New York
The New York State Department of Health (NYS DOH) announced the Centers for Medicare & Medicaid Services (CMS) approval of New York’s section 1115(a) demonstration waiver. This approval is effective from April 1, 2022 through March 31, 2027. In accordance with federal guidelines, the State has 30 days to accept the related Standard Terms and Conditions (STCs), which is an operating agreement between the State and CMS.
The NYSDOH 1115(a) waiver request included a white paper which structured the waiver request proposal around four subsidiary goals:
- Building a more resilient, flexible and integrated delivery system that reduces racial disparities, promotes health equity, and supports the delivery of social care;
- Developing supportive housing and alternatives to institutions for the long-term care population.
- Redesigning and strengthening health and behavioral health system capabilities to provide optimal response to future pandemics and natural disasters; and
- Creating statewide digital health and telehealth infrastructure
The CMS approval letter can be found on the NYS DOH website here.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Medicaid coverage season for Synagis will end March 31, 2022. Pharmacy providers should not submit point of sale claims with date of service after March 31, 2022, for any prior authorization granted during the eight-month extended coverage season from Aug. 15, 2021, to March 31, 2022. Physician providers should submit an EPSDT request for coverage of Synagis beyond March 31, 2022. More information can be found here.
Also in North Carolina, as indicated in the previously issued standing order, which allows qualified pharmacists' authority to initiate hormonal contraceptive therapy, immunizing pharmacists "who provide contraception products in accordance with this standing order must also complete North Carolina Hormonal Contraception Training Program." The North Carolina Association of Pharmacists (NCAP) has produced this training program, which is now available here. The Board of Pharmacy has agreed to fund the training program for up to 6,000 North Carolina resident pharmacists over the next 12 months. NCAP will maintain records of pharmacists who have completed this training. Board staff are adding a "Contraceptive Trained" status button to each pharmacist's Board of Pharmacy on-line profile. Once that status button is added, pharmacists will be notified and must log on to their Board profile to record their training (just as pharmacists currently update vaccinator status and long-acting injectable trained status).. ard staff will notify pharmacists as soon as this status update option is operational.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Pennsylvania
Physician General Dr. Denise Johnson issued an updated naloxone standing order to include a form of eight milligram naloxone nasal spray. NACDS reminds members that Pennsylvania has a broad program that will reimburse pharmacies for patient copayments for naloxone when the patient is hesitant to pay and any patient with any type of insurance coverage is eligible. For more detail, see the program bulletin and detailed adjudication specifications.
For more information, contact NACDS' Jill McCormack at 717-525-8962.
Tennessee: Renee Williams-Clark has left TennCare as Chief Pharmacy Officer. Lorraine Buerhaus has been named interim CPO. Pharmacists interested in applying for this position can do so here.
Also in Tennessee, The Institute for Safe Medication Practices (ISMP) will present its free online seminar, "Diversion is a Threat to Patient Safety: Adopting Best Practices for Safe Management of Controlled Substances," on April 6, 1-2 pm ET.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Renee Williams-Clark has left TennCare as Chief Pharmacy Officer. Lorraine Buerhaus has been named interim CPO. Pharmacists interested in applying for this position can do so here.
Also in Tennessee, The Institute for Safe Medication Practices (ISMP) will present its free online seminar, "Diversion is a Threat to Patient Safety: Adopting Best Practices for Safe Management of Controlled Substances," on April 6, 1-2 pm ET.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Vermont
The Vermont Office of Boards, Commissions & Public Service announced that there was a vacancy on the Board of Pharmacy. If a Vermont pharmacist is interested in filling the vacant spot the application for filling the new position can be found here. The next Board of Pharmacy meeting is April 27.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Virginia
Two conference committee reports, HB 1323, and SB 672, that would make pharmacists’ and technicians’ immunization and testing authority permanent have been approved by the General Assembly and are Governor Youngkin’s desk. The bills would also allow pharmacists to prescribe tobacco cessation medications, adding to the current list of therapies pharmacists can initiate under a Board of Pharmacy protocol. The immunization provisions would be effective upon the expiration of the PREP (Pre-Exposure Prophylaxis) Act declarations. Gov. Youngkin (R) has until midnight on April 11 to approve the bills or let them become law without his signature. NACDS and VACDS (Virginia Association of Chain Drug Stores) were actively involved in the drafting and passage of these bills as part of our Scope of Practice Campaign. We will be reaching out to Gov. Youngkin to urge him to sign these bills and will provide inform
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
Governor Kay Ivey (R) has signed SB102 which authorizes an approved pharmacy intern or extern to compound or dispense prescription. Authorizes the Board of Pharmacy to issue a pharmacy intern/extern permit authorizing the pharmacy intern or extern to compound or dispense prescriptions while serving under the direct supervision of a licensed pharmacist. Creates a pharmacy intern/extern permit application process that authorizes the collection of a fee and a background check. Immediate direct supervision is defined as at least one pharmacist being always present and available on the premises of the pharmacy for consultation with the intern or extern.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
SB (Senate Bill) 1016, legislation requiring a pharmacist to dispense all prescription orders during a public health state of emergency with certain immunity protections and conditions for refusal to dispense, failed to pass the State Senate with a vote of 14-15.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Arkansas
Prior to adjourning the fiscal session sine die on March 15th, the House of Representatives selected Rep. Matthew Shepherd (R) to serve a third term as Speaker of the House when the 94th General Assembly convenes in January 2023.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following alerts to the Medi-Cal Rx Web Portal:
- Enteral Nutrition Recall (March 14)
- Enteral Nutrition Updates: Maximum Quantity Rejections (March 15)
Also in California, the Board of Pharmacy amended the expiration date of the following waiver: Mass Vaccination Sites – AMENDED AND REISSUED; the expiration date is June 30, 2022, or until 90 days following the declared disaster, whichever is sooner. All Pharmacy Law waivers are posted under the COVID-19 Updates and Resources.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Health Care Policy and Financing (HCPF) is hosting a virtual Health Cabinet Policy Summit on March 24 and 31. Topics include affordability, behavioral health transformation, pandemic to endemic & future readiness, and keeping Coloradans covered after the Public Health Emergency. HCPF is expanding their value-based payment models that reward providers for better patient outcomes and closes health disparities while driving affordability. Register in advance.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Delaware
The Delaware Controlled Substance Advisory Committee amended the Uniform Controlled Substances Act regulations to make the provisions on expiration and partial filling of controlled substance prescriptions consistent with federal standards. The changes are effect March 11, 2022
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Illinois
The Illinois Department of Healthcare and Family Services has posted the Uniform Prior Authorization Workgroup Agenda for 03/18/2022 at the following link.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
HEA 1169, legislation allowing pharmacy technicians to immunize all vaccines delegated by a pharmacist and to do verbal transfers was signed into law by Gov. Eric Holcolm (R) on March 15, 2020.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Board of Pharmacy issued its March 2022 newsletter that includes the following articles:
- "Non-electronic Prescriptions – Reminder of Requirements"
- "FDA Warning on Dissolvable Buprenorphine and Dental Problems"
- "Get to Know Your Pharmacy Board Members – Gayle Mayer"
- "Shipping Compounded Prescriptions Outside the State of Iowa? – Reports Due by April 1, 2022"
- "Statewide Protocols"
- "Technician Trainee Renewal/Reactivation Update"
- "Interim Pharmacist-in-Charge – New Option for Pharmacies"
- "Pharmacists Required to Report Serious Adverse Events to FAERS Following Medication Administration"
- "Board Requests Code Change in 2022 Legislative Session"
Also in Iowa, the Board of Pharmacy posted is January 11, 2022 Meeting Minutes. Interesting stats related to the Pharmacist Narcan® Dispensing Program, Pharmacist Disposal Kit Dispensing Program and Board -Sponsored Medication Disposal are reported on Page 6. "Rules and Legislation" section appears on pages 7-8.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
Two Senate bills advancing of interest to pharmacies were amended and are now pending action by the full House. SB 200 allows pharmacists to test and initiate therapy for strep, flu, and urinary tract infections under protocols developed and approved by the Collaborative Drug Therapy Management Advisory Committee. SB 28 requires PBMs (Pharmacy Benefits Managers) to be licensed and regulated by the Insurance Department. It also addresses MAC (Maximum Allowable Cost) pricing and delineates what items a PBM (Pharmacy Benefit Manager) can request during a MAC appeal. If these bills pass the House, they will be returned to the Senate for ultimate action to concur with the House changes.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
Legislation that makes permanent provisions granted under the PREP (Public Readiness and Emergency Preparedness) Act filed by Rep. Chris Turner (R) will be heard in the House Health and Welfare Committee on Wednesday morning, March 23 at 9:30 AM. HB 474 will allow the pharmacist, pharmacy intern and pharmacy technician, without a patient specific prescription or medical order, to administer all vaccines to anyone three years old and older.
Also in Louisiana, Gov John Bel Edwards (D) announced that he would NOT renew the COVID-19 public health emergency order that expired on March 16th. The Board of Pharmacy (Board) issued a guidance document listing all the current interim policies and their expiration dates.
At their May 11th meeting, the Board will consider whether to terminate or further extend any interim policies. Three of the policies (identified in guidance document) were based on the federal declaration of emergency as opposed to the state declaration of emergency. Since the federal declaration of emergency is still in effect, the expiration dates for those three interim policies were extended for the duration of the federal public health emergency.
Of particular importance to many pharmacies and pharmacists is the authority provided by the federal PREP Act Declaration and its subsequent amendments for pharmacists to order and administer COVID-19 tests and therapeutics. For as long as the federal public health emergency and PREP Act Declaration are in place and not modified, that authority remains in effect.
Finally in Louisiana, all providers who file claims with the Louisiana Department of Health (LDH), including pharmacy providers and immunizing pharmacists, are reminded that they must enroll in the new Medicaid Provider Enrollment Portal to continue being reimbursed. All existing providers must log in and submit an enrollment through the portal. LDH had requested a deadline extension from March 31st to June 30, 2022, but it is still pending approval from CMS, so providers are encouraged to act now to complete enrollments so that their claims will not be denied.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
Massachusetts Medicaid, MassHealth, released its March Pharmacy Facts which includes updates for pharmacy providers on MassHealth policy.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
At the Michigan Pharmacy Provider Liaison Quarterly Meeting. Discussion focused on clarifications of several policy documents. The next pharmacy liaison meeting will be held on June 9.
Final Policies Issued
HASA 22-02: COVID-19 Response: Coverage of FDA Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers
Published L-Letters
L 22-05: Clarification of Michigan Automated Prescription System (MAPS)
Record Retention
L 22-04: Additional Guidance and Clarification for the Coverage of COVID- 19 Prevention, Treatment, and Support Services.
Proposed Policy:
2156-Pharmacy: Signature Log and Proof of Delivery Requirements
2202-Pharmacy: COVID-19 Response: Coverage of U.S. Food & Drug Administration (FDA) Emergency Use Authorization (EUA) COVID-19 Monoclonal Antibody Injections by Pharmacy Providers
2155-Pharmacy: Update to Contraceptive Supply Limit
Web Announcements:
Summary of Michigan Single PDL (Preferred Drug List) Changes – effective 2/01/2022 https://michigan.magellanrx.com/provider/external/medicaid/mi/doc/en us/MIRx PDL changes.pdf
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The Department of Health and Senior Services (DHSS) issued a standing order on March 15th signed by the state Epidemiologist, Dr. George Turabelidze, enabling individuals to receive coverage for purchased tests for SARS-CoV-2. This policy authorizes Missouri pharmacies to charge an individual's insurance carrier, whether it is private insurance, Medicaid, or Medicare coverage, for COVID-19 testing. Additional state testing resources are available at health.mo.gov/communitytest.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services posted the fee schedule for COVID-19 Monoclonal Antibodies effective March 11.
Also in Nebraska, the Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on April 6 at noon (Central). This webpage also includes links to notes and audio recordings of previous calls.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Board of Pharmacy issued its March 2022 newsletter that includes the following articles:
- "No. 671 New Rules for Telework"
- "No. 672 New Temporary Rules: Accurate Hours of Operation, Temporary/Emergency/Permanent Pharmacy Closures, and PT and COPT Licensure"
- "No. 673 Rulemaking Updates"
- "No. 674 Compliance Updates"
- "No. 675 Technicians Must Work Under the Supervision, Direction, and Control of a Pharmacist at All Times"
- "No. 676 Licensing"
- "No. 677 Board Member News: A New Board Member and Current Opportunities"
Also in Oregon, as the state enters a new phase of the pandemic, the Oregon Health Authority announced its five-point plan, "Oregon RISE: Resilience in Support of Equity."
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The Department of Health issued a Public Health Alert due to increased opioid overdose activity in Hopkinton, Richmond, East Greenwich, West Greenwich, and Exeter (Region 9). Read the full Alert here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
The Department of Health and Human Services (SCDHHS (South Carolina Department of Health and Human Services)) will reimburse for Food and Drug Administration-approved coronavirus disease 2019 (COVID-19) over the counter (OTC) tests for home use. SCDHHS will reimburse SCDHHS-enrolled pharmacy providers for these tests as authorized within sections 9811 and 9821 of the American Rescue Plan Act, and further delineated within the August 30, 2021, letter from the Centers for Medicare and Medicaid Services (SHO# 21-003).
OTC tests will be covered without prior authorization or cost share with a quantity limit of eight tests per 30-day period. Prescriptions for tests are not required. A one-time override will be allowed per 30-day period (up to a maximum of 10 tests per 30-day period). The per test (unit) rate of reimbursement will not exceed $12 ($24 for a box of two tests). To be eligible for reimbursement, claims must be submitted as a pharmacy claim. For billing purposes, pharmacies will use one of the five SCDHHS-recognized OTC test kits in the table below.
SCDHHS will reimburse for dates of service on or after Jan. 1, 2022. The Medicaid program cannot pay a member directly for a test they have purchased on their own; therefore, SCDHHS will only reimburse providers for OTC COVID-19 tests. SCDHHS will also update guidance regarding coverage of additional COVID-19 OTC tests as required.
Questions regarding fee-for-service claims processing should be directed to Magellan Medicaid Administration's Call Center at (866) 254-1669. The call center is available 24 hours/day.
For questions regarding pharmacy benefits related to the managed care organizations (MCOs) serving South Carolina Healthy Connections Medicaid members, please contact the MCO (Managed Care Organizations) directly.
Also in South Carolina, PSyn (a Health Insurance Consulting Firm), Inc has been contracted by DHEC's Division of Diabetes and Heart Disease Management to gain insight from pharmacists regarding your knowledge and interests in primary care clinics. We would appreciate it if you would take some time to complete this survey to help PSyn, Inc and DHEC develop their research.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) published information on pharmacy coverage of COVID-19 test kits.
Also in Texas, Beginning May 31st, HHSC will stop using the Texas Medicaid Standing Order for Mosquito Repellent. Pharmacies must obtain a prescription from a Medicaid-enrolled prescribing provider to dispense mosquito repellent beginning June 1, 2022, for Medicaid, Children's Health Insurance Program (CHIP), and Healthy Texas Women (HTW). HHSC has extended the effective date of the current standing order until May 31, 2022, to ensure providers have adequate notice regarding upcoming changes to the mosquito repellent benefit. Pharmacy staff may obtain a copy of the extended standing order by submitting a request via email to vdp-formulary@hhsc.state.tx.us.
Pharmacies or pharmacists not operating under the standing order will require a prescription from a valid healthcare provider before dispensing mosquito repellent to people enrolled in Medicaid. Pharmacies may use the standing order if a new prescription or a refill is required until May 31, 2022. Afterward, the terms of the standing order will no longer be valid. For refill requests, pharmacies should not contact or fax Dr. Van Ramshorst, the physician signing the standing order. Refer to the mosquito repellent section of the Pharmacy Provider Procedure Manual for more information about the benefit.
For more information, contact NACDS’ Mary Staples at 817-442-1155.