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.
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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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.