New York

The New York State Department of Health has proposed to amend regulations to limit the Medicaid fee for service prescriptions to a maximum of 11 refills within a 12-month issuance Comments are due by March 6, 2022.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 14, 2022|New York|

North Carolina

The January 18th Board meeting will be conducted via Microsoft Teams. You will be able to join the meeting either by downloading the Microsoft Teams app or you may open the link in a web browser. Simply click on this link at the start of the meeting. If you prefer to attend the meeting by phone, call (336) 604-5350. The conference ID is 907 040 796#. You may view the agenda here. 

Also in North Carolina, NC Medicaid is increasing the reimbursement for COVID vaccine administration from $40 to $65. The effective date of the rate change will be retroactive to April 1, 2021. All claims previously submitted with dates of service from April 1, 2021, through the NCTracks implementation date of the rate change will be systematically reprocessed. No action will be required by providers to receive the retroactive rate increase.  

Finally in North Carolina, the Board of Pharmacy issued the following guidance regarding the role of pharmacists in oral therapeutics to treat COVID-19. 

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

January 14, 2022|North Carolina|

South Dakota

The Board of Pharmacy published its January 2022 Newsletter, including information about the new Prescription Drug Monitoring Program NarxCare Report called “Tile View”, an update on the drug take-back program, and other information of interest to pharmacies and pharmacists.

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

January 14, 2022|South Dakota|

Washington

The State Health Care Authority (HCA) issued a statement that while they are not able to implement at this time, HCA is working to create a process to meet these legislative mandates in a law passed last year, Substitute Senate Bill 5195. The law requires HCA to reimburse hospitals, behavioral health agencies, or pharmacies who dispense opioid overdose reversal medication to uninsured individuals by January 1, 2022. The plan will include a process to back-dated opioid reversal medication claims to January 1, 2022.

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

January 14, 2022|Washington|

Wisconsin

The 2022 list of 100 most used generic prescribed drugs has just been releasedEach Wisconsin pharmacy must provide notice to the public on how it may access the Pharmacy Examining Board list.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 14, 2022|Wisconsin|

Alabama

Effective January 1, 2022, the Alabama Medicaid Agency will have contracts with eight companies that offer Medicare Advantage coverage in Alabama: Aetna Better Health, Inc., Arcadian Health Plan, Inc. (Humana), Centene Venture Company Alabama Health Plan, Inc. (Ascension Complete), HealthSpring Life & Health Insurance Company, Inc. (CIGNA), Simpra Advantage, Inc., UnitedHealthcare of the Midlands, Inc., VIVA Health, Inc., and WellCare of Alabama, Inc. 

 Providers are encouraged to check Medicaid’s Eligibility Verification File, under the Managed Care Section, to determine if capitation payments have been made for recipients during a particular month. If a capitation payment has not been made, providers should refer to Chapter 5 of the Provider Billing Manual, Sections 5.6.1 – 5.6.2, for claims filing instructions. Questions may be directed to Shari Rudd at (334) 353-3403 or shari.rudd@medicaid.alabama.gov. 

 Also in Alabama, the Board of Pharmacy is reporting that only 35% of licensed technicians have renewed their licenses. Please be aware that the submission of a renewal by the December 31 deadline does not mean that individuals are clear to work on January 1. The renewals must be processed, not just submitted. We recommend that you renew your license NOW, with plenty of lead time to handle any issues that may come up.  

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

January 7, 2022|Alabama|

Arkansas

The Division of Medical Services rules allowing six refills per month, add certain medications that do not count toward the monthly prescription cap, and allow up to nine medically necessary prescriptions per month for Living Choices Assisted Living Program clients went into effect on January 1, 2022. The rule also specifies that patients must pay for their own medications beyond the maximum benefit, remove the extension of benefits provisions, and revise refill requirements.  

Also in Arkansas, the Division of Provider Services and Quality Assurance (DPSQA) issued a COVID-19 Response Manual. 

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

January 7, 2022|Arkansas|

California

Medi-Cal Rx was implemented on January 1, 2021. The Monthly Bulletin for January has been posted to the Medi-Cal Rx Web Portal.  

Also in California, Medi-Cal Rx issued a Share of Cost bulletin to clarify that the process will be unchanged by the implementation of Medi-Cal Rx.  

Also in California, Medi-Cal Rx issued an alert announcing that reject code 16 M/I Prescription/Service Reference Number is temporarily suspended. Pharmacy providers may resubmit claims if they receive this rejection.  

Also in California, the Board of Pharmacy published its January 2022 monthly update. Note the last item about pharmacy laws effective in 2022. 

Finally, the Board of Pharmacy also published a reminder of the new e-prescribing laws effective January 1, 2022. 

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

January 7, 2022|California|

Florida

The Department of Health has issued a Notice of Meeting/Workshop Hearing. The Board of Pharmacy will conduct a workgroup meeting to discuss white bagging and brown bagging pharmacy practices, February 9, 2022, 1:00 p.m. ET at the DoubleTree by Hilton Hotel Deerfield Beach – Boca Raton, 100 Fairway Dr., Deerfield Beach, FL 33441.

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

January 7, 2022|Florida|

Idaho

The Idaho Administrative Rules Special Edition Bulletin, Volume 21-12SE, December 22, 2021, has been published. The following rules have been adopted by the respective agency and are now pending review by the 2022 Idaho State Legislature for final approval. 

  • Office of the Attorney General – See “Rules of Administrative Procedure for Consideration of Cooperative Agreements Filed by Health Care Providers” on pages 527-41. 
  • Department of Health and Welfare – Medicaid Basic Plan Benefits
  • See “664. PRESCRIPTION DRUGS: PROVIDER QUALIFICATIONS AND DUTIES” on pages 1778-9;  
  • “665. PRESCRIPTION DRUGS: PROVIDER REIMBURSEMENT” on pages 1779-83 and 
  • “666. PRESCRIPTION DRUGS: QUALITY ASSURANCE” on page 1783. 
  • The Division of Occupational and Profession Licenses pending fee rule – See pages 3350-1 for the Idaho State Board of Pharmacy fees. 

Also in Idaho, the Board of Pharmacy published the “Idaho State Newsletter” – December 2021. Below is an outline of its contents. Note the Idaho PDMP (Prescription Drug Monitoring Program) requirement effective November 1, 2021. 

  • Remaining CPE (Council for Pharmacist Education) credits for 2021 
  • “Culture of Safety” – Medication events and process improvements in 2021
  • Requirement for “Date Sold” in Idaho PDMP 
  • Technician registration assistance 
  • 2022 Board Meeting Schedule 

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

January 7, 2022|Idaho|

Iowa

The Department of Human Services, Iowa Medicaid Enterprise (IME) published INFORMATIONAL LETTER No. 2301-MC-FFS regarding a variety of listening sessions for providers scheduled for January and FebruaryIME’s goal for these sessions is to hear from providers with experience related to assorted topics and who have ideas for ways to improve processes and policies associated with these topics.

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

January 7, 2022|Iowa|

Louisiana

At the Regulation Revision Committee (RRC) meeting on January 5th, members revised and approved several proposed legislative bill drafts of interest to chain pharmacies, including (1) amending the prescription monitoring program law to provide limited access to audit trail information to designated representatives of Louisiana Medicaid; (2) require Pharmacy Benefit Managers to obtain a permit from the Board of Pharmacy; (3) revising the definition of collaborative practice and authorizing pharmacists to provide certain patient care services in accordance with statewide protocols developed by the Board’s Public Health and Pharmacy Protocol Advisory Committee and approved by the Board of Pharmacy; and (4) changing the definition of collaborative practice and adding a definition of a collaborative practice agreement authorizing pharmacists to engage in collaborative practice in accordance with rules promulgated by the Board of Pharmacy. The RRC also approved a draft CLIA (Clinical Laboratory Improvement Amendments) Waived Testing Policy statement confirming pharmacist’s authority to perform these tests under federal law. The full Board of Pharmacy will be considering all these issues at their February 16th meeting. 

Also in Louisiana, the Department of Health (LDH) issued a new Naloxone standing order. They also issued Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement and Bypass Diagnosis Codes – Effective January 1, 2022Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Criteria Updates – Effective January 1, 2022; and Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective January 1, 2022 

Finally in Louisiana, in advance of the December 28, 2021, Board of Pharmacy’s Public Hearing, NACDS submitted comments in support of proposed rules that make permanent certain authorities for pharmacy technicians and interns authorized under the PREP (pre-exposure prophylaxis) Act. Specifically, the proposed rules would codify authority for pharmacy technicians and interns to administer vaccines, in addition to making other changes to the existing rules that simplify existing administrative requirements for vaccines provided by pharmacy providers. We anticipate that the final rule will be published on March 20, 2022, Louisiana Register, and become effective immediately. 

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

January 7, 2022|Louisiana|

Missouri

The Board of Pharmacy is seeking comments by January 14, 2022, on proposed rules removing geographic restrictions on remote data entry sites and allowing pharmacy technicians and intern pharmacists to perform remote data entry from a site located in another U.S. state or territory. 

 Also in Missouri, the National Association of Insurance Commissioners (NAIC) selected the Missouri Department of Commerce and Insurance Director Chlora Lindley-Myers as President-Elect for 2022. 

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

January 7, 2022|Missouri|

Montana

The Dept. of Public Health and Human Services issued a Notice of Public Hearing on proposed amendments to ARM 37.85.105, updating effective dates of Medicaid fee schedules; see the relevant section related to outpatient drugs located on pages 1888-9. The public hearing will be held on January 13 and comments are due January 22. 

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

January 7, 2022|Montana|

Nebraska

Gov. John Peter “Pete” Ricketts (R) signed Executive Order 21-18, facilitating hospital planning, and ensuring additional healthcare workforce capacity, on December 20, 2021. This extends the current Executive Order 21-15, allowing “pharmacists to have any number of pharmacist interns and pharmacy technicians under their supervision insofar as they determine it necessary within their professional discretion when administering vaccinations”, until March 31, 2022. 

Also in Nebraska, the 471-000-540 Nebraska Medicaid Practitioner Fee Schedule for Injectables was updated effective January 1. 

Also in Nebraska, the Dept. of Health and Human Services issued a Health Alert Network Update:  Omicron Predominant in Nebraska and Therapeutics Updates  that includes an update on the Omicron variant of SARS-CoV-2 in Nebraska, NIH’s criteria for identifying and prioritizing those expected to benefit the most from receiving the limited supply of COVID-19 therapeutics currently available and the NIH’s treatment algorithm.  

Also in Nebraska, the Board of Pharmacy will meet on January 10 and have posted the meeting agenda. Also, the November 8, 2021, meeting minutes are available. 

Finally in Nebraska, the Dept. of Health and Human Services has posted the DUR (Drug Utilization Review) Board January 11, 2022, meeting agenda and DUR Policy Statements (as of July 2021).

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

January 7, 2022|Nebraska|

New York

On New Year’s Eve NYS Governor Kathy Hochul (D) signed into law two pieces of legislation supported by NACDS. The first S3556 strengthens state anti-mandatory mail order (ammo) law. Legislators, concerned that the AMMO law was not operating as intended, passed S3566 to ensure that patients can get their prescriptions at their local pharmacy rather than be directed to mail order by their PBM. In addition, Governor Hochul signed into law S.3762 which provides for licensure and registration of pharmacy benefit managers. The bill also sets forth duties and obligations that PBMs must follow when performing services and allows the department of financial services to enforce the law and receive complaints from consumers, pharmacies, and healthcare providers. Unfortunately, Governor Hochul did veto S6603 which would have provided Medicaid pharmacy payment parity citing the fiscal note as her reasoning.  

Also in New York: The State Education Department published its Notice of Adoption of their regulation related to Licensure Examination, Licensure by Endorsement, and Continuing Education Requirements in the Profession of Pharmacy The regulation is effective January 1, 2022 and eliminates the Part III exam requirement. Also commencing with registration periods beginning on or after January 1, 2023, a new requirement for a licensee to complete as part of the 45 hours of formal continuing education at least three hours of formal continuing education acceptable to the department in compounding, among other changes. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

January 7, 2022|New York|
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