Massachusetts
On March 22, the Massachusetts Board of Registration in Pharmacy and Department of Public Heath, in a notice, publicly reaffirmed the state’s policy that “all pharmacies located in Massachusetts and licensed by the Board must maintain a continuous, sufficient supply of all family planning medications, including mifepristone (Mifeprex® ), misoprostol (Cytotec® ), emergency contraception and contraceptive prescriptions to meet the needs of the community.”
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The 2023 Pharmacy Practice Guide containing updated compliance tips and information on recent statutory/rule changes, including new/revised sections on Working Conditions, Technician Supervision & Expanded Technician Activities, Electronic Final Product Verification for Pharmacists, Technology-Assisted Product Verification for Interns & Technicians and Quality Assurance is currently available.
Also in Missouri, Section 338.013, RSMo, provides that all individuals who assist a pharmacist with the practice of pharmacy must be registered with the Board as a pharmacy technician, including anyone involved in the handling of a filled prescription that is not ready for sale or delivery to the patient without further packaging, bagging, or manipulation, including cashiers or delivery staff handling a filled prescription (patient vial/container, unit of use package, bubble card, etc.) that is not packaged/bagged for final sale or delivery to the patient are required to be registered as a technician.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
On March 21, NACDS joined the Pharmacists Society of the State of New York (PSSNY) in a rally in support of the Medicaid transition to fee-for-service. Beginning April 1, all Medicaid members enrolled in Mainstream Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Oregon
SB 1085, legislation permitting pharmacists to test and treat for certain health conditions, requiring payment for pharmacist services and allowing pharmacists to delegate to a pharmacy technician or intern to perform testing under the pharmacist's supervision, is scheduled for a hearing in the Senate Committee on Health Care on March 29. The health conditions include influenza; lice; COVID-19 or other respiratory conditions, diseases, or illnesses; skin conditions, such as athlete's foot or ringworm; streptococcus; urinary tract infection; other health conditions identified by the Oregon Health Authority as a public health emergency or other health conditions as identified by the Board of pharmacy by rule for which a patient may be tested.
Also in Oregon, the Board of Pharmacy is seeking subject matter experts to serve on a workgroup concerning Collaborative Drug Therapy Management (CDTMs) and Clinical Pharmacy Agreement (CPAs). The purpose of this workgroup is to gather information related to CDTMs and CPAs and provide input for rules to ensure patient health, safety and welfare. It is anticipated that the workgroup will provide input on development of updated rules and provide the Board with recommendations, insights, and input on proposed rules. See additional information below. If you would like to serve on the CDTM/CPA workgroup, please complete the online form by Friday April 7, 2023. Those that are selected will receive confirmation by Friday April 14, 2023.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Dakota
On March 23, 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.
Tennessee
TennCare has contracted with Mercer Government Human Services Consulting to conduct a professional cost of dispensing survey and a survey of acquisition cost data. Both surveys will begin on April 3 and must be submitted to Mercer no later than May 12. All network pharmacies will be required to complete the professional cost of dispensing survey; however, only select pharmacies will also be required to complete the biannual AAAC (Average Actual Acquisition Cost) survey. Please direct questions regarding the survey to Lora.Underwood@tn.gov or mercerrxpassage@mercer.com.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
To show legislators that this year pharmacies are a united front on PBM issues, NACDS submitted a support letter to the Texas House Insurance Committee on PBM ERISA reform legislation being led by the Texas Pharmacy Association and the Texas Pharmacy Business Council, HB 2021. A hearing was held on March 21.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
HB 1007, legislation establishing a statewide protocol that would allow pharmacists to diagnose and assess conditions for HIV and to dispense PrEP and PEP, passed the House by a vote of 95 to 0, and was heard in the Senate Public Health, Welfare and Labor Committee this week.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kansas
HB 2263, the pharmacy technician vaccine administration bill, continues to advance. It was heard in the Senate Public Health and Welfare Committee on March 15th.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
SB 37 was amended in the Senate reforms the Board of Pharmacy Advisory Council to add seats for mail order, specialty, hospital, veterinary, and independent pharmacists. Subsequently, the bill was reported by the House Health Services Committee and is expected to pass the House as currently drafted. The bill began as a piece of legislation that would have re-vamped the Board of Pharmacy composition with dedicated seats for different practice settings, including PBMs and mail order. However, an agreement was reached with the sponsor to instead change the composition of the Advisory Council. The General Assembly is set to adjourn at the end of this week.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
Prefiling bills has begun in advance of the fiscal session that convenes on April 10th.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Board of Pharmacy published an agenda for an April 7 regulation workgroup meeting where they will be taking oral testimony on the Pharmacy Technician Rules. They will accept written comments at BPL-BoardSupport@michigan.gov until the close of business on April 6. For a copy of the draft rule and more information, click here.
Also in Michigan, the Department of Health and Human Services has issued a proposed policy for public comment; comments should be sent to frankmane@michigan.gov by April 18.
- 2305-F2F-P – COVID-19 Response: Reversal of Temporary COVID-19 Relaxation of Face-to-Face Requirement Policies and Update of Face-to-Face and In Person Definitions. The proposed effective date is May 12.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
Prior to the legislature taking a week off for Spring Break, HB 41 passed the Senate and was referred to the House for further action. The bill allows a pharmacist to order and administer vaccines approved or authorized by the FDA, or by the state or federal government during a state or federally declared public health emergency. The bill also permits certain qualified pharmacists to provide influenza, group A streptococcus, and COVID-19 medication therapy services pursuant to a statewide standing order issued by the Director of the Department of Health and Senior Services or a physician licensed by the Department.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
On March 21, 2023, NACDS will be joining the Pharmacists Society of the State of New York (PSSNY (Pharmacists Society of the State of New York)) in a rally in support of the Medicaid transition to fee-for-service. Beginning April 1, 2023, all Medicaid members enrolled in Mainstream Managed Care will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. The rally is to advocate to the legislature so no action would alter the planned transition.
On March 21 at 1:00 p.m., the New York State Department of Health will be holding its next online seminar for all stakeholders about the pharmacy benefit transition. Members, providers
and all interested stakeholders are welcome to attend regarding the transition.
The New York Deparment of Financial Services’ Pharmacy Benefits Bureau is requesting comments directly from pharmacies about the usefulness of PBM audits. Specifically, the requested comments are about whether and how the Department should exercise its authority about audits of pharmacies conducted by PBMs. New York Insurance Law §§ 2905-2906 empowers the Department to establish, by regulation, minimum standards for the issuance of a license to a PBM, including both prerequisites for the issuance of a license and requirements for maintenance of a license. Among the questions for pharmacies are: “In what way, if any, does an auditing PBM communicate its audit policies and procedures to your pharmacy?”, “What types of audits have you experienced in the past five (5) calendar years?”, “How many times per year for the past five (5) calendar years have PBM audits occurred for your pharmacy?”, “During the most recent audit conducted by a PBM for your pharmacy, was the purpose or subject of the audit identified prior to the audit occurring?”, “Was the same identified purpose or subject included as part of the PBM’s draft and/or final audit report?”, etc. Comments should be sent directly to the Department at PBM@dfs.ny.gov by March 24, 2023, with “PBM2022-07” included in the subject line.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Oklahoma
SB 827, legislation by pharmacist Sen. Standridge(R) authorizes pharmacists to prescribe nonprescription drugs for the purposes of extemporaneous compounding passed the Senate by 44-0 and was referred to the House or Representatives.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
Medicaid published the following bulletins related to the Managed Care Program:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
Brian Clark, a South Carolina pharmacist with experience in a broad range of pharmacy roles as well as service in state and national professional associations, has been named chief executive officer of the South Carolina Pharmacy Association effective April 1. Clark, director of operations at Riley’s Drugs in Lexington, SC, will lead the association that serves as the public face and voice of all sectors of the state’s pharmacy community, from students and technicians to pharmacists.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare has contracted with Mercer Government Human Services Consulting to conduct a professional cost of dispensing survey and a survey of acquisition cost data. Both surveys will begin on April 3. Mercer will conduct a technical online seminar on March 20 at 10am CT to discuss both surveys and answer provider questions. Join the online seminar at this link with passcode 030511.
Also in Tennessee, the recent TennCare issue regarding AAAC rate updates has been resolved. Please review this document and contact tenncare_inquiry@optum.com with any questions.
Finally, to help TennCare prescribers and providers, prior authorization (PA) requirements can be bypassed for certain medications when specific medical conditions exist. Those specific medications and diagnoses are on the Appropriate Diagnosis for PA Bypass document. Prescribers are encouraged to include the applicable diagnosis code on written prescriptions for inclusion on the electronic pharmacy claim. The submitted claim should include a Diagnosis Code Qualifier (Field # 492- WE) of “02,” indicating ICD-10, as well as the appropriate Diagnosis Code (Field # 424-DO). Note: A list of the preferred agents and the clinical criteria can also be found at www.optumrx.com/oe_tenncare/landing.
Please contact OptumRx Provider Liaison Ginger Stoves (ginger.stoves@optum.com) if you have additional questions. Ginger is the primary contact for Middle Tennessee, and the temporary primary contact for East and West Tennessee.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The deadline to file bills was Friday, March 10th.
Also in Texas, Rep. Julie Johnson (D) filed HB 3774, legislation providing pharmacists with liability protections when dispensing certain medications that could be used for an abortion.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
Pharmacy had several important victories in the 2023 Legislative Session that adjourned last week. The Legislature approved several priority pharmacy bills that are now on Governor Justice’s desk for signing. These include SB 345, which gives legislative approval for the PBM Auditing Rule pursuant to the passage of HB 4112 of last session. HB 2754 which adopts PREP Act immunization authority for both pharmacists and technicians at age 3 and deletes the long-standing prescription requirement for childhood vaccines. Lastly, SB 361, an omnibus Rules package that increases 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.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
Reminder, effective October 1, 2022, the Alabama Medicaid Agency removed the requirement of absence of alcohol and illicit drug use by recipients for the prior approval of antiviral drugs used in the treatment of hepatitis C. A copy of the patient's drug and alcohol screening lab report is no longer required. All other criteria remain, including the patient consent form with the patient's and physician's signature, which must be submitted with requests.
The updated Prior Authorization (PA) request form and criteria booklet should be utilized by the prescriber or the dispensing pharmacy when requesting a PA.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Gov. Katie Hobbs (D) vetoed SB (Senate Bill) 1248, legislation repealing several components of the sunrise process for scope expansion, including pharmacy.
Also in Arizona, on March 6, SB 1254 (Senate Engrossed), legislation repealing the requirement for a Schedule II opioid prescription that is directly dispensed by a pharmacist and that is not for the immediate administration to the ultimate user to have a red cap, failed to pass the House Health and Human Services Committee by a 3-4 vote.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
HB (House Bill) 1007, legislation establishing a statewide protocol that would allow pharmacists to diagnose and assess conditions for HIV and to dispense PrEP (Pre-Exposure Prophylaxis) and PEP (Post Exposure Prophylaxis), was amended in the House Committee on Public Health, Welfare and Labor.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
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 February 24-March 2 (March 3)
- Reinstatement Spotlight (March 3)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
SB 23-162, legislation chain pharmacies support that would increase access to pharmacy services by allowing a pharmacist to delegate to a pharmacy technician any task within the practice of pharmacy for which the pharmacy technician has been specifically trained, except for patient counseling, drug regimen review and clinical conflict resolution, was heard in the Senate Health and Human Services Committee on March 9. The bill also removes the pharmacy technician to pharmacist ratio at a central fill pharmacy, and it authorizes reimbursement under the medical assistance program for dispensing or administering vaccines to children under 19 years of age.
Also in Colorado, HB 23-1201, a PBM reform bill that creates transparency and eliminates spread pricing, was introduced, and assigned to the House Health & Insurance Committee.
Finally, March 15 is Pharmacy Day at the Capitol.
For more information, contact NACDS’ Mary Staples at 817-442-1155.