Oregon
The Oregon Health Authority's Immunization Policy Advisory Team (IPACT) will meet September 1 via Zoom. To register in advance for this meeting, use this link.
Also in Oregon, the Oregon Health Authority released its 2021 Coordinated Care Organization (COO) Metrics Report. Although statewide performance showed improvement on most of the 14 incentive measures, the exceptions were two immunization measures related to youth immunizations which were down 7.7% for adolescents and 8.3% for immunizations received by the child's second birthday. These continue to be affected by the disruptions in preventive care that occurred during the pandemic.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
The Board of Pharmacy adopted the pharmacy counseling waiver and non-sterile compound rules at the August 2nd meeting. A summary of all the rules adopted is available here.
Also in Texas, the Board of Pharmacy created an infographic clarifying for pharmacists the requirement to check a patient’s controlled substance history in the Prescription Monitoring Program (PMP) before dispensing opioids, benzodiazepines, barbiturates, or carisoprodol. The Board inspectors have found that some integrated pharmacy management systems require that the pharmacist manually initiate a report request by clicking to “View/Show Report” and access the full controlled substance history report for the patient to comply with the mandated PMP lookup requirement. However, if your integrated pharmacy management system loads both the patient score and the full patient report, the pharmacist does not need to load the report separately to be compliant with the mandate.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Medi-Cal posted the following:
- News: “Coming Soon: Novavax COVID-19 Vaccine Authorization” – The Department of Health Care Services is aggressively pursuing the necessary system and operational changes required to enable successful claims adjudication for administration of the Novavax COVID-19 vaccine. (August 3)
- News: “New Provider Financial Data Request Form Available” – Providers should use the Financial Data Request Form for questions regarding missing warrants, copies of Remittance Advice Details (RADs), accounts receivable transactions, and copies of 1099s. (August 3)
- News: “New Approval Messages for COVID-19 Uninsured Group User Guide” was posted to the Medi-Cal News – COVID-19 Uninsured Group (UIG) coverage will be updated with new approval messages for qualifying individuals. (July 29)
- Alert: “Temporary Problem for Real-Time Eligibility Transactions” – The Medi-Cal Program has been affected by a temporary problem that has affected all providers using CalPOS leased line connection for Real-Time eligibility transactions. (July 29)
Also in California, the Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal.
- Enteral Nutrition Updates to the List of Covered Enteral Nutrition Products, Effective September 1, 2022, and December 1, 2022 (August 1)
- Medi-Cal Rx Monthly Bulletin for August (August 1)
- Changes to Contract Drugs List (CDL) (August 1)
- Updates to the Medi-Cal Rx Provider Manual (August 1)
- Electronic Claims Agreement – Submission Deadline Extended (July 29)
- Medi-Cal Rx Weekly Wrap-Up for July 22-28 (July 29)
Finally in California, the Board of Pharmacy communicated the following:
- NEW Pharmacy Law Waiver: Prescriber Dispensing of Tecovirimat (TPOXX or ST-246) Oral Antiviral Medication to Emergency Room Patient (BPC sections 4068(a)(1), 4068(a)(5), 4068(a)(6), 4076.5 and 4427.2(a))
- Next Standard of Care Committee Meeting – August 25, 2022 (NEW DATE)
- Notice of Second Modified Text to amend sections 1793.5 and 1793.6 and to add section 1793.65 to Title 16 of the California Code of Regulations related to Pharmacy Technicians and Second Modified Text; written comments will be accepted until August 17, 2022.
- Effective January 1, 2023, Order of Adoption amending Division 17 of Title 16 of the California Code of Regulations, section 1715.65, related to Inventory Activities and Inventory Reconciliation Reports of Controlled Substances
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
The Board of Pharmacy published the following rulemaking.
- Adopted (effective August 31, 2022)
- ARC 6416C adopted and amends Chapter 3, “Pharmacy Technicians”, and Chapter 6, “General Pharmacy Practice” related to pharmacist delegation of technical functions.
- ARC 6417C adopted and amends Chapter 8, “Universal Practice Standards”, and Chapter 19, “Nonresident Pharmacy Practice”
- ARC 6418C adopted and amends Chapter 12, “Precursor Substances”
- Notice of Intended Action (Comments may be submitted until 4:30 p.m. on August 16, 2022.)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Massachusetts
The Massachusetts legislature completed, and Governor Charlie Baker (R) signed into law the state budget — HB (House Bill) 5500, which included several provisions of interest to pharmacies.
Mandatory Reporting by PBM (Pharmacy Benefit Manager) for State Agency Managed Care Contracts. The report must be filed with the Legislature by February 15, 2023, on the financial performance of the managed care and accountable care organizations, as well as their effectiveness in serving the MassHealth recipients.
Funding for Public Awareness Campaign Relative to Prescriptions for Contraceptives
Funding for Programs to Combat Opioid Addiction
Expanding Protection for Reproductive Rights – This law provides legal protections for Massachusetts health care providers, including pharmacists, from prosecution by out-of-state jurisdictions for legally protected health care and reproductive health care services and products, including contraceptives, provided in Massachusetts to out-of-state residents. This language protects these providers from criminal prosecution and associated civil lawsuits from states that prohibit access to legal health care and reproductive health services and products. This bill also provides for one statewide standing order to be issued to authorize the dispensing of emergency contraception by licensed pharmacists. This language would replace
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Mississippi
The Mississippi Division of Medicaid (DOM) is in the process of implementing a new Medicaid Management Information System (MMIS) – which will include a new Provider Portal – known as MESA: Medicaid Enterprise System Assistance. The new system, going live at the beginning of October, is being developed by Gainwell Technologies.
Before switching over to the new system, every Medicaid-enrolled provider, clearing house or billing services vendor that currently submits electronic data transactions (for example, filing claims) to DOM must undergo Electronic Data Interchange (EDI) registration and testing with Gainwell Technologies. This process for ensuring the secure transmission of electronic information is required of all states when implementing a new system.
Medicaid providers are asked to identify their designated staff member, someone who is already involved in the submission of claims or other electronic transactions within the current provider portal, and direct them to this page on DOM’s website:
This also applies to any trading partner or billing services vendor that submits claims on behalf of a provider.
The website provides step-by-step instructions and supporting materials on how to register as a trading partner through an online portal and test electronic transactions. Providers are asked to begin this process as soon as time allows.
If providers have any questions about which representatives should be designated to follow these steps, please contact Gainwell’s Help Desk at MS_EDI_Helpdesk@dxc.com.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Nebraska
The Department of Health and Human Services (DHHS) announced the next COVID-19 Medicaid Provider call will take place on September 7 at noon (Central). Call details will be posted at this website one week before the call. Also, a recording of the August 3 COVID-19 provider call is now available.
Also in Nebraska, the DHHS (Department of Health and Human Services) posted the COVID-19 Fee Schedule July 2022 (Revised 7.28.22).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
Governor Kathy Hochul (D) issued an executive order that declares a state of emergency due to the spread of the monkeypox virus and directs all relevant state agencies to assist local governments in responding to the outbreak.
The executive order grants healthcare providers, including pharmacists, emergency permission to administer monkeypox vaccines through August 28, 2022.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Oregon
The Board of Pharmacy issued a Public Meeting Notice and published the agenda and meeting materials for its next meeting to be held August 10-12, 2022.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
Don’t miss the FREE module on preventing Type 2 Diabetes in South Carolina. This course is designed to help you use the South Carolina Provider Toolkit to evaluate, test, treat and refer patients with prediabetes to an in-person or online evidence-based diabetes prevention program. To learn more, click here to view the flyer.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
TennCare is abandoning plans to set limits on some prescription drugs. This change comes after advocacy groups voiced concerns for low-income patients whose medication access may be limited.
Also in Tennessee, the Tennessee Pharmacy Association (TPA) wants to hear from you! If you are a pharmacist or pharmacy technician, please take their 2022 Needs Assessment to share your educational needs and your interest in diverse types of educational programming.
TPA’s “COVID-19 Updates: Paxlovid Prescribing and Best Practices for Vaccinating under 5” Webinar on Wednesday, August 10, 12-1pm CT, will provide the most current COVID updates.
Finally in Tennessee, updated versions of the PDL (Preferred Drug List), criteria PDL, and interim criteria PDL as well as the monthly provider notice for August 2022 can be found here.
The updates below became effective 8/1/2022:
- Vimpat moved from preferred to non-preferred
- ciprofloxacin/dexamethasone otic suspension moved from non-preferred to preferred
- Sirturo was added to as non-preferred
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy posted new guidelines clarifying the Prescription Monitoring Program (PMP) mandatory lookup requirements in integrated health records for pharmacists checking a patient’s controlled substance history before dispensing opioids, benzodiazepines, barbiturates or carisoprodol.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
Alabama Pharmacy Association (APA) has been working with the Department of Insurance as they create a way for pharmacists/pharmacies as well as patients/consumers to file complaints regarding PBMs (Pharmacy Benefits Managers). APA has created two QR codes that can be printed out for easy access. One is for pharmacists/pharmacies and will take you directly to a page on the Department of Insurance website specifically for the purpose of filing a PBM complaint. The other is for patient use. You may find it useful to print this out and place it where patients can easily access it with the camera on their smart phone.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Board of Pharmacy, Department of Consumer Affairs (DCA) and the Department of Health Care Access and Information (HCAI) issued a reminder to complete the workforce survey. HCAI, in partnership with the Board of Pharmacy and DCA, developed a workforce survey for individuals to complete during the electronic licensure renewal process. Individuals are asked to contribute to this important data collection effort by completing the survey at the time of licensure renewal. Please feel free to contact HCAI at workforcedata@hcai.ca.gov. Answers to frequently asked questions (FAQs) about the HCAI licensure data collection are also posted on the Board’s website under License Renewal Online.
Also in California, NACDS and the California Retailers Association (CRA) submitted a joint letter to the Board of Pharmacy expressing members’ concerns with recent delays in approvals of licenses and permits by the Board of Pharmacy. In the letter, we offered to work with the Board on solutions to this issue to ensure demand for critical medications and other pharmacy services are being met.
Also in California, NACDS and CRA submitted a joint letter to the Senate Appropriations Committee to “opposed unless amended” AB 852, legislation that would revise requirements originally enacted under AB 2789 (Wood, Ch. 438, Statutes of 2018) pertaining to e-prescribing. Of particular concern, AB 852 would require pharmacies to accept electronic prescriptions without advance notice and minus the lead time necessary to build out system capabilities both internally and with external system vendors to accommodate this. NACDS and CRA urge lawmakers to amend the legislation to clarify that pharmacies do not have to accept electronic prescriptions from software vendors without a mutually agreeable contractual relationship with a pharmacy that includes assurances of interoperability and complies with applicable laws, regulations and industry standards.
Also in California, the Department of Health Care Services posted the following alerts on the Medi-Cal Rx Web Portal.
- Update: Implementation of Phase I, Wave III – Reinstatement of Prior Authorizations for 11 Drug Classes (July 26)
- Now Active – Reinstatement of Reject Code 88 (July 22)
- Medi-Cal Rx Weekly Wrap-Up for July 15-21 (July 22)
Finally in California, on July 28, Medi-Cal posted the following:
- Alert: “Real Time Eligibility Transactions” – Medi-Cal is currently experiencing intermittent technical difficulties with the Point of Service system network for eligibility transactions submitted by Leased Line users.
- News: “Coming Soon: Laboratory Test CPT Code for the Orthopoxvirus” – New CPT code 87593 created to streamline the reporting of moneypox testing. A notification for claims submission to follow.
- News: “Update for Paper RADs and No Pay Documents” – The discontinuance of paper RAD, Electronic Fund Transfer and No Pay documents has been extended. No future discontinuance date has been announced.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Board of Pharmacy will hold a virtual Stakeholder Meeting on August 5th on multiple proposed revisions including Rule 17 (Collaborative Pharmacy Agreements); Appendix C (Statewide Protocol for Pre-Exposure and Post-Exposure Prophylaxis of HIV (Human Immunodeficiency Virus)); Appendix A (Statewide Protocol for Prescribing Hormonal Contraceptive Patches and Oral Contraceptives), and the Colorado Self-Screening Contraception Risk Assessment Questionnaire to include Vaginal Rings and Depot Medroxyprogesterone Acetate (DPMA); and the proposed Appendix E (Proposed New Statewide Protocol for Statin Therapy). Potential considerations to revise the rules to implement new legislation concern: Colorado Senate Bills 22-116, 22-173, 22-027, and 22-098; and Colorado House Bills 22-1235, 22-1246, 22-1326, 22-1115, and 22-1122.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Back-to-School Sales Tax Holiday begins July 27th and runs through August 7th. Florida shoppers are eligible to purchase clothing and school supplies tax-free for the next two weeks.
School-related items include:
- Clothing and shoes, priced $100 or less per item;
- Backpacks, handbags, and wallets, priced $100 or less per item;
- School supplies, priced $50 or less per item;
- Learning aids and jigsaw puzzles, selling for $30 or less;
- Personal computers or personal computer-related accessories, priced up to $1,500.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Illinois Department of Healthcare and Family Services has posted a new Provider Notice regarding Confirmation of Coverage for Continuous Glucose Monitors per Public Act 102-1093.
Also in Illinois, the state’s sales tax holiday begins on August 5th, runs through August 14th, and applies to clothing and footwear with a retail selling price of less than $125 per item and certain school supplies. School supplies are not subject to the $125 threshold.
The Illinois Department of Revenue has released an Informational Bulletin providing comprehensive details including how to handle coupons, exchanges, returns, backorders, etc. It also lists qualifying and non-qualifying items.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
A special session on banning abortion and taxes was convened on Monday, July 25. Pharmacies are promoting an amendment allowing pharmacists prescribing self-administered hormonal contraceptives.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services issued INFORMATIONAL LETTER NO. 2352-MC-FFS outlining the following August 2022 Iowa Medicaid Pharmacy Program Changes effective August 1, 2022.
- New Drug Prior Authorization (PA) Criteria
- Finerenone (Kerendia)
- Odevixibat (Bylvay)
- Pegcetacoplan (Empaveli)
- Changes to Existing PA Criteria
- PCSK9 Inhibitors
- Point of Sale Billing Updates:
- ProDUR Quantity Limits
- Drug Utilization Review (DUR) Update
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) issued a Provider Bulletin to inform all providers rendering services to Louisiana Medicaid members with updates on COVID-19 covered services.
Also in Louisiana, the Board of Pharmacy announced Joe Fontenot, Jr, RPh (registered pharmacists) as their new Executive Director, replacing Malcolm Broussard who retired after serving 23 years.
Finally in Louisiana, the Board issued Bulletin No. 22-01 – Status of Interim Policies From COVID-19 Declaration of Emergency, terminating some of the policies effective May 31, 2022, and further extending some of the policies including the 4:1 pharmacy technician ratio until the end of the calendar year.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Minnesota
The latest issue of the Department of Health’s weekly vaccine update can be found here and includes a link for members to sign up to receive it directly.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
Effective 8/30/2022, all pharmacies located in the state must post physically or electronically a sign at the pharmacy indicating that the pharmacy is licensed and regulated by the Missouri Board of Pharmacy including the Board’s address, telephone number, and email address. The Board will be mailing each pharmacy a sign at no cost prior to August 15th. An electronic version of the sign will also be available for copying after August 1st. The required sign must be prominently posted near the pharmacy in a manner and location that is easily viewable and readable by the public.
Also in Missouri, the New Preferred Drug Searchable Database for MO HealthNet Pharmacy Program is now live.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services published a Notice of Public Hearing for changes to Nebraska Administrative Code (NAC) Title 172, Chapter 1 – Rules of Practice and Procedure Governing Reinstatement of a Health Professional License. The hearing will be held on September 6 at 10:00 a.m. Written comments may be provided no later than the day of the hearing.
Also in Nebraska, the Department of Health and Human Services posted a Notice of Public Hearing for changes to 172 NAC – Wholesale Drug Distributors and 172 NAC 134 – Delegated Dispensing Permits. The hearing will be held on September 7 at 10:00 a.m. Written comments may be provided no later than the day of the hearing.
Also in Nebraska, the Department of Health and Human Services posted the following under Drug Utilization Review (DUR) Resources:
Finally in Nebraska, the Department of Health and Human Services published Provider Bulletin 22-13: Pediatric COVID-19 Vaccinations effective June 17.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Jersey
The New Jersey Board of Pharmacy recently released a letter on its determination to extend the Remote Processing Pilot Program.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New York
As you are aware, late in 2021 several PBM legislative packages were signed into law. Now as the NYS Department of Financial Services is developing regulations, the Department is seeking public comment on a series of issues. Those requests for comments can be found on the Department of Financial Services website: www.dfs.ny.gov/pbm.
The most recent Department request is for public comments about the applicability of the Pharmacy Benefit Manager (“PBM”) laws set forth in New York Insurance Law Article 29, as well as the need for rules to be promulgated thereunder, on PBM conduct while credentialing and re-credentialing pharmacies into a PBM network. View the Request for Public Comments (PDF)
Responses should be emailed to PBM@dfs.ny.gov, with “PBM2022-05” included in the subject line. Failure to include “PBM2022-05” in the subject line may result in your comment not being considered. The deadline for responses is September 9, 2022.
Also in New York, NYS Medicaid recently held a pharmacy sector meeting and discussed the work being done to ensure a smooth transition for pharmacy benefits from Medicaid Managed Care to Fee for Service (FFS). Here are the NYSDOH Pharmacy Benefit transition slides presented at the July 20th Medicaid meeting.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.