New York

On November 14, NYSDOH (New York State Department of Health) hosted its monthly NYRx industry call regarding the Medicaid Fee for Service program. Following agenda items were discussed: 

  • RSV (Respiratory Syncytial Virus) vaccination update: Discussion on recent statewide standard orders from NYSDOH including the most recently issued order for pharmacists to give RSV to pregnant individuals. These resources and others can be found at a dedicated RSV page on NYSDOH’s website. 
  • PrEP (Pre exposure Prophylaxis) testing by pharmacies: Request was made for NYSDOH to partner in enabling pharmacies to provide such testing through needed statutory changes/authorizations. 
  • Pharmacy billing guidance for new generic launches: NYSDOH walked through its process to add generic coverage once a generic becomes available and after that move certain brands to this program. 
  • Refill period: Request made to expand refill period similar to MMC for over the counter (OTC) products (11 refills). NYSDOH discussed their policy and processes in response. 
  • Reminder of Pharmacists as Immunizers 
  • Office of Medicaid Inspector General (OMIG) update: presentation on NYS OMIG’s Recipient Restriction Program and how pharmacies can fill their prescriptions including a number of limitations and additional requirements. Prescriptions cannot be transferred to other pharmacies under the program.  

NYRx also published billing guidance for brand name drugs with new generic launces.  

On November 15, the formal printing of the withdrawal of the PBM regulations by the Department of Financial Services was published. Within the publication are: 

  • Notice of Withdrawal of Rule on Definitions, Licensing of PBMs, Contracting with Network Pharmacies, Acquisition of PBMs, Consumer Protections, and Audits; and 
  • Notice of Adoption regarding Pharmacy Benefits Bureau; Pharmacy Benefit Manager Assessments; Filings and Other Requirements for Issuance 

The New York State Board of Pharmacy held its regular meeting on November 8. Relevant to chain pharmacies, the meeting included the following: 

  • During the Report of the Chair: referenced the State Plan Amendment was approved in August related to Medicaid reimbursement for pharmacist authorized services within their scope, claims to be paid to pharmacies. 
  • During the Report of the Executive Secretary: Central Fill regulations will not be pursued based on comments received and instead plan to address within the broader context of Shared Services. The Long Acting Injectables bill is pending the Governor’s action, plus new self-administered contraceptives in pharmacy law takes effect in 2024. 
  • Discussion on Pharmacy Workplace Issues: The Board discussed the USA Today article on recent events with pharmacy workplace issues/walkouts. The Board discussed how to promote the profession to youth/students to encourage them to go into the profession given enrollment declines, shortages, and related challenges. The Executive Secretary reported receiving requests that the Board should take up regulations to address this like regulating quotas, but noted its regulations follow statutory changes providing authority, which has not happened. One member of the board noted receiving feedback that there are pharmacist shortages, so pharmacies are being forced to close causing access issues.  

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

2023-11-17T11:01:27-05:00November 17, 2023|New York|

Ohio

The Senate Health Committee held the third and final hearing on SB (Senate Bill) 144, sponsored by Sen. Mark Romanchuk (R). The bill would allow pharmacists and technicians to provide all ACIP (Advisory Committee on Immunization Practices) immunizations to children. Witness testimony from all three hearings has been posted on the committee page. We are cautiously optimistic the bill will be reported from the committee before the holiday break but do not expect action in the House until 2024.  

Also in Ohio, the Board of Pharmacy has issued the following rule updates: 

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

2023-11-17T11:00:35-05:00November 17, 2023|Ohio|

Oklahoma

Pursuant to “Technician Rules for Administering Immunizations [535:15-13-6.1] rules, a permitted Oklahoma pharmacy technician must have successfully completed an Accreditation Council for Pharmacy Education (ACPE) immunization training program for technicians. All technician applications submitted must include the initial training Certificate of Completion / Achievement from one of the accredited programs: APHA (American Pharmacists Association), PTCB (Pharmacy Technician Certification Board), ACA, ASHP (American Society of Hospital Pharmacists), NPTA or Purdue University.

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

2023-11-17T10:59:32-05:00November 17, 2023|Oklahoma|

Oregon

The Board of Pharmacy posted the November 2023 Newsletter including the following headlines: 

  • No. 723 New Rules for Pharmacists, Interns/Preceptors, Certified Oregon Pharmacy Technicians/Pharmacy Technicians, Board Administration, and Universal Rules – Effective March 1, 2024 
  • No. 724 Coming Soon! Updated and New Rules Related to Short-Acting Opioid Antagonists and Immunizations
  • No. 725 Rulemaking 
  • No. 726 Compliance: Updated Inspection Processes, Requests for Additional On-Site Inspections, and a Reminder About Prescriptions from Veterinarians 
  • No. 727 Licensing: How to Update Outlet Contact Information and Pharmacist Work Email in e-Gov 
  • No. 728 Minutes for Board-Related Meetings 

Also in Oregon, the Oregon Health Authority announced the Immunization Policy Advisory Team (IPAT) will meet on December 7 and posted an agenda for this meeting. 

Finally in Oregon, the Department of Consumer and Business Services will be hosting a public hearing on prescription drug prices on December 7 from 1:30 pm to 4:00 pm via Zoom.   

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

2023-11-17T10:58:43-05:00November 17, 2023|Oregon|

Pennsylvania

Medicaid plans to implement a system to reimburse pharmacies for a variety of services within their current scope of practice by the end of the first quarter of 2024. We understand these would include immunizations, counseling, and diabetes management and would apply to the Fee-For- Service and the Managed Care Program. We expect DHS (Department of Human Services) (Department of Human Services) to release a Bulletin announcing the new program in December. NACDS will provide updates as we receive them, including instructions on enrollment. NACDS has been supporting member and in-state efforts to develop the program.

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

2023-11-17T10:58:05-05:00November 17, 2023|Pennsylvania|

Tennessee

TennCare’s updated dispensing fees took effect on November 1. TPA (Tennessee Pharmacists Association) is interested in collecting feedback on whether your pharmacy is receiving the updated dispensing fees from TennCare and other obligated payors. Please reach out to olivia@tnpharm.org with any feedback or questions  

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

2023-11-17T10:57:33-05:00November 17, 2023|Tennessee|

Texas

NACDS sponsored the Texas Federation of Drug Stores’ (TFDS) Legislative Champions reception and dinner in Austin last week, honoring State Sen. Pete Flores (R) and State Rep. Four Price (R), sponsors of the immunization bill that would have made PREP Act permanent, and State Rep Stephanie Klick (R), the House Public Health Committee Chair and sponsor of our Medicaid U&C (usual & customary) bill. 

Also in Texas, the Board of Pharmacy held a quarterly meeting on November 7. The new Executive Director/Secretary Danny Carroll Pharm.D., R.Ph., presided over his first Board meeting. 

Also, in Texas, before the third 30-day special session adjournment, the Legislature sent Gov. Greg Abbott (R) two pieces of legislation before adjourning the third Special Session on November 7. SB 4 by Sen. Pete Flores (R) addressed border security, and HB (House Bill) 7 by Rep. Jeff Leach (R) and Sen. Mayes Middleton (R) prohibits private employers from adopting policies that require the COVID-19 vaccine as a condition of employment. The Governor is expected to sign both bills into law. 

Also in Texas, immediately after the end of the third special session. Gov. Greg Abbott (R) announced a fourth special session on school choice and border security. 

Also in Texas, the Health, and Human Services Commission (HHSC) published an annual report on the Prescription Drug Rebate Program for health benefit programs administered by HHSC System: Texas Medicaid Program, Children’s Health Insurance Program (CHIP), Kidney Health Care (KHC) Program, Children with Special Health Care Needs (CSHCN) Services Program and the Healthy Texas Women (HTW) Program. 

Also in Texas, Medicaid clarified the new policy implementing HB 916 passed earlier this year that amends Section 1369.102 of the Texas Insurance Code to require health benefit plans, including Medicaid fee-for-service and managed care, to follow certain quantity supply criteria for prescription contraceptive drugs. The Medicaid fee-for-service and managed care policy is effective January 1, 2024. 

Finally in Texas, the November 7 election results: 

  • Texas voters approved 13 of the 14 constitutional amendments.
  • State Sen. John Whitmire (D) and U.S. Congresswoman Sheila Jackson Lee (D) are headed to a December runoff in Houston’s mayoral race. 
  • In Texas State House District 2, Jill Dutton (R) and Brent Money (R) advance to runoff for a House special election replacing expelled former state Rep. Bryan Slaton (R).  

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

2023-11-17T10:56:56-05:00November 17, 2023|Texas|

Virginia

Pursuant to passage SB 1538 of 2023, DMAS (Department of Medical Assistance Services) is building and implementing a pharmacy payment for services claims they have dubbed “PAP” (Pharmacists as Providers) system. Tomorrow they will publish a new Supplement to the Pharmacy and Practitioner Manuals adding billing instructions for the new system. Please review the Supplement and share your comments with Jill McCormack as soon as possible. Comments are due to DMAS on November 30.  

DMAS is hosting a Pharmacists as Providers (PAP) educational session for interested parties (in-person and virtually) on November 30 from 1:00 pm to 4:00 pm at 600 E. Broad Street in Richmond. To attend virtually, register here. here. 

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

2023-11-17T10:56:18-05:00November 17, 2023|Virginia|

Washington

CMS approved the Washington State SPA (State Plan Amendment), implementing the new updated July 1, 2023, dispensing fees based on the Oregon dispensing fee tiers. Washington Medicaid will soon be paying pharmacies the higher dispensing fees as well as making retroactive payments.  

Also in Washington, the Pharmacy and Family Planning Programs within the Clinical Quality Care Transformation division at the Health Care Authority is requesting pharmacy staff complete this pharmacy contraceptive access survey about barriers and solutions in prescribing and dispensing contraception. 

Also in Washington, in observance of Thanksgiving, the Health Care Authority’s offices will be closed on November 23 and 24. Provider payments for the week of November 20 will be made on November 22, including the delivery of Remittance Advices (RAs) and HIPAA (Health Insurance Portability and Accountability) 835 remittance files. 

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

2023-11-17T10:55:46-05:00November 17, 2023|Washington|

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