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.
Maryland
The Senate Finance Committee will hold a hearing on SB 64, legislation that would allow pharmacists to prescribe post-exposure prophylaxis (PEP) for HIV prevention, on January 31. If any members wish to submit written testimony, please contact NACDS’ Jill McCormack.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
The Board of Pharmacy has approved draft sterile compounding regulations to conform with the new USP standards. These regulations will require a public hearing and comments and review by the Governor before they are finalized.
Also in Massachusetts, an APS (Automated Pharmacy Systems) that meets all the requirements of the policy, and having been approved by the Board, is considered an extension of the pharmacy's licensed area whether its location is contiguous or non-contiguous to the pharmacy. As a reminder, one of the policy's requirements is that the APS must be at the same physical address as the pharmacy. Please see the updated policy 2022-07 relative to Automated Pharmacy Systems.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Montana
The Department of Public Health and Human Services posted the 2023 Naloxone Standing Order on its Opioids and Overdose website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Nebraska Department of Health and Human Services (DHHS) will launch a new iServe Nebraska portal on January 27 that will serve as 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. Also, starting March 1, DHHS will review each Medicaid member’s current eligibility. Members who are no longer eligible for Medicaid will have their information forwarded to the federal marketplace for follow-up about other coverage options.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The next payment for the Supplemental (managed care) dispensing fee (as pharmacy commonly refer to it) is scheduled to be paid to pharmacies between February 1-15. This is the first payment of the fee for 2023 and since the October 1 implementation of the SPBM. Under the SPBM, the payments will run as a special financial cycle and will appear on the non-Claim 835. You can identify these payments on your Remittance Advice by the reason code of 9638 – "QtrSuppDispFee." For more information, please see the FAQ ODM was issued this week. The supplemental fee expires in June 2023, as it was meant to be a stopgap to assist pharmacies while the SPBM system was being developed.
Also in Ohio, NACDS submitted a comment letter to the Common Sense Initiative (CSI) regarding the Board of Pharmacy's proposed rule that would allow pharmacy technicians to administer vaccines. The letter expresses pharmacy's strong support for the bill but asks that the CSI recommend that the Board remove the ratio for technician vaccinators and align the training requirement hours with the PREP Act.
Finally in Ohio, the Department of Medicaid posted Myers & Stauffer's 2022 Pharmacy Cost of Dispensing Survey report. NACDS is currently analyzing the report that found that the cost to dispense increased since 2022. They reported a weighted mean of $9.46 and a weighted median of $8.44 as the cost to dispense for non-specialty providers.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
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 clawbacks, increasing transparency and eliminating spread pricing. Though LBFC cited they had difficulty accessing key data, the report makes several recommendations to the General Assembly to tighten up current law, increase pricing transparency and enforce the requirement for the release of data. NACDS is working with the Pennsylvania Association of Chain Drug Stores (PACDS), the Pennsylvania Pharmacists Association and other allies to advocate for legislation to address these issues.
Also in Pennsylvania, the Board of Pharmacy released its January 31 meeting agenda. Please note they will be discussing the proposed Pharmacy Technician Rules.
Finally in Pennsylvania, Medicaid issued a Bulletin with updated billing instructions for the COVID-19 bivalent booster, and Magellan announced updates and enhancements to PACE/PACENET web portal, including its embedded software applications and tools.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
After evaluating utilization data and consulting with the state’s managed care organizations (MCOs), the provider community and other stakeholders, SCDHHS (South Carolina Department of Health and Human Services) is announcing updates to the policy changes it previously issued. The updates announced in this bulletin are specific to the temporary flexibilities that were created during the COVID-19 PHE (Public Health Emergency) and do not impact other agency policies that existed prior to the PHE unless specifically indicated. The changes announced today will take effect once the current federal PHE has expired. While the exact end-date is not yet known, providers are advised that the Secretary of the U.S. Department of Health and Human Services previously announced that the federal PHE will remain in effect until at least April 11.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
The Division of TennCare invites you to our virtual Annual Feedback Session for the Episodes of Care Program on March 23. This Session is open to all stakeholders to share successes, ask questions and give feedback to improve program design. The entire session is anticipated to take approximately one hour; however, the session will conclude when all feedback is given. This is a free event, although registration is required. Click HERE to register.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Lt. Governor Dan Patrick announced the Senate Committee assignments this week.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
Two companion bills that would allow pharmacists to test and treat under a statewide Board of Pharmacy protocol have advanced in their respective chambers. HB 2274 is poised for a vote on the House floor and SB 948 passed the Senate unanimously. The bills add the authority for pharmacists to test and treat for Flu, Strep, COVID and UTIs to the existing ten conditions/therapies that pharmacist can currently treat. However, opposition from the medical community to the UTI provision drove 10 negative votes in the House Health, Welfare and Institutions Committee, with the bill just squeaking out of committee with 11 favorable votes. NACDS has been working closely with in-state partners and members to advance these practice advancements over the last several sessions and issued an RxImpact Alert this week encouraging outreach to House members prior to the upcoming floor vote.
Also in Virginia, the Board of Pharmacy published a reminder that pharmacists must obtain at least two (2) hours of continuing education (CE) in 2023 on the following subjects related to opioids: medications for opioid use disorder (OUD), including methadone, buprenorphine, naltrexone, naloxone or any other drug indicated for OUD. The CE must be obtained between January 1 and December 31. Inquiries may be directed to pharmbd@dhp.virginia.gov
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
West Virginia
HB 2754, legislation that would codify pharmacy immunization authority to match that of the PREP Act has advanced. HB 2754 deletes the prescription requirement for children’s vaccines and allows pharmacy technicians to immunize. The bill received swift committee approval, overwhelmingly passed the House (90-5) and has been referred to the Senate Health and Human Resources.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wisconsin
The Department of Health Services announced February 2023 will be the last month families will receive extra benefits in the state’s FoodShare program as a result of enactment of Consolidated Appropriations Act, 2023, passed by the U.S. Congress in late December. This act ends a federal program that has been providing additional benefits to households enrolled in the FoodShare program.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alabama
The Alabama Medicaid Agency has 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. Updated forms and criteria can be found here.
Also in Alabama, the Alabama Department of Public Health (ADPH) Pharmacy Division is asking that you complete the following ReadyOp survey if you are unable to obtain oseltamivir (Tamiflu) for your patients due to drug shortages or supply issues. The information provided through this survey will enable ADPH to assess potential oseltamivir shortages quickly and respond appropriately.
The link will remain open until June 1, 2023. Questions should be directed to pharmacy@adph.state.al.us.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
NACDS, along with the Arizona Independent Pharmacy Coalition and American Pharmacies, sponsored “Putting Patients Before Profits in Healthcare.” The breakfast briefing for state legislators and staff provided information about how PBMs currently operate in the marketplace and the adverse impacts these practices are having on patients, prescribers, and pharmacies.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
The legislature convened on January 9, 2023. HB (House Bill) 1007 was a prefile. The bill would expand a pharmacist's authority to prescribe HIV pre- and post-exposure prophylaxis (PrEP/PEP) under a statewide protocol.
Also in Arkansas, the Department of Human Services posted pharmacy billing Medicaid copay changes and exemptions effective January 1, 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.