California
On June 1, Legislative Leaders announced a 2022-2023 Joint Budget Agreement that contains budget priorities from the Assembly and the Senate as well as elements of the Governor's budget proposals. The agreement provides an overall plan to provide relief to families and small businesses, including $142.8 million over two years designated to forgive recoupment of pharmacy reimbursement rate reductions in Medi-Cal from prior years for independent pharmacies. NACDS and the California Retailers Association (CRA) have been advocating in recent months for forgiveness of the Medi-Cal Recoupments for all pharmacy providers. On June 3, NACDS and CRA submitted a joint letter to Gov. Gavin Newsom (D) urging him to allocate the $142.8 million for Medi-Cal pharmacy rate recoupment to all applicable pharmacies, including chains.
Also in California, the Department of Health Care Services posted the following alerts and notices on the Medi-Cal Rx Web Portal.
- Coordination of Benefits – Billing Medicare Part B and D Claims (June 6)
- Medi-Cal Rx Coordination of Benefits (COB) Reminder (June 6)
- Medi-Cal Rx Checkwrite Schedule – State Fiscal Year 2022-23 Available (June 3)
- Medi-Cal Rx PAVE Enrollment for ORP Providers (June 3)
- Medi-Cal Rx Newborn Claims (June 3)
- Medical Rx Weekly Wrap-Up for May 27-June 2 (June 3)
Finally in California, the Board of Pharmacy has posted the following documents for its Full Board Meeting to be held on June 16.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maine
The Maine Board of Pharmacy has released its minutes from April and May meetings. The next Board meeting will be on August 4.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts
The Massachusetts Board of Pharmacy has updated its Policy 2022-03 which deals with unfilled Prescriptions. The Board decided to update the policy based on information from the DEA to allow pharmacies to send unfilled electronic prescriptions for federally controlled substances, including CII, to another pharmacy for initial fill. This can be done either by verbal transfer or election transmission, but methods must be pharmacist-to-pharmacist and follow the transfer requirements of 21 CFR section 1306.25. The next Board of Pharmacy meeting is scheduled for August 4.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Minnesota
HF 4065, an omnibus health care bill was signed into law by Gov. Tim Walz (D). The bill includes a provision that allows pharmacists to administer intramuscular and subcutaneous drug injections and to place drug monitoring devices according to prescription, protocols, or collaborative practice agreements.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New York
Before the New York State Legislature recently adjourned, both Houses passed legislation (A3040B-S4807B) which would authorize pharmacists to administer long-acting injectable medication for MH/SUD per a prescription or order. In addition, the legislature rejected efforts to delay or repeal the planned FFS (Fee for Service) transition of the pharmacy benefit set to take effect on April 1, 2023.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Department of Medicaid (ODM (Ohio Department of Medicaid)) has published an important update regarding the implementation of the Single Pharmacy Benefit Manager (SPBM). The update clarifies that reimbursement rates for the new program will be announced later this month, that Gainwell has launched a new webpage that includes important program information and useful guides including the SPBM Pharmacy Reference Guide (Provider Manual). The website will continue to be updated with information for members, pharmacies, and prescribers. Lastly, they have also released an updated version of their SBPM FAQ (Frequently Asked Questions), which includes answers to many questions NACDS had previously submitted on behalf of members.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Rhode Island
The Department of Health has announced their endemic strategy for COVID-19 vaccination and testing.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Governor Bill Lee (R) has signed HB2228, effective July 1, 2022, under this measure, prescribers are required to include a prescription for naloxone hydrochloride or another opioid overdose reversal agent with any opioid prescription. This only applies for prescriptions of more than a 3-day supply of an opioid medication, when prescribed concurrently by the same provider with a benzodiazepine, when the patient presents an increased risk for overdose, or the patient at substantial risk of witnessing an opioid overdose event. Violations of this measure are considered a Class D felony.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
West Virginia
On June 2, the Insurance Commission filed the Pharmacy Auditing Entities and Pharmacy Benefit Managers Rule with an effective date of July 1, 2022. This rule is pursuant to passage of HB (House Bill) 2263 of 2021. The new rule amends the current rule relating to Pharmacy Audits that was effective on April 1, 2021 and remains in effect.
Also in West Virginia, The Insurance Commission has proposed a rule 114CSR99 to reflect changes to the WV Code because of the passage of Enrolled HB 4112 which was approved by Governor Justice on March 30, 2022. The rule will be considered by the Legislative Rule Making Review Committee during the 2022 legislative interims and put before the WV Legislature for approval in 2023. If you have comments, please email them to Jill McCormack before the close of business on June 23. Otherwise, you may email them to michael.n.malone@wv.gov of the Insurance Commission by 5pm on July 5, 2022.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Arkansas
Attorney General Leslie Rutledge announced a lawsuit against drug manufacturers and Pharmacy Benefit Managers (PBMs) for manipulating and inflating insulin and drug prices in Arkansas. In the complaint filed in Pulaski County, Attorney General Rutledge alleges that Novo Nordisk, Sanofi, and Eli Lilly conspired with Express Scripts, Caremark and Optum to significantly increase their revenues by unfairly and deceptively driving up the costs of insulin, making insulin, and other diabetic treatments unaffordable for many diabetics in Arkansas and creating an enormous financial burden for Arkansas consumers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy announced its June meeting schedule.
- June 16, 2022 – Petitioner Board Meeting
• June 22, 2022 – Standard of Care Ad Hoc Committee Meeting
• June 22, 2022 – Medication Error Reduction and Workforce Ad Hoc Committee Meeting
Also in California, Gov. Gavin Newsom (D) appointed Jessica Crowley to the Board of Pharmacy. Having held a variety of positions within CVS pharmacy between 2010-2020, Dr. Crowley has been a staff pharmacist for Pavilions Pharmacy since 2020. She is a member of Lambda Kappa Sigma, United Food and Commercial Workers, the California Pharmacists Association and Phi Lambda Sigma.
Also in California, this week, the Department of Health Care Services (DHCS) announced its plans for Medi-Cal Rx Reinstatement of Claim Edits and Prior Authorizations. DHCS along with Magellan hosted a series of webinars to provide an overview of a phased approach for reinstatement of safety edits and prior authorizations and the phasing out of the Transition Policy. Stakeholder feedback has been fundamental to the reinstatement design and will remain a critical component throughout the reinstatement process. DHCS is requesting stakeholder feedback to refine the approach to reinstatement. Stakeholders who would like to submit comments may do so through the close of business on June 10 via email to Reinstatement@dhcs.ca.gov.
Finally in California, the Department of Health Care Services posted the following alerts and notices on the Medi-Cal Rx Web Portal.
- Age Restrictions on Psychotropics Updated (June 1)
- Medi-Cal Rx Monthly Bulletin for June (June 1)
- Changes to Contract Drugs List (CDL) (June 1)
- Changes to Contract Drugs List (CDL) – Over-the-Counter Drugs (June 1)
- Updates to the Medi-Cal Rx Provider Manual (June 1)
- Maximum Allowable Ingredient Cost (MAIC) 30-Day Pharmacy Provider Notice (June 1)
- Medical Supplies Prescriber Updates (June 1)
- Diabetic Supplies Updates (June 1)
- Medi-Cal Rx Checkwrite Schedule – State Fiscal Year 2021-22; Hold Notation Update (May 27)
- Reminder: Fiscal Year Two-Week Fee-For-Service Hold for Specific Provider Payments (May 27)
- Medi-Cal Rx Weekly Wrap-Up for May 20-26 (May 27)
- Changes to Family PACT Pharmacy Formulary (May 26)
- Medi-Cal Rx Updated FAQs (May 23)
- Medi-Cal Rx Weekly Wrap-Up for May 13-May 19 (May 20)
- Submitting a Claim – Best Practices (May 19)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
Governor JB Pritzker (D) has signed HB4595, on May 13, 2022, effective July 1, 2022, this legislation amends the state’s insurance contract and provides that a contract between a pharmacy benefit manager or third-party payer and a covered entity under the 340B program may not contain certain provisions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kentucky
On June 1, Medicaid filed concurrent emergency and ordinary regulations making changes to the 340 (B) program and increasing the frequency of permitted dispensing fees for drugs to treat substance abuse disorders to weekly.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH) has recently updated its Medicaid COVID-19 vaccine billing schedule adding reimbursement for booster doses for ages 5-11.
Also in Louisiana, LDH requested NACDS remind pharmacies that file claims with Louisiana Medicaid must enroll in Medicaid's new web‐based provider enrollment portal by June 30, 2022. Any existing Medicaid providers that do not submit an application to initiate the screening process through the new portal will have their claims denied.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
Last year, the legislature passed LD 8 which established a prescription drug take-back program in Maine for pharmacies. Pharmacies will have the choice of a secure collection kiosk or offering customers a voucher for a mail-back envelope to properly dispose of unused prescription medications. Drug manufacturers are due to submit a plan to the Maine Department of Environmental Protection (DEP) by July 1, 2022.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Maryland
A bill, HB299, allowing pharmacists to administer injectable medications for the treatment of sexually transmitted infections became law last week and will be effective Oct. 1, 2022, pending the adoption of regulations.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The Michigan Department of Health and Human Services (MDHSS) has updated the Medicaid PDL (Preferred Drug List) effective 6/1/2022.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
Pharmacy technician licenses expired May 31, 2022. Any technician that did not renew cannot work until the Board office has renewed their license. While the online renewal option ended on May 31st, a paper renewal is available online.
The Department of Commerce and Insurance's (DCI) Department of Health and Senior Services (DHSS) is opening its application portal for pharmacies to receive and dispense the oral antivirals Paxlovid and Lagevrio (Molnupiravir) to COVID-19 patients with prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
On May 13, the Department of Public Health, and Human Services (DPHHS) revised its Provider Revalidation Extension. The following is currently posted on the DPHHS website:
"On December 13, 2021, Montana Healthcare Programs began sending revalidation notices to providers who are due for provider revalidation. The letters specify a due date. Montana Healthcare Programs is extending the required revalidation date for any provider who has received a revalidation notice. This extension is primarily due to a known system issue that is creating challenges for some providers when trying to revalidate. Providers should not attempt to revalidate their provider information at this time. Notices will be posted when the online revalidation feature is working properly. Providers will be given a minimum of 90 days
to complete revalidation activities once notification has occurred."
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
The Department of Health and Human Services posted the COVID-19 Pediatric Vaccine Update effective May 17.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on July 6 at noon (Central).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Hampshire
The New Hampshire legislature passed SB229 and it is on its way to the Governor for his signature. This measure allows licensed or certified pharmacy technicians to administer vaccines under the supervision of a licensed pharmacist. To administer vaccines, pharmacy technicians must be registered with the board and must have completed training that includes hands-on injection techniques and the recognition and treatment of emergency reactions to vaccines.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New Jersey
NACDS submitted a letter to the New Jersey Board of Pharmacy asking the Board to extend the Remote Processing Pilot until the rulemaking to permanently allow for this activity is finalized. Although the Board has already initiated rulemaking to allow remote processing more broadly, the pilot is scheduled to expire at the end of June and therefore must be extended for participating pharmacies and pharmacy personnel to continue to engage in remote processing activities.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
State Health Director Dr. Betsey Tilson issued an updated COVID-19 Vaccine Standing Order that includes booster for patients between 5-11 years old.
You can find all the statewide standing orders for pharmacists at the Department of Public Health website provided here.
Also in North Carolina, the most recent North Carolina Medicaid Pharmacy Newsletter can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Board of Pharmacy posted the June 8-10, 2022 Board Meeting agenda and meeting materials.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
Governor Henry McMaster (R) signed SB628 on May 23, 2022. The hormonal contraceptives bill, which was amended to include Central Fill, will take effect upon the issuance of written joint protocol by the Board of Medical Examiners and the Board of Pharmacy, not later than six months from passage.
Also in South Carolina, the Department of Health, and Human Services (SCDHHS) has announced it is seeking feedback on its draft "South Carolina Medicaid Quality Strategy." The draft document is available here on SCDHHS' website. The agency will collect public comments on the draft document until June 18, 2022.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.