Asa Hutchinson (R) announced that the Secretary of Health Dr. Jose Romero is resigning on May 6th to take a job with the U.S. Centers for Disease Control and Prevention.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
On March 30, Gov. Doug Ducey (R) signed HB 2490 (Chapter 98), providing clarity for collaborative practice agreements including requirements, rules, and definitions.
Also in Arizona, on March 24, Gov. Doug Ducey (R) signed HB 2612 (Chapter 59), removing certain occupational licensing requirements and regulations that applicants/persons must be “of good moral character” to be approved for certain licenses and certifications including pharmacists and pharmacy technicians.
Finally, in Arizona, on March 25, Gov. Doug Ducey (R) signed SB 1639 (Chapter 78), that requires integrating a medical practitioner’s electronic medical records system with the state’s Controlled Substances Prescription Monitoring Program (CSPMP) central database tracking system either directly or through the statewide health information exchange or a third-party vendor, by December 31, 2026.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
As a reminder regarding the COVID-19 declaration of emergency, the Board of Pharmacy has a webpage dedicated to Pharmacy Law Waivers; interested parties may sign up to receive the Board’s alerts for the most up-to-date information. Also, the Department of Consumer Affairs (DCA) has a webpage dedicated to DCA Waivers and Guidance Documents..
Also in California, as a reminder, the Department of Health Care Services (DHCS) eased DUR edits in Medi-Cal Rx until May 1. NACDS and the California Retailers Association have been in communication with the DHCS staff to request advance notice be provided to pharmacy providers of the Department’s plans for these DUR edits in advance of May 1.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Georgia
The Georgia Board of Pharmacy is excited to announce and introduce the first installment of a new “Newsletter.” The newsletter will be produced on a quarterly basis and is intended to provide insights and updates on the profession of pharmacy in Georgia. The newsletter will also be posted on the GBOP website for easy access as well. Since the newsletter is a new resource, the Board asks that you please distribute it to others in your organization or staff.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Board of Pharmacy published the following Notices of Intended Action. Written comments may be submitted until 4:30 p.m. on April 26. A public hearing will be held at 10:00 a.m. on April 27 at the offices of the Board and via Zoom.
- ARC 6279C– amending Chapter 3, “Pharmacy Technicians” and Chapter 6, “General Pharmacy Practice to permit remote processing
- ARC 6280C – amending Chapter 12, “Precursor Substances” to add one chemical as a precursor substance in response to similar action taken by the DEA.
- ARC 6182C – amending Chapter 8, “Universal Practice Standards,” and Chapter 19, “Nonresident Pharmacy Practice” to provide modification of the handling of ownership changes, add requirements for nonresident pharmacies and other changes.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Missouri
In advance of the April 12th Senate Insurance and Banking hearing on HCR HB 1677, NACDS submitted a letter supporting certain provisions of the legislation that would strengthen Missouri’s PBMs laws to enhance patients’ ability to receive pharmacy care from their pharmacy of choice and improve provisions for fair and equitable standards for the management of pharmacy benefits. In our letter, NACDS specifically called out support for the provisions that would prohibit PBMs from preventing, penalizing or restricting patients’ ability to obtain services from a contracted pharmacy; the provisions that would enhance the appeals process to requiring PBMs to increase a pharmacy’s reimbursement in instances when reimbursement is found to be below a pharmacy’s cost for purchasing a drug; and the provisions that would prevent PBMs from imposing unwarranted fees on claims related to administering a health plan.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
Executive Order No. 22-02 — Continued Waivers to Facilitate Hospital Planning and Ensure Additional Healthcare Workforce Capacity — states “Executive Order No. 21-15, which is currently scheduled to expire on March 31, 2022, per [E]xecutive [O]rder No. 21-18, shall remain in effect through September 30, 2022.” See item 6 in Executive Order No. 21-15 suspending Neb. Rev. Stat. § 38-2866.01 and its implementing regulations “in order to permit pharmacists to have any number of pharmacist interns and pharmacy technicians under their supervision insofar as they determine it necessary within their professional discretion when administering vaccinations”.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on May 4 at noon (Central).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The State Education Department regulation expanding the pharmacist immunization authority which took effect on January 31, 2022, is set to expire on April 10. At the last Board of Regents meeting, the Board took emergency action effective April 11 to keep the regulation in effect until it can be permanently adopted at the Board May Meeting.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
SPECIAL BULLETIN COVID-19 #242: Continued Reimbursement for COVID-19-Related Services for the Uninsured. Effective April 4, 2022
NC Medicaid continues to reimburse providers for COVID-19 related services for the NC Medicaid Optional Eligibility Group (which includes the uninsured (MCV) and MAFDN Family Planning Group). This program was initiated in 2020 for COVID-19 and expanded by the America Rescue Plan Act to include COVID-19 treatment and vaccination. NC Medicaid will continue to operate this program through the federal public health emergency.
It was recently announced that the Health Resources and Services Administration (HRSA) -led initiative to reimburse for COVID-19 testing and treatment will end. This program also reimbursed health care providers for delivering COVID-19 testing, treatment and vaccines to those without health insurance. As of March 22, 2022, the program stopped accepting claims for testing and treatment services. On April 5, 2022, the program will stop accepting claims for vaccine administration.
This bulletin services as a reminder that the two programs are separate entities, and that NC Medicaid will continue to reimburse providers who deliver COVID-19 treatment, testing, and vaccine administration for the uninsured in the state. To be eligible for the program, individuals must:
- Enroll in Medicaid for the uninsured (MCV) group or MAFDN Family Planning.
- Be uninsured.
- Be a resident of North Carolina.
- Meet the citizenship and legal immigration status requirements of the Medicaid program.
Detailed eligibility requirements may be found in SPECIAL BULLETIN COVID-19 #206.
Also in North Carolina, The Board of Pharmacy has completed a rulemaking to amend Rule .1816, now titled “Centralized Pharmacy Services.” The amended rule broadens the availability of remote medication order processing (“RMOP”) arrangements among pharmacies to all pharmacy practice types. The full rule is found here: 21 NCAC 46.1816
The new RMOP provisions became effective March 1, 2022. However, the Board’s Expanded Emergency Services Waiver, issued on March 17, 2020, because of the COVID-19 public health emergency, authorized expanded RMOP arrangements: Expanded Emergency Services Waiver
Pharmacies may continue to operate RMOP arrangements pursuant to the waiver until June 1, 2022. Beginning June 1, 2022, the Board will enforce the Rule .1816-based RMOP requirements. To assist pharmacies transitioning to the rule based RMOP requirements, Board staff have prepared two guidance documents.
The first, http://www.ncbop.org/PDF/GuideToInterPharmacyRMOP.pdf – provides a detailed overview of the revised rule governing inter-pharmacy RMOP arrangements. Please note, this guidance document only concerns RMOP services arranged between two pharmacies. The Board has proposed a new rule (Proposed New Rule 21 NCAC 46.2515) authorizing intra-pharmacy remote services (i.e., a pharmacy uses its own personnel to provide off-site services). Once that rulemaking is complete, the Board staff will provide a separate guidance document on that topic. In the meantime, intra-pharmacy remote services are allowed under the Expanded Emergency Services Waiver linked above.
The second, http://www.ncbop.org/PDF/HowToRegisterAsNABPVerifyHolder.pdf – provides detailed instructions on how out-of-state pharmacists who are performing RMOP services and who are not individually licensed to practice pharmacy in North Carolina may obtain an NABP Verify credential and register with the Board of Pharmacy, as required by revised Rule .1816.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The Department of Health has developed the following COVID-19 vaccine resources:
- COVID-19 Vaccines: Second Booster Dose FAQ
- COVID-19 Vaccine Decision Tree for the General Public – includes Primary Series, 1st Booster Dose and 2nd Booster Dose information
- COVID-19 Vaccine Decision Tree for Those Who are Immunocompromised – includes Primary Series, 1st Booster Dose and 2nd Booster Dose information
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Medicaid (ODM)announced that Myers and Stauffer have begun sending acquisition cost surveys to pharmacies to help them determine Ohio Average Acquisition Cost (OAAC). ODM intends to use OAAC as part of the “lower of” calculation for ingredient cost reimbursement, to include NADAC and Usual and Customary, when they implement “The Next Generation of Managed Care.” Completed surveys are due April 30 and can be submitted by email, U.S. Post, or fax, as noted below, though electronic submission is preferred.
- Email OHSurveys@mslc.com. The email subject link should read: “Ohio Pharmacy Survey.”
- Mail Myers and Stauffer LC, Attn.: Ohio Pharmacy Survey 800 East 96th Street, Suite 200 Indianapolis, IN 46240.
- Fax 317-566-3203. On the cover page, please include “ATTN – Ohio Pharmacy Survey.”
To learn more about the Next Generation of Medicaid managed care, visit Ohio Medicaid Single Pharmacy Benefit Manager (SPBM) | Ohio Medicaid Managed Care or email ODM at MedicaidSPBM@medicaid.ohio.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Oregon Health Authority is implementing changes to the Prior Authorization Guide and the Preferred Drug List, including select over-the-counter product classes, to ensure the safe and appropriate use of cost-effective prescription drug for Oregon Health Plan’s fee-for-service recipients. his is a temporary rule effective April 1, 2022, through June 25, 2022.
Also in Oregon, the Oregon Health Authority issued a Notice of Proposed Rulemaking, making permanent changes to the Prior Authorization Guide and the Preferred Drug List, including select over-the-counter product classes, currently in effect as a temporary rule effective April 1, 2022, through June 25, 2022. Comments are due 5:00 p.m. on May 21.
Finally in Oregon, the Board of Pharmacy posted a REVISED agenda and meeting materials for the April 13-15 meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
Please see the updates to the PDL, Clinical Criteria, and Interim Criteria below for April 2022. These changes went into effect on April 1st.
- BaG additions: Combigan
- Added to preferred: naloxone, Valtoco, glycopyrrolate solution, Myfembree
- Added to non-preferred: Dartisla ODT, Eprontia, Xarelto suspension, Xenleta, Brexafemme, nitazoxanide, Elepsia XR, Azstarys, adapalene/benzoyl peroxide, carglumic acid, Zokinvy, Palforzia, Lumakras, Tepmetko, Qinlock, bimonidine/timolol, Bronchitol
- Added to interim: Recorlev, Tarpeyo, Livmarli, Trudhesa, Tyrvaya, Skytrofa, Besremi, Tavneos, Adbry, Livtencity
- Modified criteria/quantity limits for Adderall, Adderall XR, Adefovir, Adhansia XR, Adzenys ER solution, Adzenys XR ODT, amphetamine ER suspension, Ancobon, Arikayce, Baraclude solution, clonidine ER, Cotempla XR ODT, Cresemba, Daytrana, Desoxyn, Dexedrine spansule, dexmethylphenidate XR, dextroamphetamine soln, Dificid tablet and suspension, doxycycline hyclate 20mg, Dyanavel XR, Evekeo tab & ODT, flucytosine tablets, Focalin, Fuzeon, Hepsera, Intuniv, Isentress HD, itraconazole, Jornay PM, ketoconazole, linezolid suspension, Lumakras, methamphetamine, Methylin solution, methylphenidate chewable, methylphenidate ER, methylphenidate SA OSM, methylphenidate XR ODT, Mycobutin, Mydayis ER, Nuzyra, Oravig, Pegasys syringes, Pegasys vials, Qelbree, Qinlock, Quillichew ER, Quillivant XR, Relexxii, Ritalin, Ritalin LA, Sporanox, terbinafine tablets, Tybost, Vemlidy, Xenleta, Zenzedi, Zyvox suspension, Zyvox tablets.
Additionally, these documents can be found on the TennCare website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
NACDS attended the Dallas County Medical Society’s 139th Annual Dinner and Awards ceremony at the Frontiers of Flights Museum on April 6th honoring chain pharmacies and pharmacists from Kroger Health and Albertsons/ Randall’s/Tom Thumb for their efforts at the beginning of the pandemic providing 20,000 COVID-19 vaccines administered to physicians who are not affiliated with a major health or hospital systems and their frontline office staff. Accepting the awards for chain pharmacies were Jeff Loesch, PharmD with The Kroger Company, and Jennifer Golden, PharmD with Albertsons Companies. This successful collaborative effort eventually led to multiple other opportunities throughout the pandemic for more chain pharmacies to work directly in Collin, Dallas, Denton Grayson, and Tarrant County Health Departments to administer COVID vaccines and tests.
People in the photos:
Dr. Philip Huang, Director, Health Authority, Dallas County Health, and Human Services Department
Jon Roth, CEO, Dallas County Medical Society
Jeff Loesch, PharmD, CHC
Jill Lester, PharmD, BCPS, BCACP
Jennifer Golden, RPh.
Emad Besslay, MPharm
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
On March 23, Gov. Spencer Cox (R) signed HB 80, allowing for Medicaid reimbursement for diabetes prevention services including an additional appropriation for the Department of Health and Human Services in Fiscal Year 2022-2023. Beginning July 1, 2022, Medicaid will reimburse a provider for an enrollee’s participation in the CDC’s National Diabetes Prevention Program under certain conditions.
Also in Utah, On March 24, Gov. Spencer Cox (R) also signed SB 3, that includes a block grant in the amount of $500,000 for alcohol, tobacco and other drug prevention, reduction, cessation, and control programs or for emergent disease control and prevention needs for the Department of Health’s Disease Control and Prevention.
Finally in Utah, on March 24, Gov. Cox signed SB 236, allows a therapeutic equivalent to be dispensed for needles or other supplies for treating diabetes and allows a pharmacist to dispense up to a 100-day supply of insulin with a valid prescription among its various provisions.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wyoming
On March 7, Gov. Mark Gordon (R) signed SF 24 (Chapter Number 7), authorizing the administration of immunizations by pharmacy technicians and pharmacy interns. It also eliminates the statutory definition of “direct” supervision requirements for pharmacy technicians and pharmacy interns, leaving the “supervision” requirements to be further specified by the Board of Pharmacy.
Also in Wyoming, on March 15, Gov. Mark Gordon (R) signed SF 101 (Chapter Number 69), permitting pharmacists to prescribe an opiate antagonist in accordance with the Emergency Administration Medical Treatment Act. It also directs the Board of Pharmacy, in cooperation with the Board of Medicine, to adopt rules delineating the requirements a pharmacist must need to prescribe an epinephrine auto-injector.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Alabama Department of Public Health has stated that allocation quantities of Paxlovid and Lagevrio (molnupiravir) have increased. ADPH has expanded access to most of the chain pharmacies and several independent pharmacies. If you are interested in being an oral antiviral provider, please review the information below.
Pharmacies interested in dispensing Paxlovid and/or Lagevrio (molnupiravir) for the treatment of COVID-19 should send an email to pharmacy@adph.state.al.us. The Pharmacy Division at the Alabama Department of Public Health will provide information and assist with setting up an HPOP account which is required by HHS. Through this account, pharmacies will report utilization daily which is also required by HHS. The Fact Sheet for Paxlovid can be found here. The Fact Sheet for Lagevrio (molnupiravir) can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Governor Doug Ducey (R) signed SB 1309 (Chapter 77), extending temporary licenses issued during the COVID-19 emergency declaration and active on March 1, 2022; they do not expire until January 1, 2023.
Also in Arizona, Gov. Ducey announced the end of the COVID-19 emergency declaration.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Board of Pharmacy has rescheduled April 19 Standard of Care Ad Hoc Committee meeting to June 22. The Board also announced the April 20 Medication Error Reduction and Workforce Ad Hoc Committee meeting will be rescheduled (TBD).
Also in California, the Department of Health Care Services posted this DUR article titled “Improving the Quality of Care: Legislative Impact on the Use of Naloxone” on its Medi-Cal Rx Web Portal. Please note the Table 2 update on March 31.
Finally in California, the Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal on March 24:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
he Illinois Department of Healthcare and Family Services has posted an updated Class Review Schedule. You may view the new schedule here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
A final rule was published in the March 20, 2022, Louisiana Register codifying the authority for pharmacy technicians and pharmacist interns to administer medications effective immediately. It also simplifies existing administrative requirements for vaccines provided by pharmacy providers.
Also in Louisiana, the House Committee on Health and Welfare meeting was cancelled this week because of the special session Gov. John Bel Edwards (D) convened on redistricting. We now expect HB 424 by Rep. Chris Turner (R) to be heard next Wednesday, April 6th. The bill allows pharmacy interns or certified pharmacy technicians, supervised by a pharmacist, to administer influenza immunizations; it lowers the minimum age from seven years of age to three without a patient-specific prescription or medical order. NACDS urges members to continue to contact all House members encouraging them to support the bill.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
The MO HealthNet Division recently issued a new COVID vaccine provider bulletin.
Also in Missouri, the Department of Commerce’s Department of Health, and Senior Services (DHSS) and Insurance issued a new Standing Order for COVID tests provided by pharmacies. DHSS’s previously issued Standing Orders are available here.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
The New York State COVID-19 Vaccine Team has recently updated its Guidance for the NYS COVID-19 Vaccination Program for individuals 12 years of age and older. The updates reflect the recent CDC changes in COVID-19 vaccine clinical guidance. The updates include:
- Options for extended intervals between doses of the mRNA primary series (pages 1 and 2)
- Additional details on myocarditis (page 2)
- J&J extended shelf life (page 11)
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Nebraska
Executive Order No. 21-18 Continued Waivers to Facilitate Hospital Planning and Ensure Additional HealthCare Workforce Capacity expired on March 31. Executive Order No. 21-18 extended Executive Order 21-15 Further Health Care Workforce Capacity that permitted pharmacists to have any number of pharmacist interns and pharmacy technicians under their supervision when administering vaccinations. Beginning April 1, the ratio reverts to pre-pandemic levels.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.