Colorado
The Department of Health Care Policy and Financing (HCPA) issued an Operational Memo informing Health First Colorado (Medicaid) providers of their obligation to effectively communicate coordination of benefits requirements to Health First Colorado members who have primary third party insurance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
The Department of Health approved a final rule requiring reporting of vaccines by all providers, including pharmacies, with 24 hours of vaccine administration to the registry. The rule will be effective when published in the DC Register.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Rule 64B16-28.108 related to labeling of Medicinal Drugs by pharmacy permits has been revised by the Board of Pharmacy and became effective November 28, 2021. The revision is primarily for Institutional Class II, Modified Class II Type B, or Class III permits that are labeling patient specific medications.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
The Department of Public Health would like to hear from pharmacies who may be interested in providing the FDA approved COVID-19 therapeutic pill, Molnupiravir. Please take a minute to complete this COVID-19 Molnupiravir Pharmacy Interest Survey.
If you would like to learn more about Merck’s Molnupiravir pill, CLICK HERE to watch a 30-minute presentation by Lisley Brooks B.S., Doctor of Pharmacy Candidate 2022 and Tracy Dabbs, PharmD, Georgia Department of Public Health.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
On December 6, the Board of Pharmacy transitioned to a new payment platform (Gov2Go) for online applications. Additional information about the Iowa eGovernment portal, Gov2Go, was posted later this week. For faster access to Gov2Go, please create a Gov2Go account at web.gov2go.com. If you experience any payment issues while applying for a new license/registration or renewing an existing license/registration, please contact Terry Witkowski.
Also in Iowa, the Department of Public Health (IDPH) posted a NEW Vaccine Information Brief (12.10.21) with update on the vaccine allocation survey on December 13 that will not include Pfizer Adolescent/Adult Vaccine in order to utilize existing inventory in the state and FDA expands eligibility for Pfizer-BioNTech COVID-19 Booster Dose to Individuals 16 and 17 years of age. Also note last week’s Vaccine Information Brief (12.3.21) announcing ACIP COVID-19 Vaccine Booster Recommendation, Moderna Shelf-Life Extension Update and Updated – Interim Clinical Considerations for Use of COVID-19 Vaccines and this week’s Vaccine Information Brief (12.8.21) with information about Pfizer transition to Comirnaty. Please direct questions to the COVID-19 Vaccine Call Center at 1-800-831-6293 ext. 1 or email.
Also in Iowa, the Department of Human Services, Iowa Medicaid Enterprise, issued INFORMATIONAL LETTER NO. 2295-MC-FFS announcing the alignment between Managed Medicaid and Medicaid Fee-for-Service to limit the number of diabetic needles that member may obtain per month. The managed care organizations currently allow 100 needles per month. Members enrolled in Medicaid Fee-for-Service were also be limited to 100 diabetic needles per month effective December 1, 2021.
Finally in Iowa, the Department of Human Services, Iowa Medicaid Enterprise, issued INFORMATIONAL LETTER NO. 2291-MC-FFS announcing several Medicaid Pharmacy Program Changes effective January 1, 2022, related to the following:
- Changes to the Preferred Drug List (PDL);
- Pharmacy benefit policy changes for albumin human, papaverine injection solution and Zoladex subcutaneous implant;
- New Drug Prior Authorization (PA) Criteria for non-biologic agents for ulcerative colitis, Vericiguat (Verquvo) and Viloxazine (Qelbree)
- Changes to Existing PA Criteria for Gonadotropin-Releasing Hormone (GnRH) Receptor Antagonist, Oral [formerly Elagolix Products], Omalizumab (Xolair) and Topical Acne and Rosacea Products
- Point of Sale Billing Updates (ProDUR Quantity Limits) and
- DUR Update
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
The Board of Pharmacy approved an emergency amendment to the pharmacy closure regulation at its Nov. 30 meeting. As an emergency regulation, once it is filed with the LRC it will be in effect immediately. The regulation changes the temporary pharmacy closure notification requirement from 5 days to 2 two days within a 14-day period or 9 days in a 30-day period and requires pharmacies to notify the board in immediately in writing of a closure meeting the threshold. Additionally, it has requirements for signage, control of prescriptions, notification of providers and post-closure claims adjudication.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Department of Commerce and Insurance (DCI) Board of Pharmacy issued a bulletin on Vaccine Provider Healthcare Assistance in response to the Board of Pharmacy received regarding if pharmacies can use non-pharmacy healthcare providers to help provide both COVID-19 and non-COVID-19 vaccines.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on December 15 at noon (Central).
Also in Nebraska, the Department of Health and Human Services (DHHS) updated the Janssen COVID-19 Vaccine Administration – Booster – Code: 0034A — $37.25 (effective November 2, 2021). DHHS also published its Provider Bulletin 21-21 – November 2021 COVID-19 Vaccines Updates, including COVID-19 booster doses and COVID-19 vaccinations for children. For questions, contact Medicaid.
Finally in Nebraska, the COVID rates have been added and been moved from the right-hand navigation list to the main list on the Department of Health and Human Service Medicaid Provider Rates and Fee Schedules website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Carolina
In response to the U.S. Food and Drug Administration amended EUA for the Pfizer-BioNTech COVID-19 vaccine, authorizing the use of a single booster dose for administration to individuals 16 and 17 years of age at least six months after completion of primary vaccination with the Pfizer-BioNTech COVID-19 Vaccine and the CDC expanding the recommendation for boosters to include 16 and 17 year old, North Carolina has updated the Standing Order regarding vaccine administration.
Also in North Carolina, the Board of Pharmacy has issued new guidance concerning the application for Pharmacist-Technician Ratio of 1:6 or Greater.
Finally in North Carolina, please see Information regarding the Administration of Long Acting Injectables in Medicaid.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Ohio Department of Health (ODH) shared flu communications toolkits for healthcare providers to use in promoting flu vaccination for their patients during the 2021 – 2022 flu season. The Centers for Disease Control and Prevention (CDC) offers a NIVW digital toolkit featuring social media language and graphics, sample newsletter language, and printable resources. ODH posted a Flu Communications Toolkit that offers social media language and graphics and sample newsletter language around the importance of flu shots, in addition to flu and COVID-19 shots, as the best defense. Healthcare providers can monitor flu activity in Ohio, including county-level data, on the ODH Ohio Flu Activity webpage.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
South Carolina
Effective Jan. 1, 2022, the South Carolina Department of Health and Human Services (SCDHHS) will increase the reimbursement rates for the services and supplies related to: Incontinence Supplies, Department of Alcohol and Other Drug Abuse Services (DAODAS) and Autism Spectrum Disorder (ASD) Services. These changes will be reflected on the SCDHHS website by Jan. 1, 2022.
Providers with questions regarding this bulletin should contact the SCDHHS Provider Service Center at (888) 289-0709. The Provider Service Center’s hours of operations are 7:30 a.m.-5 p.m. Monday-Thursday and 8:30 a.m.-5 p.m. Friday
Also in South Carolina, the Department of Insurance has provided a complaint form for pharmacies or interested parties to file complaints with the South Carolina Department of Insurance relating to pharmacy benefit manager (PBM) services. SC law requires pharmacies to make reasonable efforts to exhaust a PBM’s internal appeal requirements prior to filing a complaint with the SCDOI. A copy of the appeal outcome must accompany the complaint submission.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) semi-annual update of the Medicaid preferred drug list will occur on January 27, 2022. HHSC made the PDL changes based on recommendations made at the July and November 2021 Texas Drug Utilization Review Board meetings. Drug list decisions from those meetings are available.
Also in Texas, HHSC next Texas Vaccine Providers Webinar will be on Tuesday, December 14th at Noon Central. Register here.
Finally in Texas, in response to a request from the Texas State Board of Pharmacy, Gov. Greg Abbott (R) again temporarily suspended the requirement in §291.33(c)(1)(B)(iii) to have in-person contact for patient counseling in order to allow patient counseling to be performed by telephonic consultation. This remains in effect until March 31, 2022, or until the March 13, 2020, disaster declaration is lifted or expires, whichever is earlier.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
The Vermont Department of Financial Regulations has issued draft guidance for commercial insurance coverage of COVID-19 at-home rapid antigen testing. The Department contemplates requiring commercial health insurers to cover at-home rapid antigen testing listed as “preferred” by Vermont Medicaid without member cost sharing. Under the draft emergency rule, the tests would be fully covered when prescribed, in which case the claim would process exactly like any other prescription medication, or if the member submits a claim form. This guidance, once finalized, will be effective December 1, 2021.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
West Virginia
The Legislative Rule Making Review Committee adopted the PBM rule as currently written without any debate. The rule, based on the passage of HB 2263 or 2021, must now receive final approval by the Legislature during the 2022 session.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wisconsin
This week Governor Tony Evers (D) signed into law three pro-pharmacy bills. In specific the three bills are the Pharmacist Provider Status – providing pharmacist’s reimbursement for any clinical care services covered under the Medicaid program (SB 255), Pharmacy Technician Registration- establishing the registration of pharmacy technicians (SB 300) and Remote Dispensing Sites (SB 308) which licenses these sites and provides more flexibilities for remote supervision of site pharmacists. These laws will be in effect as the supporting regulations are finalized in 2022.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Alabama
As Alabama Medicaid continues to monitor the COVID-19 national emergency in Alabama, Medicaid is adding procedure codes for coverage. Providers may submit claims for dates of service on or after the effective dates for each procedure code as listed here. Providers may find the reimbursement rates for the COVID-19 testing procedure codes on Medicaid’s website at www.Medicaid.Alabama.gov by selecting Fee Schedules under the Providers tab.
Also in Alabama, effective January 1, 2020, all newly registered technicians are required to complete a Board approved training program within six (6) months of the registration. Technicians with Board approved training completed, PTCB or CPhT certifications, or registered prior to January 1, 2020, will be reflected as compliant with the training requirement on the technicians’ Board of Pharmacy website profile.
To view this data:
- Go to albop.com
- Click Online Services
- Choose “Individual Verification” from the dropdown menu
- Input the technician registration number or name of the technician and enter the verification code displayed and click Search
- Identify the technician and choose the Print option to view the full license details including training information for technicians.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Department of Commerce, Community, and Economic Development cut the initial registration and biennial renewal fees for the prescription drug monitoring program-controlled substance prescription database to $0 effective December 23, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
Gov. Asa Hutchinson (R) is convening a Special Session of the Legislature on Tuesday, December 6th to deal with income tax reform and repeal of the Insulin Rebate law (Act 1104/HB 1709).
Also in Arkansas, the Department of Health final rules amending the Prescription Drug Monitoring Program to provide for an alternate method of reporting and allow the department to request prescription copies from dispensers for evaluation go into effect on December 3, 2021.
Finally in Arkansas. The Division of Medical Services adopted a rule revising the rate methodology and reimbursement rates for covered long-acting reversible contraceptives (LARCs) that went into effect on December 1, 2021.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Medi-Cal Rx Monthly Bulletin for December has been posted. Below is an outline of this month’s updates. As a reminder, Medi-Cal Rx is schedule to be implemented effective January 1, 2021.
- Changes to the Contract Drugs List (CDL), Effective December 1, 2021
- Changes to the Contract Drugs List (CDL) – Over the Counter Drugs, Effective December 1, 2021
- Changes to the Family PACT Pharmacy Formulary, Effective December 1, 2021
- Medi-Cal Rx Medical Supplies Updates
- Reimbursement for COVID-19 Vaccine Administration Claims
- Updates to the Medi-Cal Rx Provider Manual
- Adult Vaccination Administration Fee: Pharmacy Claims and Reimbursement
- Maximum Allowable Ingredient Cost (MAIC) 30-Day Pharmacy Provider Notice
- 45-Day Pharmacy Provider Notice
- Contract Drugs List (CDL) Flyer
- Medi-Cal Rx Provider Training Details
- Registering Multiple NPIs in UAC
- UAC Registration and Sign-In Troubleshooting
- UAC Registration Reminders and Helpful Tips
- Introducing the Medi-Cal Rx Education and Outreach Team
- Prescriber Training Checklist
- Pharmacy Training Checklist
Also in California, NACDS submitted comments to the Board of Pharmacy in support of the proposed rule revising 16 CCR §1746.4 pertaining to requirements for notification to patients’ primary care provider following vaccine administration. In modifying the notification provisions of the rule to apply only when requested by a patient, the proposed rule change would reduce the administrative burden of preparing and forwarding potentially redundant information that is not always needed or desired by every primary care provider, especially considering that pharmacies also report administered vaccines to the California Immunization Registry. Considering pharmacist and pharmacy workload demands having amplified during the COVID-19 pandemic, eliminating unnecessary administrative requirements free up pharmacy personnel to focus on meeting public demand for increased pharmacy services.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Regulatory agencies (DORA) announced that the Board of Pharmacy, Medical Board, and Board of Nursing will hold a virtual Joint Stakeholder Meeting on December 20th seeking input on whether to develop a new statewide protocol for Statin Therapy within the scope of Collaborative Pharmacy Practice Agreements, as allowed per section 12-280-601(1), C.R.S., and Rule 17.00.00. This proposed protocol would allow pharmacists to provide evidence-based health-care services to increase access to a well-established medical standard of care. Written comments must be submitted by December 17, 2021. Oral comments will be taken from participants who are present via webinar.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Governor Ron DeSantis joined by Florida Speaker Chris Sprowls and Senate President Wilton Simpson to sign legislation that will protect Floridians from losing their jobs due to COVID-19 vaccine mandates and protect parents’ rights to make healthcare decisions for students. The bills were passed through a Special Session of the Florida Legislature and are effective upon the Governor’s signature. The legislation signed today is the strongest anti-mandate action taken by any state in the nation. Read about the legislation HERE.
Also in Florida, Agency for Health Care Administration Secretary Simone Marstiller issued the following statement in support of Florida’s challenge against the Biden Administration’s Centers for Medicare and Medicaid Services (CMS) rule mandating that health care workers receive the COVID-19 vaccine:
“The recent CMS rule issued by Biden Administration will not only damage our stretched health care industry but impact our most vulnerable and their ability to receive the health care they need,” said Secretary Simone Marstiller. “Tying Medicare and Medicaid funding to a vaccination mandate – funding that pays for medical care for elderly, disabled, and low-income individuals – is a blatant overreach of power that must be challenged. Thanks to the leadership of Governor DeSantis and Attorney General Moody, Florida is doing just that, to protect Florida jobs, ensure access to care, and empower individuals in making personal health care decisions for themselves and their families.”
Finally in Florida, the Florida HIE will be hosting a webinar on Tuesday, December 7th at 12:00pm EST. Learn about how the Encounter Notification Service (ENS) provides benefits to providers and patients across Florida. You may register here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Iowa Department of Public Health (IDPH) posted the following, including new clinical materials related to recent ACIP recommendations for a COVID-19 vaccine for children 5 through 11 years of age:
- NEW Vaccine Information Brief (11.19.21)
- The Pfizer-BioNTech COVID-19 Vaccine Standing Orders for Administering Vaccine to Persons 5 through 11 Years of Age
- The Pfizer-BioNTech COVID-19 Vaccine Preparation and Administration Summary form (Persons 5 through 11 Years of Age)
- The Pfizer-BioNTech COVID-19 Vaccine Storage and Handling Summary (5 through 11 years of age)
- The Pfizer-BioNTech COVID-19 Vaccine Storage and Handling labels (5 through 11 years of age)
- The Pfizer-BioNTech COVID-19 Vaccine Beyond Use Date guidance and labels (5 through 11 years of age)
- The Pfizer-BioNTech COVID-19 Vaccine Transporting Vaccine for Vaccination Clinics Held at Satellite, Temporary or Off-Site Locations (5 through 11 years of age)
Also in Iowa, the Board of Pharmacy has posted the meeting minutes from the August 31, 2021 meeting.
Finally in Iowa, NACDS submitted comments to the Board of Pharmacy concerning ARC 6012C related to Collaborative Pharmacy Practice Agreements and recommended the Board consider including physician assistants in the practitioner definition to include all licensed professionals duly authorized to prescribe to ensure all relevant pharmacy collaborations with prescribers can be leveraged to extend and improve care.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) held its monthly COVID-19 Vaccine Partners virtual webinar providing the latest statistics on vaccines administered, LDH also did a one-year look-back highlighting equitable distribution across the state’s nine healthcare regions. More information is available at La.Immunization@La.gov.
Also in Louisiana, in addition to electing new officers at the November 17th Board meeting, the board approved to move forward on adopting fee increases Regulatory Proposal 2021-G. They also discussed proposed New PPM.I.A.35, Emergency Prescriptions for Durable Medical Equipment (Draft #1) State of Emergency authorizing pharmacists to dispense emergency prescriptions of prescribed medications during a state of emergency. Finally, they approved Proposed Revision of PPM.I.D.28 ~ COVID-19 Public Health Emergency: Guidance for Licensees re PREP Act Declaration by HHS (Draft #1), which is a guidance document.
Finally in Louisiana, the Board of Pharmacy scheduled an in-person Public Hearing on December 28, 2021, on a proposed rule on medication administration that would make permanent pharmacy technicians and interns administering immunizations. Pharmacies are encouraged to email written supportive comments to the Board in advance of the hearing. info@pharmacy.la.gov
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Notice of Agency Rulemaking Proposal regarding Joint Rule Between the Maine Board of Pharmacy and Maine Board of Nursing on Collaborative Drug Therapy Management (CDT) has been posted to the Maine Board of Pharmacy website. The comment deadline is January 3, 2022, at 5:00 pm. EST. Written comments may be sent to Geraldine.L.Betts@maine.gov using the subject line: CDT Proposed Rule Comment.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Mississippi
Join MPhA for a virtual Last Chance Seminar! This seminar will offer two (2) live CE hours. These hours satisfy the opioid/drugs of abuse required by the Board of Pharmacy. December 12, 2021, 4:00pm – 6:00pm. Click here to register.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.