California
The Department of Health Care Services posted the following alerts to the Medi-Cal Rx Web Portal:
- Enteral Nutrition Recall (March 14)
- Enteral Nutrition Updates: Maximum Quantity Rejections (March 15)
Also in California, the Board of Pharmacy amended the expiration date of the following waiver: Mass Vaccination Sites – AMENDED AND REISSUED; the expiration date is June 30, 2022, or until 90 days following the declared disaster, whichever is sooner. All Pharmacy Law waivers are posted under the COVID-19 Updates and Resources.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Health Care Policy and Financing (HCPF) is hosting a virtual Health Cabinet Policy Summit on March 24 and 31. Topics include affordability, behavioral health transformation, pandemic to endemic & future readiness, and keeping Coloradans covered after the Public Health Emergency. HCPF is expanding their value-based payment models that reward providers for better patient outcomes and closes health disparities while driving affordability. Register in advance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Delaware
The Delaware Controlled Substance Advisory Committee amended the Uniform Controlled Substances Act regulations to make the provisions on expiration and partial filling of controlled substance prescriptions consistent with federal standards. The changes are effect March 11, 2022
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Illinois
The Illinois Department of Healthcare and Family Services has posted the Uniform Prior Authorization Workgroup Agenda for 03/18/2022 at the following link.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
HEA 1169, legislation allowing pharmacy technicians to immunize all vaccines delegated by a pharmacist and to do verbal transfers was signed into law by Gov. Eric Holcolm (R) on March 15, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy issued its March 2022 newsletter that includes the following articles:
- “Non-electronic Prescriptions – Reminder of Requirements”
- “FDA Warning on Dissolvable Buprenorphine and Dental Problems”
- “Get to Know Your Pharmacy Board Members – Gayle Mayer”
- “Shipping Compounded Prescriptions Outside the State of Iowa? – Reports Due by April 1, 2022”
- “Statewide Protocols”
- “Technician Trainee Renewal/Reactivation Update”
- “Interim Pharmacist-in-Charge – New Option for Pharmacies”
- “Pharmacists Required to Report Serious Adverse Events to FAERS Following Medication Administration”
- “Board Requests Code Change in 2022 Legislative Session”
Also in Iowa, the Board of Pharmacy posted is January 11, 2022 Meeting Minutes. Interesting stats related to the Pharmacist Narcan® Dispensing Program, Pharmacist Disposal Kit Dispensing Program and Board -Sponsored Medication Disposal are reported on Page 6. “Rules and Legislation” section appears on pages 7-8.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
Two Senate bills advancing of interest to pharmacies were amended and are now pending action by the full House. SB 200 allows pharmacists to test and initiate therapy for strep, flu, and urinary tract infections under protocols developed and approved by the Collaborative Drug Therapy Management Advisory Committee. SB 28 requires PBMs (Pharmacy Benefits Managers) to be licensed and regulated by the Insurance Department. It also addresses MAC (Maximum Allowable Cost) pricing and delineates what items a PBM (Pharmacy Benefit Manager) can request during a MAC appeal. If these bills pass the House, they will be returned to the Senate for ultimate action to concur with the House changes.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
Legislation that makes permanent provisions granted under the PREP (Public Readiness and Emergency Preparedness) Act filed by Rep. Chris Turner (R) will be heard in the House Health and Welfare Committee on Wednesday morning, March 23 at 9:30 AM. HB 474 will allow the pharmacist, pharmacy intern and pharmacy technician, without a patient specific prescription or medical order, to administer all vaccines to anyone three years old and older.
Also in Louisiana, Gov John Bel Edwards (D) announced that he would NOT renew the COVID-19 public health emergency order that expired on March 16th. The Board of Pharmacy (Board) issued a guidance document listing all the current interim policies and their expiration dates.
At their May 11th meeting, the Board will consider whether to terminate or further extend any interim policies. Three of the policies (identified in guidance document) were based on the federal declaration of emergency as opposed to the state declaration of emergency. Since the federal declaration of emergency is still in effect, the expiration dates for those three interim policies were extended for the duration of the federal public health emergency.
Of particular importance to many pharmacies and pharmacists is the authority provided by the federal PREP Act Declaration and its subsequent amendments for pharmacists to order and administer COVID-19 tests and therapeutics. For as long as the federal public health emergency and PREP Act Declaration are in place and not modified, that authority remains in effect.
Finally in Louisiana, all providers who file claims with the Louisiana Department of Health (LDH), including pharmacy providers and immunizing pharmacists, are reminded that they must enroll in the new Medicaid Provider Enrollment Portal to continue being reimbursed. All existing providers must log in and submit an enrollment through the portal. LDH had requested a deadline extension from March 31st to June 30, 2022, but it is still pending approval from CMS, so providers are encouraged to act now to complete enrollments so that their claims will not be denied.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
Massachusetts Medicaid, MassHealth, released its March Pharmacy Facts which includes updates for pharmacy providers on MassHealth policy.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Michigan
At the Michigan Pharmacy Provider Liaison Quarterly Meeting. Discussion focused on clarifications of several policy documents. The next pharmacy liaison meeting will be held on June 9.
Final Policies Issued
HASA 22-02: COVID-19 Response: Coverage of FDA Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers
Published L-Letters
L 22-05: Clarification of Michigan Automated Prescription System (MAPS)
Record Retention
L 22-04: Additional Guidance and Clarification for the Coverage of COVID- 19 Prevention, Treatment, and Support Services.
Proposed Policy:
2156-Pharmacy: Signature Log and Proof of Delivery Requirements
2202-Pharmacy: COVID-19 Response: Coverage of U.S. Food & Drug Administration (FDA) Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers
2155-Pharmacy: Update to Contraceptive Supply Limit
Web Announcements:
Summary of Michigan Single PDL (Preferred Drug List) Changes – effective 2/01/2022 https://michigan.magellanrx.com/provider/external/medicaid/mi/doc/en us/MIRx PDL changes.pdf
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Missouri
The Department of Health and Senior Services (DHSS) issued a standing order on March 15th signed by the state Epidemiologist, Dr. George Turabelidze, enabling individuals to receive coverage for purchased tests for SARS-CoV-2. This policy authorizes Missouri pharmacies to charge an individual’s insurance carrier, whether it is private insurance, Medicaid, or Medicare coverage, for COVID-19 testing. Additional state testing resources are available at health.mo.gov/communitytest.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services posted the fee schedule for COVID-19 Monoclonal Antibodies effective March 11.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on April 6 at noon (Central). This webpage also includes links to notes and audio recordings of previous calls.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Board of Pharmacy issued its March 2022 newsletter that includes the following articles:
- “No. 671 New Rules for Telework”
- “No. 672 New Temporary Rules: Accurate Hours of Operation, Temporary/Emergency/Permanent Pharmacy Closures, and PT and COPT Licensure”
- “No. 673 Rulemaking Updates”
- “No. 674 Compliance Updates”
- “No. 675 Technicians Must Work Under the Supervision, Direction, and Control of a Pharmacist at All Times”
- “No. 676 Licensing”
- “No. 677 Board Member News: A New Board Member and Current Opportunities”
Also in Oregon, as the state enters a new phase of the pandemic, the Oregon Health Authority announced its five-point plan, “Oregon RISE: Resilience in Support of Equity.”
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The Department of Health issued a Public Health Alert due to increased opioid overdose activity in Hopkinton, Richmond, East Greenwich, West Greenwich, and Exeter (Region 9). Read the full Alert here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
The Department of Health and Human Services (SCDHHS (South Carolina Department of Health and Human Services)) will reimburse for Food and Drug Administration-approved coronavirus disease 2019 (COVID-19) over the counter (OTC) tests for home use. SCDHHS will reimburse SCDHHS-enrolled pharmacy providers for these tests as authorized within sections 9811 and 9821 of the American Rescue Plan Act, and further delineated within the August 30, 2021, letter from the Centers for Medicare and Medicaid Services (SHO# 21-003).
OTC tests will be covered without prior authorization or cost share with a quantity limit of eight tests per 30-day period. Prescriptions for tests are not required. A one-time override will be allowed per 30-day period (up to a maximum of 10 tests per 30-day period). The per test (unit) rate of reimbursement will not exceed $12 ($24 for a box of two tests). To be eligible for reimbursement, claims must be submitted as a pharmacy claim. For billing purposes, pharmacies will use one of the five SCDHHS-recognized OTC test kits in the table below.
SCDHHS will reimburse for dates of service on or after Jan. 1, 2022. The Medicaid program cannot pay a member directly for a test they have purchased on their own; therefore, SCDHHS will only reimburse providers for OTC COVID-19 tests. SCDHHS will also update guidance regarding coverage of additional COVID-19 OTC tests as required.
Questions regarding fee-for-service claims processing should be directed to Magellan Medicaid Administration’s Call Center at (866) 254-1669. The call center is available 24 hours/day.
For questions regarding pharmacy benefits related to the managed care organizations (MCOs) serving South Carolina Healthy Connections Medicaid members, please contact the MCO (Managed Care Organizations) directly.
Also in South Carolina, PSyn (a Health Insurance Consulting Firm), Inc has been contracted by DHEC’s Division of Diabetes and Heart Disease Management to gain insight from pharmacists regarding your knowledge and interests in primary care clinics. We would appreciate it if you would take some time to complete this survey to help PSyn, Inc and DHEC develop their research.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) published information on pharmacy coverage of COVID-19 test kits.
Also in Texas, Beginning May 31st, HHSC will stop using the Texas Medicaid Standing Order for Mosquito Repellent. Pharmacies must obtain a prescription from a Medicaid-enrolled prescribing provider to dispense mosquito repellent beginning June 1, 2022, for Medicaid, Children’s Health Insurance Program (CHIP), and Healthy Texas Women (HTW). HHSC has extended the effective date of the current standing order until May 31, 2022, to ensure providers have adequate notice regarding upcoming changes to the mosquito repellent benefit. Pharmacy staff may obtain a copy of the extended standing order by submitting a request via email to vdp-formulary@hhsc.state.tx.us.
Pharmacies or pharmacists not operating under the standing order will require a prescription from a valid healthcare provider before dispensing mosquito repellent to people enrolled in Medicaid. Pharmacies may use the standing order if a new prescription or a refill is required until May 31, 2022. Afterward, the terms of the standing order will no longer be valid. For refill requests, pharmacies should not contact or fax Dr. Van Ramshorst, the physician signing the standing order. Refer to the mosquito repellent section of the Pharmacy Provider Procedure Manual for more information about the benefit.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
Effective March 12th, Gov. Jay Inslee (D) issued Proclamation 20-25 rescinding face covering requirements in most places except healthcare settings including pharmacies, long-term care facilities, correctional facilities, and jails.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
Effective April 1, 2022, the Alabama Medicaid Agency will:
- Require Vascepa to be billed with a Dispense as Written (DAW) Code of 9. DAW Code of 9 indicates the following: Substitution Allowed by Prescriber but Plan Requests Brand. This value is used when the prescriber has indicated, in a manner specified by prevailing law, that generic substitution is permitted, but the Plan requests the brand product to be dispensed.
- Require Prior Authorization (PA) for Icosapent Ethyl (generic Vascepa). Brand Vascepa will be added as preferred.
- Require Prior Authorization (PA) for Colchicine capsules (generic Mitigare). Brand Mitigare will remain non-preferred.
- Treatments for COVID-19 will remain accessible and available through the pharmacy benefit on an outpatient basis through the Federal Public Health Emergency (PHE) period. Approval was granted to ensure any drug with an FDA-approved or EUA-authorized indication for the treatment of COVID-19 be made available as a preferred drug through the duration of the Federal PHE.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The following alerts have been posted to the Medi-Cal Rx Web Portal:
- Update to CCS Service Authorization Requests (March 4)
- Claim Edit Prescriber Enrollment (March 7)
- New Ixinity National Drug Codes (March 8)
Finally in California, the Board of Pharmacy will host the Pharmacy Technician Summit on April 19; details TBD. In advance of this summit, the board invites California pharmacists and California pharmacy technicians to participate in Pharmacist Listening Sessions and Pharmacy Technician Listening Sessions. For those unable to participate, the board is also accepting feedback via short online surveys for both pharmacists and technicians, respectively.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Georgia
The Georgia Pharmacy Association presents “APhA’s Delivering Medication Therapy Management Services: A Certificate Training Program for Pharmacists” on March 27 from 8:00 a.m. to 5:00 p.m. This live training is being held via Zoom Meetings. Click here to register!
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
NACDS sent a letter to Medicaid detailing our concerns regarding tiered reimbursement rates that we raised with the Family and Social Services Administration (FSSA) and Myers and Stauffer on our February 11 Zoom call.
Also in Indiana, on March 3, Gov. Eric Holcolm (R) issued an Executive Order 22-09 rescinding the public health emergency disaster declaration for COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2322-MC-FFS announcing three Program Integrity (PI)/Payment Error Rate Measurement (PERM) quarterly training sessions for Medicaid Providers. Sessions will be held via Zoom and details are available in the letter. Providers only need to attend one training session. For those unable to attend, session recordings will be posted to the department’s website.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2320-FFS announcing the 2022 Refund Address.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2316-MC-FFS announcing new Vaccine for Children (VFC) Program Codes.
Also in Iowa, the Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2324-MC-FFS-CVS stating that several monoclonal antibodies are no longer authorized for use and may not be administered for treatment or post-exposure prevention of COVID-19 under the EUA until further notice by the FDA.
Finally in Iowa, Gov. Kim Reynolds (R) announced numerous appointments to the state’s boards and commissions including the following appointments to the Board of Pharmacy: Dane Nealson, Story; Kathy Stone, Harrison; Bob Egeland, Polk and Joan Skogstrom, Polk.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
The Department of Health (MDH) is currently accepting applications and nominations for physicians and pharmacists to serve on the Medicaid Program’s Pharmacy and Therapeutics (P&T) Committee beginning in May 2022. The application deadline has been extended, please submit all applications no later than March 18. All interested applicants are required to submit a formal application through the MDH’s Office of Appointments and Executive Nominations. Please email Mangesh Joglekar at Mangesh.Joglekar@maryland.gov for further information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
The Massachusetts Board of Pharmacy has updated information on the Licensee Scope of Practice dealing with certified pharmacy technicians and has issued a document on Extended Absence of a Manager of Record.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Minnesota
Several bills have been introduced to advance NACDS’ Scope of Business Campaign. HF 4008 and SF 3823 would provide payment parity for pharmacy-based services and HF 4009 would update the states’ pharmacy immunization and testing authority to match the PREP Act.
Also in Minnesota, the House Health Finance and Policy Committee heard HF 3854, allowing pharmacists to prescribe HIV prevention medications. NACDS and our in-state partners were instrumental in forming a coalition of stakeholders that is proactively advancing the bill. Committee members had no major concerns and there was no opposition voiced at the hearing from the medical community. The committee held the bill over for possible inclusion in an omnibus committee bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.