Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania RH Rhode Island South Carolina South Dakota Tennessee Texas Uncategorized Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

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.  

Also in California, Medi-Cal posted the following:   

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 13, 2023|California|

Colorado

The legislature convened on January 9, 2023. 

Also in Colorado, the Department of Health Care Policy and Financing (HCPF) is hosting an informational session on preparing for the end of the Public Health Emergency. This online seminar is geared toward community partners such as advocacy organizations, providers and community organizations that may provide other assistance to Health First Colorado (Medicaid) or CHP+ members. Register in advance for the January 25 online seminar scheduled from 1:00 pm to 2:30 pm MST. 

Finally in Colorado, Prescription Drug Affordability Board established under SB21-175 is currently evaluating draft rules for the Upper Payment Limits. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Colorado|

Florida

This week, Governor Ron DeSantis held a press conference at the Villages to outline proposed legislation that would target pharmacy benefit managers to try to lower prescription-drug costs in the state. NACDS President and CEO Steven C. Anderson released the following statement after the press conference. 

Finally in Florida, all Medicaid Fee-For-Service claims submitted January 1, 2023, or after from a non-exempt provider type that does not have a ROPA [Referring, Ordering, Prescribing, and Attending] provider listed on the claim will be denied. The exempted provider types that will not require a ROPA on the claim are listed here, all other provider type claims must have a ROPA provider identified by NPI (National Provider Identifier) on the claim for reimbursement by Medicaid. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

January 13, 2023|Florida|

Illinois

The Illinois Department of Labor ("IDOL") recently issued the new 2023 "Your Rights Under Illinois Employment Laws" poster that ALL ILLINOIS EMPLOYERS are required to post in a conspicuous place in the workplace, where notices are customarily posted. See the links here. The poster includes information related to the Wage Payment and Collection Act, Child Labor Law, Minimum Wage Law, Equal Pay Act, Victims' Economic Security and Safety Act and the One Day Rest in Seven Act ("ODRISA").  

Importantly, the ODRISA amendments that went into effect on January 1, 2023, require not only posting in the workplace, but also, for employees who do not regularly report to a physical workplace, and instead work remotely or travel for work, the poster must be provided to them via email or uploaded onto the employer's website. The ODRISA amendments also now include civil penalties for failure to comply with the ODRISA, including the posting requirements. Employers who fail to comply with the posting requirements will be subject to a civil penalty not to exceed $250, payable to the IDOL.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

January 13, 2023|Illinois|

Indiana

The legislature convened on January 10, 2023. Several bills of interest to pharmacies have been filed, including several different bills that will allow pharmacists to prescribe hormonal contraceptives – SB (Senate Bill) 153 & SB 206, and HB 1224. Test and Treat, HB 1182, requires the state health commissioner to issue a standing order for pharmacists to treat or screen, test, administer or dispense for respiratory illness including influenza, severe SARS-CoV-2, and RSV (Respiratory Syncytial Virus); group A strep; lice; minor skin conditions; and emerging or existing public health threats identified by the state health commissioner. Also filed was SB 214, legislation that would establish a standing order for pharmacists to prescribe naloxone. 

Also in Indiana, all are welcome to participate at the Indiana Pharmacists Association's (IPA) annual Legislative Day at the Indiana State House starting at 9:30 am on January 24. This event will allow all pharmacists, pharmacy students and pharmacy technicians from all practice settings to connect with legislators and colleagues across the state. Register here before January 19.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Indiana|

Iowa

The Iowa Insurance Division adopted and filed emergency rules (ARC 6739C), effective January 1, 2023, to implement changes made in 2022 Iowa Acts, House File 2384, regarding pharmacy benefits managers. 

Also in Iowa, NACDS submitted a letter to the Iowa Insurance Division expressing appreciation for proposed rule changes (ARC 6740C) to Chapter 59, "Pharmacy Benefit Managers" ("PBMs") in accordance with 2022 Iowa Acts, House File 2384, and urging the necessary enforcement of included provisions to further the state's efforts on PBM reform and transparency. In particular, NACDS stated its support for language preventing PBMs from retroactively adjusting reimbursement of a clean claim paid to a pharmacy. Lastly, NACDS urged legislators and regulators to take additional action to help ensure pharmacies are fairly and adequately reimbursed with the ability to appeal below-cost reimbursement through the establishment of a maximum allowable cost appeals process.  

Finally in Iowa, the Board of Pharmacy published its December 2022 newsletter including the following articles/updates: discontinuation of printed license and registration certificates, reminder for licensees to maintain current contact information, compounding records rule update, pharmacy's social media presence, electronic perpetual inventory logs, care facility documentation of immunizations, licensure of outsourcing facilities update, Narcan® and disposal programs, hard copy prescriptions during prescriber technical difficulties, Schedule II prescription annotations and 2023 board meeting schedule. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 13, 2023|Iowa|

Kentucky

The Board of Pharmacy held a "special called" meeting on January 4 where they withdrew a new regulation and proposed rule amendments regarding out-of-state pharmacies. The rules would have created a new non-resident pharmacist license requirement for out-of-state pharmacists and stricter requirements for an out-of-state pharmacy to acquire a non-resident pharmacy permit. At the meeting, it was stated that the withdrawal was due to the voluminous number of public comments they received.  

Following this, two Senate bills were introduced last week: 

  • SB 36 would reorganize the Board of Pharmacy to assign seats to different practice settings and make appointments subject to Senate confirmation. 
  • SB 37 would prohibit an out-of-state pharmacy permit holder from being required to have their pharmacists licensed, except for the Pharmacist in Charge (PIC). 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

January 13, 2023|Kentucky|

Louisiana

Effective January 1, 2023, the Louisiana Medicaid Pharmacy Program expanded to include a sixth managed care organization (MCO), Humana Healthy Horizons. For more information on verifying eligibility and processing claims, go to Pharmacy Facts. 

Also in Louisiana, effective January 1, 2023, Medicaid Fee-for-Service (FFS) Pharmacy Program and Managed Care Organizations (MCOs), will implement a point of sale dispensing of contraceptives allowing a 6-month supply when the recipient has a previous history of contraceptive agents. The allowance applies to pharmacy claims submitted to FFS and MCOs (Aetna, AmeriHealth Caritas, Healthy Blue, Humana Healthy Horizons, Louisiana Healthcare Connections and UnitedHealthcare). 

Finally in Louisiana, the 2023 Naloxone standing order was updated effective January 1, 2023 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Louisiana|

Massachusetts

Please see these updated Provider Bulletins here (2022) and here (2023) regarding Coverage and Reimbursement Policy for Coronavirus Disease 2019 (COVID-19) Bivalent Vaccine Doses and Pre-exposure Prophylaxis, Extension of Flexibilities for Prior Authorization of Formula, Pediatric Immunization Vaccine / Administration SL Modifier Change and Managed Care Entity Bulletin 95: Access to Health Services through Telehealth Options for Members Enrolled in Managed Care Entities. To view and download other MassHealth publications visit Provider Publications. 

Also in Massachusetts, on January 11, 2023, the Massachusetts Public Health Council approved redrafted regulations at 105 CMR 700.00 which will authorize pharmacy technicians to administer influenza and other immunizations as designated by the Department of Public Health. Regulations also reduce the age of persons from 9 to 5 who may receive a vaccination at a pharmacy. DPH also adopted an amendment that will allow a pharmacist to administer the first dose of a controlled substance for the treatment of mental health and substance abuse disorders. These regulations are expected to be published in the next two weeks. 

Also in Massachusetts, regarding Long Term Care Facilities and Pharmacies, 105 CMR 721.070(A)(11) provides an exception to the e-prescribing mandate for prescriptions written for long term care (LTC) residents. This exception was set to expire on January 1, 2023, or such later date as determined by the Department. Considering the Centers for Medicaid and Medicare Services (CMS) extending, from January 1, 2023, to January 1, 2025, its implementation of the requirement to e-prescribe Medicare prescriptions in LTC facilities, the Department will follow suit and hereby extends, until January 1, 2025, the exception for prescriptions issued to LTC resident under 105 CMR 721.070(A)(11). Those LTC facilities with e-prescribing in place are encouraged to continue using it.  

Please see 105 CMR 721 (mass.gov) and accompanying 2019 ePrescribing Manual for details.  

Finally in Massachusetts, while Amoxicillin Oral Powder for Suspension remains on the FDA drug shortage list, Board-licensed pharmacies may compound this product from solid oral dosage forms provided that the FDA guidance on compounding beta-lactam products in shortage is followed to mitigate the potential risk of cross-contamination.  

Once the shortage has resolved, use of commercial products must resume.  

Please review the Board's Policy on Compounding Copies of Commercially Available Drugs.  

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

January 13, 2023|Massachusetts|

Michigan

NACDS reminds members that pharmacists can prescribe self-administered hormonal birth control under delegated authority, including oral contraceptives, the patch, and the ring, by opting into the program. The change happened under an interpretive statement issued by the state's Licensing and Regulatory Affairs Department (LARA) under direction of a previous executive directive 2022-05 issued by Gov. Gretchen Whitmer (D) in May of 2021. Pharmacists must enter into a delegation agreement; a sample delegation agreement is available on LARA's website. The governor's executive directive in May instructed state departments and agencies to identify and assess opportunities to increase protections for reproductive health care.

Also in Michigan, on October 3, LARA issued a notice that the state will formally begin enforcing Michigan's 2020 e-prescribing law on January 1, 2023. Though the law was originally to take effect in 2021, it included a provision allowing Bureau of Professional Licensing to delay enforcement until the federal Centers for Medicaid and Medicare (CMS) began enforcing the mandate on Part D prescription drug programs. LARA also released an Application for waiver of electronic prescribing requirements form for prescribers and posted an FAQ document. Note that pharmacists are not required to verify that a prescriber qualifies for a waiver when filling paper prescriptions.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

January 13, 2023|Michigan|

Missouri

The legislature convened on January 4, 2023. Several PBM reform bills have been filed, including SB 402/HB 198 and SB 26/HB 197. Also filed were two bills expanding the Pharmacy Practice Act related to the administration of medication by pharmacist including HB 331 and SB 41.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Missouri|

New York

On January 17, from 1:00 p.m. – 3:00 pm, the Department of Health (DOH) is hosting the next in its series of monthly stakeholder informational webinars about the transition of the pharmacy benefit from Medicaid Managed Care to Medicaid Fee for Service (NYRx). Registration is required in order to access the meeting links. Presentations from past meetings are available on the transition website. 

Also in New York, the DOH issued an update to the Medicaid Fee for Service Program "Dispense Brand Name Drug When Less Expensive Than Generic" list effective January 19. Additionally, DOH published an updated standing order for Naloxone under the signature of Dr. Sharon Stancliff. 

Finally in New York, as 2022 ended, Gov. Kathy Hochul (D) signed several bills important to pharmacy practice into law, including: 

  • S4870B authorizing pharmacists to administer certain long acting injectables (Note: rules will need to be promulgated and a new bill for 2023 with minor technical changes to the law has been agreed to.) 
  • A7469 allows for 30-day emergency refills 
  • A187 permits pro-rated cost sharing on short fills and maintains the full dispensing fee to enable medication synchronization in the state's Medicaid program 

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

January 13, 2023|New York|

Montana

LC 1633, related to 340B, was a prefile for the 2023 state legislative session. As drafted, PBMs or health insurers may not:  

  • Prohibit federally certified health entities or pharmacies from participating in the insurer's network;  
  • Reimburse a federally certified health entity or pharmacy differently than reimbursing other similarly situated pharmacies;  
  • Require a claim or a drug to include a modifier to indicate that the drug is a 340B drug, unless the claim is for Medicaid payment; or 
  • Create restrictions or impose additional charges on patients who choose to receive drugs from a federally certified health entity or pharmacy  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

January 13, 2023|Montana|

North Carolina

This is advance notice of reprocessing information that will be sent to affected providers on or about January 17. Due to a system error with the generic dispensing fee, pharmacy claims were paid incorrectly. The affected claims will be reprocessed to apply the correct rate. This reprocessing notice applies to pharmacy claims that were processed and paid in NCTracks from November 1, 2013, through April 7, 2014. The affected claims will be systematically reprocessed as adjustments. No provider action is required. Applicable claims will be reprocessed in the February 7 check write. For more information, visit NCTracks here.  

For more information, contact NACDS' Leigh Knotts at 803-243-7207. 

Ohio: The Ohio Department of Medicaid (ODM) and Gainwell Technologies, the Single Pharmacy Benefit Manager, are continuing the re-implementation of prior authorizations (PA) based on specific drug classes. Of note, the PA reimplementation only applies to new, initial authorizations, and does not apply to those patients who have previously taken the drug supported by recent claims history prior to January 17. Phase 2 of reimplementation will begin on January 17 and encompass the following drug classes:  

Please reference the Unified Preferred Drug List (UPDL) posted on the SPBM portal to see the products that require prior authorization. Prior authorizations may be submitted via phone, fax, mail and the SPBM portal. Additional prior authorizations are planned for reimplementation in a similar, incremental fashion during the first quarter of 2023. For questions, contact the Gainwell Help Desk at 1-833-491-0344.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

January 13, 2023|North Carolina|

Pennsylvania

Gov.-elect Josh Shapiro (D) has named Valerie Arkoosh, an anesthesiologist and chair of the Montgomery County Commissioners, as his Secretary of the Department of Human Services. Arkoosh led her county's response in the early days of the coronavirus pandemic, which elevated her to the spotlight as Montgomery County was in the epicenter of the virus' spread. She also has been a professor of anesthesiology and obstetrics and pitched an unsuccessful run for Congress in 2014 before being re-elected to the County Commission. He also named: 

  • Secretary of Health: Debra Bogen, a pediatrician, and the director of the Allegheny County Health Department. 
  • Secretary of Drugs and Alcohol: Latika Davis-Jones, senior director of behavioral health at Highmark Wholecare, a Medicaid managed care provider in southwest Pennsylvania. 
  • Secretary of Aging: Jason Kavulich, Lackawanna County Director of Agency on Aging. 
  • Insurance Commissioner: Mike Humphreys, who has held the role temporarily since last spring. 

Also in Pennsylvania, the Department of Human Services (DHS) issued a Medicaid bulletin announcing they will be reinstating pre-COVID provider enrollment requirements effective February 27, 2023; while the PACE Program announced their Part D pharmacy benefit plan partners for 2023. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

January 13, 2023|Pennsylvania|

South Carolina

Centers for Medicare and Medicaid Services (CMS) has announced the enrollment application fee amount for calendar year 2023 will be $688. This fee is required by CMS with any applicable Healthy Connections Medicaid provider enrollment application.  

The South Carolina Department of Health and Human Services (SCDHHS) will collect the application fee before executing a provider agreement. The fee applies to initial enrollment, reactivation, revalidation, or addition of a new practice location. SCDHHS has contracted with the SC.gov Enterprise Payment System to facilitate collection of the application fee. Payments may be made by debit, credit, or e-check. Paper checks will not be accepted. More information on payment options can be found by visiting www.scdhhs.gov/provider and selecting, "Online Application Fee Payment."  

The provider enrollment application fee is only applicable to providers CMS has identified as institutional providers. South Carolina Healthy Connections Medicaid recognizes and enrolls the following institutional providers: Ambulatory Surgery Centers, Community Mental Health Centers, Comprehensive Outpatient Rehabilitation Facilities, Durable Medical Equipment, End Stage Renal Disease Facilities, Federally Qualified Health Centers, Home Health Agencies, Hospice, Hospitals, Independent Clinical Laboratories, Pharmacies, Skilled Nursing Facilities and Rural Health Clinics. For more information, please see the Bulletin.  

Also in South Carolina, the South Carolina Department of Social Services (SCDSS) is announcing an end to the federally approved Supplemental Nutrition Assistance Program (SNAP) emergency allotments (supplements) to all South Carolina households effective January 31. Since March 2020, the assignment of emergency SNAP allotments (supplements) has brought all authorized households up to the maximum benefit allotment, based on household size. 

January 2023 has been approved by the United States Department of Agriculture Food and Nutrition Services as South Carolina's "transition" month, prior to going back to normal SNAP benefit allotments for all households. 

Effective February 1, all SNAP households will go back to receiving their regular monthly benefit amount.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

January 13, 2023|South Carolina|

Texas

The state legislature will convene its 140-day biennial session on January 10, 2023. Rep. Dade Phelan (R) was elected Speaker of the House. 

Also in Texas, the State Comptroller Glenn Hegar (R) announced on January 9 that the state has a $32.7 billion surplus.  

Also in Texas, the Health and Human Services Commission's (HHSC) Executive Commissioner Cecile Erwin Young announced that Dr. Jennifer Shuford would serve as Commissioner of the Texas Department of State Health Services (DSHS), replacing Dr. John Hellerstedt. Previously Shuford served as chief state epidemiologist at DSHS. 

Finally in Texas, several bills of interest to pharmacies have been filed: 

  • HB 1105 by Rep. Four Price (R) would make 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.  
  • HB 1293 by Rep. Toni Rose (D), the Medicaid transparency reimbursement bill, would establish a rate floor for Medicaid MCOs. 
  • SB 160 by Sen. Charles Perry (R) would provide for pharmacists to furnish medications for flu, strep and COVID under a written protocol with additional training, if identified through a CLIA Waived test. Also, it would allow for a physician to dispense drugs for flu, step and COVID, if identified through a CLIA-waived test, and dispense all antibiotics and drugs authorized under an emergency rule. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Texas|

Washington

The legislature convened on January 9, 2023. 

Also in Washington, legislation creating a new stand-alone chapter for regulating PBMs was filed this week. SB 5213 and HB 1253 were designed by the Office of the Insurance Commission (IOC) and the Washington State Pharmacy Association (WSPA) to regulate PBMs directly regardless of whether the contract is with a state-regulated plan or a self-funded plan. The bill prohibits requiring the use of mail-order pharmacies (except for specialty drugs), reimbursing pharmacies below costs and excluding pharmacies from the network. 

Also in Washington, the Washington State Pharmacy Association (WSPA) Legislative Days are January 25 and February 13. These events will allow all pharmacists, pharmacy students and pharmacy technicians from all practice settings to connect with legislators and colleagues across the state. 

Also in Washington, the Health Care Authority recently updated its provider billing guides and fee schedules for Apple Health (Medicaid). 

Finally in Washington, the Department of Health (DOH) is developing a campaign in 2023 to encourage families to catch up on immunizations. To accomplish this goal, DOH is surveying health care providers for guidance on what materials and resources are needed. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

January 13, 2023|Washington|

California

Last week, the Department of Health Care Services (DHCS) announced plans for the reinstatement of prior authorization and the retirement of the transition policy taking place in a series of phases… II, III and IV. A webpage has been developed for "Medi-Cal Rx Reinstatement" that includes information about the timeline, key days, announcements and alerts and resources. If you already receive Medi-Cal Rx alerts, you will also begin to receive Reinstatement alerts. There is no need to subscribe to an additional listserv according to DHCS staff. 

Also in California, the DHCS posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal. Please note the reinstatement resources in New Resources for Reinstatement Education and Support. 

Also in California, Medi-Cal posted the following:   

Finally in California, NACDS and the California Retailers Association (CRA) sent several joint letters to the Board of Pharmacy addressing issues of concern to members.  

  • With respect to e-prescribing requirements effective January 1, 2023, NACDS and CRA are seeking guidance from the Board about how members can comply with requirements to accept electronic prescriptions without advance notice from a vendor with whom they do not have a current business relationship.  
  • We are also seeking clarity from the Board via answers to a brief list of questions to provide members the appropriate guidance to aid their efforts to comply with a 2021 law related to pharmacy quotas; recall, this law only applies to companies operating 75 or more pharmacies in the state under one ownership.  
  • Finally, we are expressing concern with a proposal under consideration by the board to create a "staffing floor" that may lead to pharmacy closures if at least one clerk or pharmacy technician is not on staff and fully dedicated to performing pharmacy-related services while the pharmacy is open; this proposal would also permit the pharmacist on duty to close the pharmacy if, in their opinion, the staffing at the pharmacy is inadequate to safely fill or dispense prescriptions or provide services in a safe manner without fear of retaliation. We asked to work with the board on solutions so that pharmacies can remain open to their patients.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

December 16, 2022|California|

Georgia

The Board of Pharmacy shared “Volume 4” of its newsletter. The newsletter is created on a quarterly basis and is intended to provide insights and updates on the profession of pharmacy in the state. The newsletters can be found on the GBOP website for easy access.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

December 16, 2022|Georgia|

Iowa

The Board of Pharmacy adopted the following rules effective January 4, 2023:  

  • ARC 6685C has been adopted and amends Chapter 23, "Care Facility Pharmacy Practice." 
  • ARC 6686C has been adopted and amends Chapter 41, "Outsourcing Facilities." 
  • ARC 6687C has been adopted and amends Chapter 14, "Public Information and Inspection of Records." 
  • ARC 6688C has been adopted and amends Chapter 12, "Precursor Substances." 
  • ARC 6689C has been adopted and amends Chapter 10, "Controlled Substances." 

Also in Iowa, the Board of Pharmacy published ARC 6696C as a Notice of Intended Action to amend Chapter 3, "Pharmacy Technicians," Chapter 6, "General Pharmacy Practice," Chapter 8, "Universal Practice Standards," Chapter 18, "Centralized Prescription Filling and Processing," Chapter 21, "Electronic Data and Automated Systems in Pharmacy Practice," and Chapter 39, "Expanded Practice Standards." Comments may be submitted until 4:30 p.m. on December 20. 

Finally in Iowa, the Department of Health and Human Services, Iowa Medicaid published INFORMATIONAL LETTER NO. 2405-MC-FFS announcing January 2023 Iowa Medicaid Pharmacy Program Changes. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

December 16, 2022|Iowa|

Maryland

The Maryland Pharmacists Association (MPhA) is seeking nominations for two trustee Board positions for 2023-2024. Trustees serve a three-year term. Any active MPhA member in good standing is eligible for nomination and self-nomination is acceptable. Interested parties may submit their nominations online.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

December 16, 2022|Maryland|
Go to Top