Indiana
The Family and Social Services Administration (FSSA) posted several bulletins of interest to pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy announced the following effective March 15:
- ARC 6843C has been adopted and amends Chapter 10, "Controlled Substances" placing one substance into Schedule I of the Iowa Controlled Substances Act (CSA) in alignment with .
- ARC 6844C has been adopted and amends Chapter 37, "Iowa Prescription Monitoring Program" establishing council membership information for the PMP Advisory Council and clarifying that only overdoes-reversal opioid antagonists are required to be submitted to the PMP.
Also in Iowa, the Board of Pharmacy issued a "Notice of Intended Action" related to ARC 6874C amending Chapter 10, "Controlled Substances," and Chapter 12, "Precursor Substances." This proposed rulemaking temporarily adds four substances to Schedule I, excludes one substance from Schedule II and adds one substance as a precursor substance to the Iowa CSA in alignment with response to similar action taken by the DEA ARC 6874C amending Chapter 10, "Controlled Substances," and Chapter 12, "Precursor Substances." This proposed rulemaking temporarily adds four substances to Schedule I, excludes one substance from Schedule II and adds one substance as a precursor substance to the Iowa CSA in alignment with DEA's action. Comments may be submitted until 4:30 p.m. on February 28.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) announced that they now plan to migrate Medicaid to a single payor system on October 1. All patients will be assigned to a managed care organization and will receive a new universal prescription benefit card.
Also in Louisiana, the Board of Pharmacy met on February 15 & 16.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
MassHealth, the state Medicaid agency, is asking pharmacies to post this flier for notice to recipients of the planned redetermination of all MassHealth beneficiaries that will begin on April 1. One half million Massachusetts residents were added to MassHealth under the PREP Act and individuals may lose their MassHealth coverage and be moved to other state sponsored or commercial health plans.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Missouri
The revised 2023 Pharmacy Practice Guide is available on the Board's website. It contains updated compliance tips and information on recent statutory/rule changes, including:
- Pharmacy Working Conditions
- Technician Supervision & Expanded Technician Activities
- Electronic Final Product Verification (Pharmacists)
- Technology-Assisted Product Verification (Interns & Technicians), &
- Quality Assurance
Also in Missouri, the Department of Health and Senior Services recently issued a revised naloxone standing order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
HB 379, extending the prohibition on PBMs to require federally certified health entities to identify 340B drug from June 1, 2023 to June 1, 2025, was amended and passed the House Business and Labor Committee on February 14.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services (DHHS) issued Bulletin 23-04: Nebraska Medicaid Managed Care Contracts 2024. Contracts between DHHS and Molina Healthcare of Nebraska, Nebraska Total Care and United Healthcare have been signed and these organizations will prepare to provide services under the new contract beginning January 1, 2024.
Also in Nebraska, DHHS posted the draft minutes from the November 15, 2022, Drug Utilization Review Board meeting.
Finally in Nebraska, LB 778, amending the Pharmacy Benefit Manager Licensure and Regulation Act, has been scheduled for a hearing on March 21.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On February 15, the Department of Financial Services published a proposed rule regarding General Duties, Accountability and Transparency Provisions for Pharmacy Benefit Managers. The proposed rule sets forth to clarify, define and limit the duties, obligations, requirements and other provisions relating to pharmacy benefit managers under Public Health Law section 280-a(2) and provides a safe harbor provision for compliance with the regulation. It also defines, limits and clarifies the requirements for pharmacy benefit managers to provide an accounting to health plans and sets forth the terms and conditions of contract relating to pharmacy benefit management services provided to health plans by the pharmacy benefit managers, including provisions related to an appeal to the bureau for a determination on disclosure.
On February 13, NACDS participated in the Community Pharmacy Association of New York State lobby day. NACDS joined with members to advocate for Gov. Kathy Hochul's (D) budget proposal, including the Medicaid Fee-for-Service transition effective on April 1.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Dakota
SB 2031, designing and implementing a prescription drug reference rate pilot program to study the possibility of controlling excessive prices for prescription drugs, failed in the Senate (14-33).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
ODM (Ohio Department of Medicaid) Director Maureen Corcoran announced a proposed 5.7% increase in the Professional Dispensing Fee (PDF) for the SPBM (Single PBM) pharmacy program as part of the biennial state budget. The percentage as proposed would be applied to all three PDF tiers. NACDS has been advocating for an increase since the September announcement of the PDFs for the SPBM The budget also includes an opportunity for pharmacies to enhance PDFs through a outcomes-based incentive payment. No further details are available upon this writing, but NACDS expects to have them soon.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Oregon Board of Pharmacy adopted the following Temporary Rule, effective February 10.
- Division 020 – related to Protocols for COVID-19 Monoclonal Antibody & COVID-19 Antiviral - Effective February 10.
The Emergency Use Authorization (EUA) for each product has been updated. The updated EUA for Paxlovid now differs from the approved statewide drug therapy management protocol which necessitates the protocol's suspension. REGEN-COV is not authorized for use in any US region which also necessitates this protocol's suspension.
- COVID-19 Monoclonal Antibody- REGEN-COV. EUA updated 1/24/2022. REGEN-COV (casirivimab and imdevimab) is not currently authorized in any U.S. region due to the high frequency of circulating SARS-CoV-2 variants that are non-susceptible to REGEN-COV. Therefore, REGEN-COV may not be administered for treatment of COVID-19 under the Emergency Use Authorization until further notice by the FDA.
- COVID-19 Antiviral- Paxlovid. EUA updated 2/1/2023. The U.S. Food and Drug Administration has issued an EUA for the emergency use of PAXLOVID for the treatment of adults and pediatric patients (12 years of age and older weighing at least 40 kg) with a current diagnosis of mild-to-moderate coronavirus disease 2019 (COVID-19) and who are at high risk for progression to severe COVID-19, including hospitalization or death.
Temporarily suspends the statewide drug therapy management protocols for COVID-19 Monoclonal Antibody and COVID-19 Antiviral due to:
- COVID-19 Monoclonal Antibody- REGEN-COV. REGEN-COV (casirivimab and imdevimab) is not currently authorized in any U.S. region.
- COVID-19 Antiviral- Paxlovid. Under Oregon state laws, pharmacists cannot diagnose. The current Paxlovid EUA requires a diagnosis to prescribe Paxlovid, which is not required in the Board's Paxlovid protocol (based on the EUA dated 10/27/2022) and appears to be preempted by federal law.
The FDA has stated that EUAs preempt any differing requirements under states' laws. As a result, the Oregon Board of Pharmacy will not take disciplinary action against persons who act in accordance an EUA, as a result of the FDA's position that state law is preempted. If a complaint is received relating to activities covered under an EUA, the Board will expect the licensee to provide documentation of full compliance with the EUA. Failure to do so may result in disciplinary action.
Also in Oregon, the Board of Pharmacy permanently adopted the following rules at the February 2023 Board Meeting:
- Divisions 019/041 related to Safe Pharmacy Practice Conditions: RPH Autonomy, Outlet Requirements – Effective February 14
- Division 110 related to Pharmacy Prescription Kiosk (PPK) Registration Fee – Effective February 15
- Division 019 related to Definitions – Effective February 14
Also in Oregon, the Board of Pharmacy is seeking subject matter experts (SMEs), including pharmacists, to serve on the Public Health & Pharmacy Formulary Advisory Committee (PHPFAC). The board utilizes SMEs to develop and revised protocols in the Protocol Compendium. If you would like to serve as a SME for the PHPFAC please complete the online form by March 1. Individuals selected will receive confirmation by March 15. Email SME related inquiries to pharmacy.formulary@bop.oregon.gov.
Also in Oregon, the Board of Pharmacy posted the agenda for the Compounding Workgroup meeting on February 21.
Also in Oregon, the Board of Pharmacy posted the agenda for the Interns Workgroup meeting on February 22.
Finally in Oregon, the Oregon Health Authority (OHA) will resume health coverage renewals on April 1 for Oregon Health Plan (OHP) members. OHA is required to review eligibility for all 1.47 million OHP members by June 2024. Anyone who no longer qualifies for OHP coverage still have affordable health coverage options. The Oregon Health Insurance Marketplace (OHIM) will send information to people who are no longer eligible for OHP benefits and advise of potential coverage options and financial help through the Marketplace. The Marketplace Transition Help Center will help people understand their options, how to transition to the Marketplace, and to find help from local health coverage experts.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Dakota
HB 1135, legislation related to PBMs and transparency in the pricing of prescription drugs, passed the House (62-5) on February 13. It was referred to the Senate and Health and Human Services Committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
TPA [Tennessee Pharmacists Association] will offer Mental Health First Aid training to 25 attendees at the TPA Winter Meeting, held in Nashville on February 26–27. Space is limited. Register Today!
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Register TODAY to participate at the 2023 Texas Pharmacy Day at the Capitol on February 28.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
On March 1, the Department of Workforce Services (DWS) will begin to review all Medicaid cases over the next 12-month unwinding period of continuous eligibility/coverage.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
HB 2274, a bill that would allow pharmacists to test and treat for flu, COVID, strep and UTIs (urinary tract infections) under a statewide Board of Pharmacy protocol, is on Governor’s desk for signing. Its companion, SB 948, was conformed to the house bill and is now on the House Floor after passing the Senate unanimously. NACDS continues to collaborate with members and in-state partners to get these bills across the finish line. They are the final piece in updating Virginia’s law to match the PREP Act. NACDS is also advocating for SB 1538, which would strengthen the Medicaid reimbursement provisions for pharmacy-based services. This bill passed the Senate and will now be heard in the House.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
West Virginia
NACDS continues to work on priority issues. HB 2754, that would make the pharmacy immunization allowances from the federal PREP Act permanent in state law, passed the House and is now in the Senate Health and Human Resources Committee. HB 2723, now included in a Senate Rules package, SB 361, authorizes the Board of Pharmacy to promulgate a rule increasing the pharmacy technician ratio from 1:4 to 1:6. The same bill also includes a final rule modernizing collaborative practice agreements to allow for population–based care. Notably, the collaborative practice rule is currently effective as an emergency rule. NACDS is also tracking a bill that would provide legislative approval of the PBM rule pursuant to the passage of HB 2263 of 2021. That language is now engrossed in Committee Substitute SB 345 which has passed the Senate and been sent to the House Judiciary Committee.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
This week, a call for topics for the 2023 joint interim committee was announced with a deadline of February 24 at 4:00 p.m. Requested topics may originate from any source but should be submitted or sponsored by a legislator and presented to the committee by a legislator. Submissions must be made using the online form. Questions regarding the submittal of the interim topic request form may be directed to Kelly Lower.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Medicaid is preparing for the end of the continuous enrollment conditions originally associated with the COVID-19 public health emergency (PHE). The Consolidated Appropriations Act, 2023 (CAA) included significant changes to the continuous enrollment condition outlined in the Families First Coronavirus Response Act (FFCRA). These changes take effect April 1, 2023. For more information, please review the ALERT.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
SB 1460, permitting pharmacists to test and treat for influenza, a respiratory infection and a condition related to a public health threat by the Department of Health Services for which a statewide standing order, rule or executive order is issued, will not advance this year. Stakeholder meetings will take place in the interim in preparation for legislation in 2024.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal. Please note the reinstatement resources and information below.
- Drug Use Review (DUR): Additive Toxicity (AT) – System Issue Resolved (February 6)
- Reinstatement Spotlight (February 3)
- Correction to Alert Link for 30-day Countdown – Reinstatement of Prior Authorization Requirements for 46 Drug Classes Including Medical Supplies (February 3)
- Medi-Cal Rx Weekly Wrap-up for January 27-February 2 (February 3)
- Updated: Appendix H – List of Physician Administered Drugs (PADs) with Reject Code 816 (February 1)
- Updates to Over-the-Counter (OTC) COVID-19 Antigen Test Kits, Effective March 1, 2023 (February 1)
- Medi-Cal Rx Monthly Bulletin for February (February 1)
- Changes to Contract Drugs List (CDL) (February 1)
- Updates to Medi-Cal Rx Provider Manual (February 1)
- Medi-Cal Rx Weekly Wrap-up for January 20-26 (January 27)
- Reinstatement Spotlight (January 27)
Also in California, Medi-Cal posted the following: Medi-Cal Update – Pharmacy – January 2023 – Bulletin 1032 (Correction) (January 31)
Finally in California, the Board of Pharmacy posted agenda and meeting materials for the February 15 meeting of the Enforcement and Compounding Committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
House Speaker Paul Renner and Senate President Kathleen Passidomo announced on February 3 that legislators will hold a 12-day special session that started on February 6.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Department of Healthcare and Family Services (HFS) wishes to inform providers that due to the widespread availability of generic Tamiflu (oseltamivir), the Department will end the temporary procedures outlined in the December 9, 2022 provider notice effective March 1. This affects the Medicaid fee-for-service (FFS) program and the managed care organizations (MCOs).
Effective March 1, the Department will no longer reimburse providers for dispensing brand name Tamiflu or for compounding suspensions with brand name Tamiflu. While there is no current shortage of oral suspension, compounding with the generic oseltamivir will be allowed only in emergency situations, as there still may be localized areas of shortage where demand is high.
The drugs will be removed as preferred products on the Preferred Drug List, and prior authorization will again be required for brand Tamiflu under the FFS program and the MCOs.
Please direct questions regarding this notice to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565 for FFS claims, or the appropriate MCO.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
NACDS and the National Association of Specialty Pharmacy NACDS submitted a comment letter to the Iowa Division of Insurance suggesting modifications which would limit the definition of “specialty drugs.”
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
HB 2263, legislation that would add pharmacy technicians over 18 years of age to the list of those that can administer vaccinations under Kansas law was amended and reported favorable from the House Health and Human Services Committee on February 6. Next, the bill goes to the full House. NACDS pharmacist and technician constituents are urged to contact their state representative and ask them to vote for HB 2263.
For more information, contact NACDS’ Mary Staples at 817-442-1155.