Oregon

The Board of Pharmacy issued a public notice of and agenda for its Strategic Planning Meeting scheduled to be held November 8-9, 2023. See agenda for details to participate in the meeting either in-person or virtually. 

Also in Oregon, On August 11, 2023, the Oregon Board of Pharmacy voted to permanently adopt, effective March 1, 2024, OAR 855-115-0150(3) Pharmacist: Prohibited Practices. This rule says that pharmacists are not allowed to diagnose patients. The Board adopted this rule because there is no authority in ORS chapter 689 for pharmacists to diagnose and the Board wanted to make sure that pharmacists know this. On September 25, 2023, the Oregon Board of Pharmacy received a petition to repeal OAR 855-115-0150(3) pursuant to OAR 137-001-0070 Petition to Promulgate, Amend, or Repeal Rule; see below for details. 

Proposed Amendments: OAR 855-115-0150(3) Pharmacist: Prohibited Practices 

Petitioner’s proposed amendment: 

“Pharmacists must not:” 

“(3) Diagnose.” 

Pursuant to OAR 137-001-0070(3), the Board of Pharmacy is inviting written public comment on the adopted rule, including 

(a) Options for achieving the existing rule’s substantive goals while reducing the negative economic impact on businesses; 

(b) The continued need for the existing rule; 

(c) The complexity of the existing rule; 

(d) The extent to which the existing rule overlaps, duplicates, or conflicts with other state or federal rules and with local government regulations; 

(e) The degree to which technology, economic conditions, or other factors have changed in the subject area affected by the existing rule, since the agency adopted the rule; and 

Written public comments may be submitted to the Board of Pharmacy by email at pharmacy.rulemaking@bop.oregon.gov. The public comment period will close on November 15 at 4:30 pm. The board will review the public comments received at the December board meeting and will in writing, within 90 days after receipt of the petition, either deny the petition or initiate rulemaking proceedings pursuant to OAR 137-001-0070(4)(c). If you have any questions, please reach out to the Rules Coordinator, at pharmacy.rulemaking@bop.oregon.gov. 

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

2023-10-27T11:55:33-04:00October 27, 2023|Oregon|

Texas

The third special session ends November 7, so lawmakers only have a short window of time to move forward on the Governor’s priority legislation on school vouchers and funding, prohibiting private employer COVID mandates and border security. Gov. Greg Abbott (R) has hinted at the possibility of a fourth special session if his school vouchers proposal does not pass.  

Also in Texas, HEB’s Austin Pharmacy and Wellness teams toured NACDS Texas lobbyists through two HEB facilities, educating our team on the operations and healthcare services provided to the local community. 

Also in Texas, Gov. Greg Abbott (R) appointed Raymond Charles Winter as Inspector General for Texas Health and Human Services, replacing Sylvia Hernandez Kauffman, who served for six years.  

Also in Texas, the Health, and Human Services Commission’s (HHSC) Department of State Health Services (DSHS) is hosting an Immunization Webinar on November 8. Topics include influenza programs, adult immunizations, current disease rates and strategies to improve immunization coverage. 

Finally in Texas, HHSC’s DSHS’ announced a $4 million dollar grant to help implement policies and programs to prevent the use of dangerous drugs like fentanyl. The agency will create new tools to analyze the causes and effects of drug poisoning and then use that information to develop science-based strategies to prevent drug use and poisonings. 

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

2023-10-27T11:54:40-04:00October 27, 2023|Texas|

Virginia

The Department of Medical Assistance Services (DMAS) has invited pharmacy stakeholders to participate in a webinar on October 30 regarding the upcoming implementation of a system to reimburse pharmacies for clinical services as mandated by the passage of HB (House Bill) 1538 of 2023. DMAS also released the presentation from the previous workgroup meeting. DMAS intends to reimburse pharmacies for all the services added to pharmacy scope of practice over the last several legislative sessions, including immunizations and test & treat. DMAS is specifically interested in guidance from pharmacies as they build the claims system. NACDS suggests that members share the invite with staff with expertise in this area.  

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

2023-10-27T12:58:50-04:00October 27, 2023|Virginia|

Washington

Since the settlement and dismissal of our six-year-old lawsuit against the State of Washington for its below cost dispensing fees, NACDS, NCPA (National Community Pharmacists Association) and the Washington State Pharmacy Association have been monitoring the state’s compliance with its obligations. In terms of the state’s obligation to pursue a cost of dispensing study, the state issued a “work request” for a vendor to do the study on September 19, with the deadline for responses due October 21. The cost of dispensing study is supposed to start November 1. In terms of the retroactive payments to pharmacies for April 2017 through June 2023, the state reports that the process is in place and payments should be starting very soon. As for implementing the adjusted dispensing fees effective July 2023, the state needs CMS’ approval of the state plan amendment (SPA) pending before CMS with those new dispensing fees first. The state anticipates such approval to be forthcoming.  

Also in Washington, the State Department of Health Office of Health Professions is hosting a Vaccine Fatigue Webinar on November 3.  

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

2023-10-27T11:33:34-04:00October 27, 2023|Washington|

Alabama

The Board of Pharmacy announced renewals for pharmacy technicians, pharmacy interns and facilities are open as of September 15 and are due December 31, 2023. Visit our website to renew and find more information. 

Also in Alabama, at the last Joint Committee meeting, both Board of Pharmacy and Board of Medical Examiners discussed the topic of Test to Treat in community pharmacies. Both Boards decided to begin the Rule-making process to amend our Rule to allow for Test to Treat under certain conditions. To learn more about what conditions must be met before beginning Test to Treat, you can view the drafted language on the website.

Furthermore, the Boards will also soon be reviewing a test-to-treat protocol that was approved at the last Joint Committee meeting. You can view the draft test-to-treat protocol here. For more information, reach out to anolen@albop.com 

The emergency rule 680-X-2-.49-.01ER Remote Work by Pharmacists is currently in place until October 29, 2023. The permanent rule is effective November 13, 2023. 

Finally in Alabama, please see the most recent Alabama Medicaid ALERT related to resuming the cumulative MME (morphine milligram equivalents) phase-down edits, effective November 1, 2023. This will be the first MME phase-down since the end of the PHE (Public Health Emergency).  

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

2023-10-20T12:24:14-04:00October 20, 2023|Alabama|

Alaska

The Board of Pharmacy is proposing to adopt regulation changes dealing with adding a retired status pharmacist license and implementing additional statutory changes to AS 08.80 under Chapter 15, SLA 2023 (HB (House Bill) 112). Written Comments should be submitted to RegulationsAndPublicComment@alaska.gov by November 16, 2023 

Also in Alaska, the Department of Commerce, Community and Economic Development – Division of Corporations, Business and Professional Licensing is proposing to remove all language referencing registrations and to add retired status pharmacist license fee. Written Comments should be submitted to RegulationsAndPublicComment@alaska.gov by November 16, 2023. 

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

2023-10-20T12:23:42-04:00October 20, 2023|Alaska|

California

Gov. Gavin Newsom (D) signed two bills, supported by NACDS, including AB (Assembly Bill) 1341 (Chapter 276, Statutes of 2023), legislation permitting pharmacists to provide COVID-19 medication as well as offer broader options for substance use disorder treatments as specified in the bill, and AB 317 (Chapter 322, Statutes of 2023), legislation helping to support patient access to essential healthcare services provided by pharmacists by requiring healthcare service plans that cover care that is otherwise within pharmacists’ scope of practice to reimbursement pharmacy providers for delivering those services. 

Also in California, Gov. Gavin Newsom (D) signed SB (Senate Bill) 786 (Chapter 414, Statues of 2023), legislation related to 340B, prohibiting PBMs from discriminating against a covered entity or its pharmacy in connection with dispensing a drug subject to federal pricing requirements or prevent a covered entity from retaining the benefit of discounted drug pricing for those drugs. 

Also in California, Gov. Gavin Newsom (D) signed AB 1286 (Chapter 470, Statutes of 2023), legislation sponsored by the Board of Pharmacy and opposed by NACDS and for which we urged him to veto because the legislation that would impose arbitrary staffing limits and impede pharmacies’ ability to optimize the use of pharmacy technicians to assist with technical duties that do not require a pharmacist’s professional judgement. This bill authorizes a pharmacy technician under the direct supervision and control of a pharmacist to prepare and administer influenza and COVID-19 vaccines, prepare, and administer epinephrine, perform specimen collection for specified tests, receive prescription transfers and accept clarification on prescriptions. The bill would prohibit a pharmacy with only one pharmacist from having more than one pharmacy technician performing these additionally authorized tasks unless the pharmacy has scheduled another pharmacy technician to assist the pharmacist with performing the nondiscretionary tasks currently authorized under existing law.  

Among the other provisions, the bill requires a pharmacist-in-charge or pharmacist on duty to immediately notify store management of any conditions that present an immediate risk of death, illness or irreparable harm to patients, personnel or pharmacy staff and requires store management to take immediate and reasonable steps to address and resolve those conditions. If those conditions are not resolved within 24 hours, it requires the pharmacist-in-charge or pharmacist on duty to notify the Board of Pharmacy. The board’s executive officer may choose to issue a cease-and-desist order, upon a reasonable belief that conditions within a pharmacy exist that present an immediate risk of death, illness or irreparable harm to patients, personnel, or pharmacy staff. Also in the bill, a chain community pharmacy, having 75 or more stores in California under the same ownership, must always be staffed with at least one clerk or pharmacy technician fully dedicated to performing pharmacy-related services with defined exceptions. Additionally, the bill requires a licensed community pharmacy to report all medication errors to an entity approved by the board.  

Also in California, Gov. Gavin Newsom (D) vetoed AB 782, legislation that would have excluded reconstitution of a drug pursuant to a manufacturer’s directions, tablet splitting or crushing, capsule opening or the addition of a flavoring agent from the Pharmacy Law’s definition of compounding. 

Also in California, on October 16, the Board of Pharmacy released the following message: 

Today this the start of National Pharmacy week, and the California State Board of Pharmacy would like to take this time to thank all pharmacy personnel for your hard work and professionalism to your patients. 

Each job plays an important part in providing the highest quality of care. According to recent statistics, more than 90% of Americans live within five miles of a community pharmacy, making your care accessible to millions of people. 

Thank you for your commitment to patient care and safety. 

Thank you! 

Also in California, the Department of Health Care Services (DHCS) posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal. Please note the postponed implementation date for Reject Code 80; see alert for details. DHCS (Department of Health Care Services) anticipates Reject Code 80 will be reinstated before the end of 2023. They have initiated efforts to more precisely communicate the diagnosis requirements that will be reinstated and will provide a 30-day notice prior to this reinstatement. Also, as a reminder, on November 10, Medi-Cal Rx will proceed with the reinstatement of the Enteral Nutrition transition policy for members ages 22 years and older and the Brand Medically Necessary (BMN) PA (prior authorization) requirements will also be reinstated on November 10. 

Finally in California, Medi-Cal posted the following: 

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

2023-10-20T12:23:03-04:00October 20, 2023|California|

Florida

The Agency for Health Care Administration (Agency) announces that it is soliciting comments from providers which it will consider as part of the re-procurement of the Statewide Medicaid Managed Care (SMMC) program. (See Section 409.966(3)(a)(8), F.S.)  

The Invitations to Negotiate (ITNs) and information about the re-procurement, including anticipated timelines and instructions for submission of provider comments, can be found on the Department of Management Services’ Vendor Bid System at: MyFloridaMarket Place Vendor Information Portal.  

Key dates to note are: 

October 27, 2023: Anticipated Posting of ITN (invitation to negotiate) Respondent Names for Provider Comment 

November 9, 2023: Deadline for Receipt of Provider Comments, due by 5:00 PM 

The reference number for the SMMC program ITN is AHCA (Agency for Health Care Administration) ITN 010-22/23.  

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

2023-10-20T12:20:48-04:00October 20, 2023|Florida|

Illinois

Effective October 1, 2023, due to the increased prevalence of Respiratory Syncytial Virus (RSV), providers may submit prior approval requests for Synagis (palivizumab). This applies to customers covered under Medicaid fee-for-service or a managed care plan. Providers should contact the appropriate managed care plan for approval guidance. For fee-for-service customers, providers must complete the Drug Authorization Request Form for Synagis and fax it to the Pharmacy Unit at 217-524-7264. Approval for the early dosing will be provided for those customers who meet the Department’s Synagis Prior Approval Criteria.  

For both fee-for-service and managed care customers, the approval period for the dose will be effective through February 29, 2024. The Department will continue to monitor for necessary changes. This is a temporary deviation from the usual Synagis guidelines, and the Department will continue to monitor RSV prevalence and respond accordingly. 

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565, or to the appropriate managed care plan.  

Also in Illinois, the Department of Healthcare and Family Services (HFS) is notifying all pharmacies of billing instructions for the new commercial COVID-19 vaccines now in circulation. These instructions apply to the fee-for-service program only.  

As HFS is still finalizing programming for the administration fee for the COVID vaccine, pharmacies cannot use “MA” in the Professional Service Code Field, nor add the administration fee until the new programming is complete. Pharmacies can still provide COVID-19 vaccinations and submit claims to HFS for reimbursement for the cost of the vaccination plus a dispensing fee as they would for other vaccinations that do not pay an administration fee.  

Once the programming is complete, pharmacies can then void and rebill for services rendered to receive the full payment including the applicable administration fee.  

A provider notice will be sent to pharmacies once programming is complete and pharmacies can bill for the administration fee. The void and rebill process to receive full payment for claims that were submitted without receiving the administration fee can commence at that time.  

Questions regarding this notice may be directed to a pharmacy consultant in the Bureau of Professional and Ancillary Services at 877-782-5565. 

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

2023-10-20T12:19:49-04:00October 20, 2023|Illinois|

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