Louisiana
The Department of Health (LDH) issued a standing order for naloxone allowing pharmacists to dispense naloxone to caregivers, family and friends of an opioid user.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
Sen. Malcolm Augustine (D) has introduced SB 372, to make state law permanently consistent with the PREP Act’s pharmacist vaccine and testing allowances. The bill is a continuation of HB 1040 of 2021, that temporarily adopted the same provisions in state law with a sunset date in June 2023. A separate bill allowing pharmacy technicians to vaccinate and perform remote data entry will be introduced soon. NACDS is actively working on the ground with in–key legislators, in-state partners and members to advance this bill in the 2023 session.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On February 3, the Department of Public Health published its final regulations (105 CMR 700) that authorizes pharmacy technicians to administer influenza and other immunizations. The regulations also reduce the age of persons from 9 to 5 years who may receive a vaccination at a pharmacy. Pharmacists may also administer the first dose of a controlled substance to treat mental health and substance abuse disorders upon the order of a practitioner. This regulation was effective upon publication.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Michigan
The Board of Pharmacy has posted the minutes from the January 19 Rules Committee Work Group Meeting, where a proposed rule regarding central fill and other shared pharmacy services was discussed.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
HF 1197 and SF 1176, companion bills that would make pharmacy immunization and testing practice consistent with the federal PREP Act, have been introduced. The bills also include Medicaid reimbursement language. NACDS is working with the Minnesota Pharmacists Association and the Minnesota Retailers Association, supporting their on-the-ground efforts to advance the bills.
Also in Minnesota, this week's Department of Health COVID Provider Newsletter includes a segment encouraging providers' to begin planning for when COVID vaccine is only available from the commercial market.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Montana
SB 112, allowing pharmacists to prescribe certain medications with limitations, passed the Senate Human Services Committee (6-3) and the Senate (34-15). The bill is now in the House Human Services Committee.
Also in Montana, SB 239, making pharmacist and technician immunization flexibilities under the PREP Act permanent, will not advance. The Montana Retail Association and the Montana Pharmacy Association are seeking a new sponsor and a new placeholder draft, LC 1310, permitting a pharmacy intern and technician to administer immunizations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services (DHHS) posted recordings from the January 4 and February 6 COVID-19 Provider Calls.
Also in Nebraska, the DHHS will host the next monthly COVID-19 provider call on March 1 at 12:00 noon (Central). Details will be posted on the website one week before the call.
Also in Nebraska, the DHHS issued Provider Bulletin 23-02: Resuming Regular Reviews of Medicaid Eligibility and Provider Bulletin 22-22: CGM [Continuous Glucose Monitoring] Coverage by Medicaid.
Finally in Nebraska, DHHS launched its iServe Nebraska Portal Explore Benefits Tool. The new portal offers an easy-to-use system for individuals to apply to get help with food, heat, electricity, healthcare, childcare, and other essential needs. Individuals may apply for a single benefit or more at the same time.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
Gov. Kathy Hochul (D) included in her budget an affirmation of the transition of Medicaid Fee-for-Service, which is set to become effective April 1. Another webinar will be held for stakeholders on February 21.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Ohio
ODM (Ohio Department of Medicaid) posted Myers & Stauffer's 2022 Fee-For-Service Pharmacy Cost of Dispensing Survey report. NACDS is currently analyzing the report that found that the cost to dispense increased since 2020 but that increase was mostly prevalent among smaller pharmacies. Survey results included a weighted mean of $9.46 and a weighted median of $8.44 as the cost to dispense for non-specialty providers.
Also in Ohio, ODM Director Maureen Corcoran testified about the proposed biennial budget proposal, confirming that the proposal includes funding for a "modest" pharmacy Professional Dispensing Fee (PDF) increase. NACDS has been advocating for an increase since the September announcement of the PDFs for the SPBM (Single PBM). No details are yet available, but NACDS expects to update members very soon.
Finally, in Ohio, ODM and Gainwell (SPBM) are continuing to re-implement prior authorizations (PA) requirements in stages by specific drug classes. The reimplementation only applies to new, initial authorizations. Phase 3 begins on February 14 for these specific classes:
- Age Restricted Medications (denoted with "AR" on the UPDL (Unified Preferred Drug List))
- Benzodiazepines
- Central Nervous System (CNS) Agents: Skeletal Muscle Relaxants, Non-Benzodiazepine
- Endocrine Agents: Diabetes- Insulin
- Endocrine Agents: Diabetes- Non-Insulin
Members can reference the Unified Preferred Drug List on the SPBM portal to see products that require a PA. Additional PAs will be reimplemented during the first quarter of 2023.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
SB 913, legislation allowing pharmacies administer medications to treat for certain conditions on the result of a positive screening test was heard in the Senate Health and Human Services Committee on February 9.
Also in Oklahoma, Insurance Commissioner Glen Mulready appointed Ashley Scott the new Director for the Oklahoma Insurance Department's (OID) Pharmacy Benefit Manager (PBM) Compliance and Enforcement Division, and Molly Clinkscales as the lead attorney for the program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
NACDS submitted comments to the Board of Pharmacy expressing concerns with the current proposals in Divisions 019 and 041 related to safe pharmacy practice conditions. As currently drafted, these proposals give a pharmacist unrestricted authority to close a pharmacy if that pharmacist feels, in their opinion, that staffing is insufficient to fill prescriptions or provide other services to patients; this may result in pharmacy closures across the state. In our letter, we stated current regulations are sufficient to provide the Board with authority to act against pharmacies that are not providing a safe work environment.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The General Assembly’s joint Legislative Budget and Finance Committee (LBFC) finally released its study of Pharmaceutical Pricing in the Commonwealth’s Medicaid managed care program this week. The study was mandated by the passage of HB 941 of 2021, legislation that required key reforms to PBM practices in the program. These included prohibiting claw backs, increasing transparency and eliminating spread pricing. Though LBFC cited they had difficulty accessing key data from PBMs and the program, the report makes several recommendations to the General Assembly to tighten up current law, by increasing drug pricing transparency and enforcing the requirement for the release of data. NACDS is working with the Pennsylvania Association of Chain Drug Stores (PACDS), the Pennsylvania Pharmacists Association (PPA) and members to develop legislation to address these issues.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Rhode Island
Please see the February 2023 provider update here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
Effective for dates of service on or after March 1, the South Carolina Department of Health and Human Services (SCDHHS) will discontinue the hemophilia program arrangement with the South Carolina Department of Health and Environmental Control (SCDHEC). Factor services may be provided by any fee-for-service (FFS) enrolled pharmacy provider. Pharmacy reimbursement utilizes the standard basis of payment for the FFS pharmacy benefit at the lowest of:
- The actual acquisition cost (AAC) plus a professional dispensing fee (PDF) of $10.50;
- The states' maximum allowable cost plus a PDF of $10.50; or,
- The usual and customary charges to the public.
Providers rendering care to Healthy Connections Medicaid members enrolled in FFS Medicaid should direct any questions related to this transition to the Magellan Medicaid Administration call center at (866) 254-1669. The call center is available 24 hours per day. For more information, click here.
Also in South Carolina, a stolen prescription pad alert has been issued. Please be very cognizant of any controlled substance prescriptions from Kraemer Women's Care. Please call (803)-956-4018 to verify a prescription before filling.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Tennessee Justice Center will be hosting a webinar on March 1, at 11:00 am (Central) focused on how to prepare your team for having conversations with TennCare beneficiaries about their eligibility redetermination.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
House Speaker Dade Phelan (R) announced committee assignments this week.
Also in Texas, Sen. Pete Flores (R) filed SB 749, legislation making permanent the Public Readiness and Emergency Preparedness Act (PREP Act) authority that authorizes pharmacists to both order and administer routine immunizations for individuals three years of age and older. The House companion bill is HB 1105 by Rep. Four Price (R).
Also in Texas, Rep. Jacey Jetton (R) filed HB 2079, legislation would allow pharmacists to furnish medications for flu, strep and COVID as a result of a positive CLIA-waived test.
Also in Texas, NACDS is a sponsor of Texas Pharmacy Day at the Capitol on February 28. This is a great opportunity for pharmacists from all practice settings to show unity promoting our legislative agenda. Space is limited, so register now.
Finally in Texas, after a closed-door session at the quarterly meeting of the State Board of Pharmacy this week, the Board terminated the Executive Director Tim Tucker.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
Companion bills that would allow pharmacists to test and treat for flu, COVID, strep and UTIs (urinary tract infections) under a statewide Board of Pharmacy protocol have passed their Chambers of origin and met the bill crossover deadline, making them eligible to continue to advance. HB 2274 passed the House by a 57-42 vote, while the Senate unanimously adopted SB 948. passed the Senate unanimously. They now go to committees in the opposite chamber for consideration. NACDS continues to collaborate with members and in-state partners to advance these bills that are the final piece in updating Virginia's law to match the PREP Act. NACDS is also advocating for SB 1418, which would strengthen the Medicaid reimbursement provisions for pharmacy-based services. This bill passed the Senate and will now be heard in the House.
Also in Virginia, Medicaid has posted a draft bulletin detailing upcoming changes that will rebrand its Fee-for-service (FFS) and managed care programs as Cardinal Care and unify the Medallion 4.0 and Commonwealth Coordinated Care Plus (CCC Plus) managed care programs under a single managed care contract, pending approval by the Centers for Medicare and Medicaid Services (CMS). The bulletin states that the changes will follow a strategic, phased-in implementation, beginning January 1, 2023, and will be fully operational by July 1, 2023. Comments on the draft bulletin are due March 15.
Finally, in Virginia, the Board of Pharmacy has published a notice outlining recent drug scheduling changes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
In advance of the February 7 hearing in the Senate Committee on Health and Long Term Care on PBM reform, SB 5213, NACDS registered in support and urged chain members to do so as well. The bill is awaiting further action in Executive Session and must be reported out of the committee of origin by February 17. Because there is a modest fiscal note, it will be sent to the Ways and Means Committee. House companion bill is HB 1253.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
NACDS continues to work on priority issues in West Virginia. 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, authorizes the Board of Pharmacy to promulgate a rule increasing the pharmacy technician ratio from 1:4 to 1:6. NACDS is also tracking a bill that would provide legislative approval of the PBM rule pursuant to the passage of HB 2263 of 2021. The language is now engrossed in Committee Substitute SB 345 which has passed the Senate and been sent to the House.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
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.
- Enteral Nutrition Updates to the List of Covered Enteral Nutrition Products, Effective January 1, 2023 (January 26)
- Age Restrictions on Psychotropics – System Issue Resolved (January 25)
- NCPDP Reject Code 83 – Duplicate Paid/Captured Claim (January 24)
- 30-day Countdown – Reinstatement of Prior Authorization Requirements for 47 Drug Classes Including Medical Supplies (January 24)
- Claims Processing Reminders for Medicare Medi-Cal Plans (January 20)
- Age Restrictions on Psychotropics System Issue (January 20)
- Medi-Cal Rx Weekly Wrap-up for January 13-19 (January 20)
- Reinstatement Spotlight (January 20)
- Medical Supplies: How to Prepare for Retirement of the Transition Policy (January 19)
- Reminder: Clear Browser Cache (January 18)
- Update on Age Restrictions of Psychotropics (January 17)
- Reinstatement Spotlight (January 13)
- Medi-Cal Rx Weekly Wrap-up for January 6-12 (January 13)
Also in California, Medi-Cal posted the following:
- Update: Incontinence Product List Medi-Cal Benefit (January 24)
- Continuity of Care for Transitioning Medi-Cal Members (January 13)
- Medi-Cal Update – Pharmacy – January 2023 – Bulletin 1031 (January 13)
- Medi-Cal Update – Durable Medical Equipment and Medical Supplies – January 2023 – Bulleting 568 (January 13)
Also in California, the Board of Pharmacy posted the agenda and the following meeting materials for the Standard of Care Ad Hoc Committee meeting on February 1.
Finally in California, the Board of Pharmacy posted the January 2023 issue of "The Script", the board's newsletter. This issue includes the following:
- New pharmacy laws for 2023.
- Governor announced end to declared state of emergency related to COVID-19.
- Statewide program for disposal of sharps waste.
- USP revised chapters 795 and 797.
- Renew HSP and DRM licenses online.
- FDA offers online resources to assist outsourcers and compounders.
- The Board welcomes two members.
- Summaries of disciplinary actions ordered July 1 through December 30, 2022.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
Based on the recent decision by the U.S. Food and Drug Administration to allow retail pharmacies to dispense Mifepristone, the Agency for Health Care Administration issued this alert to remind providers that they must continue to comply with Florida laws that govern the performance of abortions.
Two statutes are relevant here. First, section 390.0111(2), Florida Statutes, provides that "[n]o termination of pregnancy shall be performed at any time except by a [licensed] physician."
Second, section 797.03(1), Florida Statutes, states that "[i]t is unlawful for any person to perform or assist in performing an abortion on a person, except in an emergency care situation, other than in a validly licensed hospital or abortion clinic or in a physician's office." Willfully violating these provisions could result in criminal penalties. See 390.0111(10)(a), Florida Statutes, and 797.03(4), Florida Statutes.
The Agency will refer to local law enforcement any evidence of criminal activity that it discovers in its survey of providers.
Also in Florida, the House Health and Human Services Committee held a meeting on January 24 to discuss pharmacy benefits managers (PBMs) and the role they play in Florida's healthcare delivery system. House Health and Human Services Committee Chair Randy Fine (R) indicated this was the first of several more meetings to come on the issue.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
The State Board of Pharmacy issued a reminder to ensure that the delegates assigned by controlled substance (CS) registrants are still active and accurate. The delegate review is to ensure that delegate users of the state's Prescription Drug Monitoring Program (PDMP) are still authorized to perform searches on their supervisor's behalf. Supervisors are responsible for activities performed within the system by their delegate(s). Supervisors may perform the delegate review by doing the following:
- Log in to your Idaho PDMP account.
- From your dashboard click "View All Delegates."
- Review delegates listed.
- If the delegates are correct, take no further action. If a delegate should be changed, continue to step five.
- Select any delegate to remove.
- Click on "Remove."
- Click on "Reject."
- Repeat steps five, six, and seven until all unwanted delegates have been removed from the Delegate Management view.
Also in Idaho, the State Board of Pharmacy offers a variety of Idaho PDMP (AWARxE) Resources on the Board's website for prescribers and pharmacists.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
Supplemental Nutrition Assistance Program (SNAP) Emergency Allotments (EAs), which have been issued since the beginning of the COVID-19 Pandemic to address food insecurity challenges, will end in Illinois after February, when the federal increases expire. This change will impact over one million households and two million people in Illinois.
The benefit amount participants will receive starting in March will be noted in a client letter sent to all SNAP recipient households.
The Illinois Department of Human Services seeks to prepare SNAP Participants for U.S. Department of Agriculture's return of SNAP benefits to the pre- pandemic levels. Grocery and pharmacy retailers can assist in the effort by posting SNAP Reduction Customer Notice posters in their stores.
Also in Illinois, the Department of Healthcare and Family Services will review the following classes at the Drugs &Therapeutics Advisory Board meeting on April 6: CGRP migraine agents, Oral Antipsychotic (class clean-up). All clinical and financial submissions are due to the Department by 3:00 p.m. CST on March 16. Submissions should be sent to: HFS.SupplementalRebaleProgram@illinois.gov. For more information, please visit here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
NACDS was a sponsor of the January 24 Indiana Pharmacists Day at the Capitol. Pharmacists, technicians, interns and pharmacy students participated in advocacy training, provided health screening of legislators and staff and promoted the passage of several healthcare bills dealing with prescription drug rebates and pricing (SB 8, HB 1273), Medicaid reimbursement for clinical services (SB 152), prescribing and dispensing of hormonal contraceptives (SB 153, HB 1224), establishing a statewide standing order for dispensing naloxone (SB 214), “Test and Treat” (HB 1182) and auditing PBMs (HB 1445).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
Gov. Kim Reynolds (R) signed Executive Order Number 10 placing a moratorium on administrative rulemaking and initiating a comprehensive review of all existing administrative rules, including a cost benefit analysis of existing rules to evaluate the public benefits, determine whether the benefits justify the cost and explore less restrictive alternatives consistent with the intended purpose.
Also in Iowa, the Department of Health and Human Services (DHHS), Iowa Medicaid published INFORMATIONAL LETTER NO 2415-MC-FFS – End of Continuous Coverage Requirement.
Also in Iowa, as part of its realignment initiative, DHHS announced its new combined health and human services website.
Finally in Iowa, NACDS sponsored the Iowa Pharmacy Association's (IPA's) Pharmacist Day on the Hill held on January 25. Pharmacists and pharmacy students participated in advocacy education and training activities and traveled to the Capitol to advocate for the modernization of the Pharmacy Practice Act, an increase in the Medicaid professional dispensing fee and enforcement of PBM regulations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.