Wisconsin
Wisconsin Medicaid, ForwardHealth, has released an update on coverage of at-home COVID tests for Medicaid patients. As a reminder, Pharmacies must submit a claim for these tests as a prescription. There is a standing order in place from the Department of Health Services (DHS) Chief Medical Officer Dr. Ryan Westerguard. The pharmacists may order the tests and patients may receive 8 tests per 30-day period.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alaska
New rules relating to the Prescription Drug Monitoring Program (PDMP) go into effect on March 17, 2022. The regulations clarify the registration process to align with the account creation steps at alaska.pmpaware.net, replaces “registration” with “designation,” and establishes a new requirement for pharmacists and pharmacies to notify the board within 10 days of a change in dispensing/distributing status of controlled substances. The forms will be available in the coming weeks at pharmacy.alaska.gov.
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:
- Clarification of Temporary Prior Authorization (PA) Policy Change (February 21)
- Medi-Cal Rx Drug Lookup Tool and Contract Drugs List Tips (February 24)
- Medi-Cal Rx Provider Portal Troubleshooting and Support (February 24)
- Remdesivir (Veklury) for Outpatient Treatment of COVID-19 (February 24)
- Required Documentation for Claim and Prior Authorization Support (February 24)
Also in California, COVID-19 related news highlighted below:
- Governor Newsom Unveils SMARTER Plan Charting California's Path Forward on Nation-Leading Pandemic Response
- California SMARTER – The Next Phase of California's COVID-19 Response
- County of Los Angeles Department of Public Health Order of the Health Officer (Revised February 23, 2022)
Finally in California, the Department of Health Care Services is proposing a budget trailer bill language to require Medi-Cal pharmacy providers to maintain records for ten years, consistent with federal law. The current requirement in the state is three years. DHCS prepared this fact sheet about the proposal.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Health First Colorado is paying for up to 15 COVID-19 home tests per member each month when provided by an enrolled pharmacy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
District of Columbia
Medicaid has scheduled the virtual quarterly pharmacy forum on March 15 from 1-2pm and March 16 from 10-11:30 pm and are “highly encouraging” attendance. Click here to RSVP and receive the log in information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Illinois
The Illinois Department of Human Services reports pharmacies and grocer/pharmacies may see an increase in demand for Neocate formula and nutritionals with the recent recall of Abbott's EleCare and EleCare Junior products. Some participants who were prescribed EleCare have had their prescriptions adjusted and will now be coming to pharmacies with requests for Neocate products.
Click here for a copy of the IDHS Notice. For ordering information click here
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Department of Health (IDOH) and the Health Coverage Programs (IHCP) announced that they are making changes to the Vaccines for Children (VFC) policy to allow pharmacies to easily enroll in the program, effective March 14, 2022. The maximum allowable reimbursement for the administration of a VFC vaccine will be consistent with reimbursement for vaccines administered by medical providers, which is currently $15.00.
Also in Indiana, effective February 1, 2022, IHCP began reimbursing pharmacies for dispensing FDA approved COVID19 test kits at home, with a limit of two tests per 7 days per member under a statewide standing order.
Also in Indiana, the Indiana Family and Social Services Administration's (FSSA) Office of Medicaid Policy and Planning provided updates to the opioid utilization prior authorization (PA) criteria's maximum allowable daily morphine milligram equivalent (MME) effective for claims with dates of service (DOS) on or after April 1, 2022.
Finally in Indiana, HB 1158, legislation that would allow a pharmacy technician to administer any vaccines delegated by a pharmacist, passed the House and is pending in the Senate Health and Provider Services Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Human Services published the following:
- INFORMATIONAL LETTER NO. 2314-MC-FFS-CVD: This informational letter provides guidance to providers on billing for COVID-19 OTC home testing. This policy will remain in effect for the duration of the public health emergency.
- INFORMATIONAL LETTER NO. 2315-MC-FFS-CVD: On February 3, Gov. Kim Reynolds (R) signed the final extension to the state's Public Health Disaster Emergency Proclamation that announced the Public Health Disaster Emergency would expire on February 15 at 11:59 p.m. Please note: The end of the state's Public Health Disaster Emergency does not impact Medicaid flexibilities currently in place.
Also in Iowa, the Board of Pharmacy will meet on March 1 via Zoom and in-person; the meeting agenda has been posted.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
HB 200, legislation expanding the pharmacist's scope of practice to include initiation of therapy for influenza, strep throat and urinary tract infection pursuant to a statewide protocol adopted by the collaborative drug therapy management advisory committee, passed the Senate by a vote of 37-2. It was referred to the House Health and Human Service Committee for further action.
Also in Kansas, legislation that would establish a joint committee on pharmacy workplace conditions and patient safety to conduct a study and issue a report to the legislature was referred to the House Health and Human Services Committee. HB 2698
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Board of Pharmacy unanimously approved supporting filing legislation on collaborative practice agreements, statewide protocols for patient care services, requiring PBM licensing and a bill that would add pharmacy interns and certified pharmacy technicians as authorized immunizers, and reducing the age threshold from 7 to 3 years and older for influenza immunizations and from 17 to 3 years and older for all other immunizations. The legislature convenes on March 14th.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
Governor Gretchen Whitmer (D) signed into law on February 23 three bills — HB 4348, HB 4351, and HB 4352 aimed at lowering the costs of prescription drugs, ensure that pharmacists can provide advice to patients about treatment options, and provide oversight and transparency for pharmacy benefit managers. The laws will require that PBMs be licensed with the Department of Insurance and Financial Services. In addition, the legislation provides government oversight on pharmacy audits and appeals with help from state regulators. The law takes effect January 1, 2024
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Minnesota
The Department of Health has published a weekly covid vaccine providers report. To subscribe to it click here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on March 2 at noon (Central).
Also in Nebraska, the Department of Health and Human Services has posted the DUR (Drug Utilization Review) Board March 8 meeting agenda and DUR Policy Statements (as of July 2021).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Hampshire
The Board of Pharmacy has proposed to adopt regulations to establish requirements for automated pharmacy systems in community long-term care facilities, hospices, state and county correctional institutions, and hospitals. A hearing is scheduled for March 18,2022 in Concord.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New Mexico
Gov. Michelle Lujan Grisham (D) announced February 17th that effective immediately, masks will no longer be required indoors, except for in hospitals, assisted living centers, certain health care settings, as well as in state correctional and juvenile justice facilities.
Also in New Mexico, the Legislature adjourned the 30-day fiscal session on February 17th.
Finally in New Mexico, to better combat the opioid crisis, legislators passed HB 52 which will decriminalize the possession of fentanyl test strips. Gov. Michelle Lujan Grisham (D) has until March 9, 2022, to sign the bill into law.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
The NYS Department of Health has updated COVID guidance documents including:
- Guidance for the New York State COVID-19 Vaccination Program for Individuals 12 Years of Age and Older
- Information for Health Care Professionals about the Screening Checklist for the COVID-19 Vaccine: Individuals 12 Years of Age and Older
- Guidance for the New York State COVID-19 Vaccination Program: Vaccination of Children Ages 5-11
- Information for Health Care Professionals about the Screening Checklist for Administration of the Pfizer-BioNTech COVID-19 Vaccine for Children Ages 5-11
- Information for Health Care Professionals about the Screening Checklist for the COVID-19 Vaccine: Additional Dose for Moderately to Severely Immunocompromised People
- COVID-19 Immunization Screening and Consent Form: Additional Dose for Moderately to Severely Immunocompromised People
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The Board's revised centralized pharmacy services rule has cleared final review. The chief change achieved by the amendments is to broaden the availability of remote medication order processing from the health-system practice setting to all pharmacy practice settings.
Even though the amended rule is effective March 1, 2022, several implementation tasks need to be completed. Chief among them: Board staff need to program a registration system for out-of-state pharmacists who are not licensed in North Carolina, but who intend to provide RMOE services to North Carolina pharmacies by obtaining an NABP (National Association of Boards of Pharmacy) Verify credential. NABP staff are implementing the NABP Verify credential application process. Board staff expect both steps to be completed by April 1, 2022.
In the meantime, North Carolina pharmacies who have implemented RMOE systems under the Board's emergency services waiver may continue to use them. The Board will ensure that pharmacies that have deployed waiver-based RMOE operations have reasonable time and opportunity to transfer to rule-based operations. The full Board will discuss implementation at its March 8, 2022, meeting.
In the coming weeks, Board staff will also publish a detailed FAQ document on the revised centralized pharmacy services rule.
Pharmacists are reminded that the Board is proceeding with additional rulemaking to permanently authorize North Carolina pharmacy personnel to perform remote work (other than physical acts in the dispensing process) for their employing pharmacy. North Carolina pharmacies who have implemented waiver-based remote work systems in North Carolina may continue to use them while this rulemaking proceeds. More information on this proposed rule is found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
HB 37, a bill that NACDS and the Ohio Council of Retail Merchants jointly supported, has passed both Chambers and is on its way to the Governor for signature. Sponsored by Rep. Gayle Manning (R), it authorizes pharmacists to dispense emergency refills three times a year and requires health insurers to cover these prescriptions.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The Pharmacy Board will be moving to a temporary location while the office building is being renovated. The office will be down during the move, from February 28 the to March 4th. The new address is 3812 N. Santa Fe Suite 300, Oklahoma City, OK 73118.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy proposed to adopt the following rules. Written comments may be submitted via email to pharmacy.rulemaking@bop.oregon.gov before 4:30 p.m. on March 29 rulemaking hearing.
- Divisions 006/041/139 – related to Definitions
- Division 020 – related to COVID-19 Antigen Self-Test Protocol
- Divisions 020/041/065/139 – related to Alarm, Audiovisual Communication, Entry & Surveillance Systems
- Divisions 021/025/110 – related to Pharmacy Technician & Certified Oregon Pharmacy Technician Licensure
- Division 041 – related to Disclosure of Patient Information
- Divisions 041/139 – related to Accurate Pharmacy Hours & Temporary Pharmacy Closures
- Divisions 041/139 – related to Drug Storage
- Division 080 – related to Schedule I Exceptions
- Division 143 – related to Pharmacy Prescription Lockers (PPLs)
Also in Oregon, the Department of Human Services announced plans to lift mask requirements for indoor public spaces and schools on March 19.
Finally in Oregon, Gov. Kate Brown (D) announced that she will lift the state's COVID-19 Emergency Declaration effective April 1.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Department of Human Services released a new bulletin announcing SARS-CoV-2 Monoclonal Antibody Product Updates that includes pharmacy reimbursement rates and billing procedures.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
The Department of Health has provided an update on COVID-19 oral antiviral therapeutics in the state, specifically, Paxlovid® by Pfizer and Molnupiravir by Merck, with guidance for pharmacies requesting them.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) is accepting comments until March 10th on the March 2022 draft Specialty Drug List. Stakeholders should send submissions on the Specialty Drug Submission Spreadsheet.
Also in Texas, the HHSC adopted a final rule establishing a process for Medicaid Managed Care organizations (MCOs) to recoup certain overpayments made to health care providers in connection with missing electronic visit verification information. The rule also requires MCOs to give providers at least 60 days to correct a deficiency.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Board of Pharmacy published its February 2022 newsletter. Highlights include the impact of HB 178 on pharmacy practice, pharmacy staff supervision, insulin refills, Controlled Substance Database (CDS) updates when returning controlled substances to stock, CDS and the DSP12 Transmission Form of Rx Origin Code and SafeUT Frontline app.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Legislature's crossover deadline for bills to pass one chamber to be eligible for further consideration was met on February 15. The following bills of interest to pharmacy met the deadline:
- HB 1323 and SB 672 – both bills expand pharmacy personnel immunization and testing authority to mirror the PREP (Public Readiness and Emergency Preparedness) Act; SB 672 also expands the state's current allowances on conditions pharmacists may test and/or treat. NACDS has been actively supporting both bills, which are headed for consideration in conference committee
- HB 1324 – this bill requires the Board of Pharmacy to adopt regulations for work environment requirements for pharmacy personnel by September 1, 2022. The regulations must include addressing pharmacy staffing and breaks; state standards that ensure adequate time to complete professional duties; and limit productivity or production quotas to the extent that such factors interfere with the ability to provide appropriate professional services to the public. The bill was amended to remove language that would have allowed it to be promulgated as an emergency measure, thus ensuring stakeholders' ability to participate in the regulatory process
For more information, contact NACDS’ Jill McCormack at 717-592-8977.