Nebraska
The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on February 16 at noon (Central).
Also in Nebraska, prior to a Health and Human Services Committee hearing, NACDS submitted a statement for the record in support of LB 812, legislation that would permit pharmacy technicians to administer vaccines under certain conditions.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
Since all counties continue to be designated high risk masks are mandatory regardless of vaccination status per Gov. Steve Sisolak’s (D) Directive 045.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
The New Hampshire Association of Chain Drug Stores testified in strong support for SB (Senate Bill) 229, a proposal which would authorize certified pharmacy technicians to immunize. The Senate Executive Departments and Administration Committee heard no testimony in opposition.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New York
The State Education Department (SED) has released draft regulations to authorize pharmacists to administer other immunizations to patients 18 years old or older, as recommended by the ACIP (Advisory Committee on Immunization Practices) of the CDC (Centers for Disease Control) (Centers for Disease Control).
Also in New York, The New York State Department of Health has approved the release of January 2022 Medicaid Update. Links to the individual articles are also available below.
All Providers
- New Provider Enrollment Portal Coming Soon to eMedNY (Cover)
- NY State of Health Open Enrollment Period Extended as Federal Public Health Emergency Continues
Policy and Billing
- Update to Fee-for-Service Reimbursement for Federally Qualified Health Center Claims After Third-Party Payers and Managed Care Visit and Revenue Reporting Requirements
- Medicaid Fee-for-Service Guidance for Duchenne Muscular Dystrophy Drugs
- Update to New York State Medicaid Coverage of Real-Time Continuous Glucose Monitors
Pharmacy
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Ohio
The Board of Pharmacy has proposed a rule to modify the “DUR” requirements outlined in OAR 4729:5-5-08 for gabapentin prescriptions Under the existing rules for DUR, pharmacists are currently required to request and review the OARRS database prior to dispensing certain controlled substances prescriptions. The proposed rule would extend the PDMP review requirement to include certain prescriptions for gabapentin. Pharmacies have been required to report prescriptions for gabapentin to OARRS since 2016. Comments are due before the close of business on February 9 to RuleComments@pharmacy.ohio.gov and CSIPublicComments@governor.ohio.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
The Department of Human Services Office of Medical Assistance Programs has issued a new bulletin with billing instructions for COVID-19 at-home test kits.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Rhode Island
The Department of Health has issued an Emergency Amendment, effective January 26, 2022, regarding Immunization, Testing, and Health Screening for Health Care Workers (216-RICR-20-15-7).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
Effective January 15, 2022, to broaden access to SARS-CoV-2 at-home testing, the Division of TennCare began coverage of rapid at-home tests with Emergency Use Authorization (EUA) through the OptumRx Pharmacy Point of Sale System.
For further questions, please contact OptumRx Provider Liaisons at tnrxeducation@optum.com
Also in Tennessee, please see updates to the TennCare Preferred Drug List, Clinical Criteria, TennCare Branded Drugs to be Classified as Generics and Interim Criteria below for February 2022. These changes went into effect on February 1st.
- Added to preferred: molnupiravir, Paxlovid
- Added to non-preferred: sertraline capsules
- Added to interim: Bylvay, Qulipta, Scemblix, Invega Hafyera, Lybalvi
- BaG removals: Xopenex, Uloric
Finally in Tennessee, Lucy A. Shell, PharmD, TPA's Director of Pharmacy Practice Initiatives and former Interim Executive Director, was named Executive Director for the Tennessee Board of Pharmacy, effective Feb. 21.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy updated the quick reference guide for prescriptions for dangerous drugs (non-controlled) and controlled substances (Schedules II – V) that may be dispensed.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
The Department of Health has issued a Standing Order to help pharmacies adjudicate test kit claims and receive reimbursement. It has been posted on the VDH website, but here is the direct link as well.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The Health Care Authority (HCA) announced that the Human papillomavirus (HPV) vaccine is now a covered benefit under the Family Planning Only programs, effective February 1, 2022. For billing information, please refer to the Family Planning Billing Guide on the HCA website.
Also in Washington, in advance of the February 3rd House Finance Committee hearing, NACDS sent letters to members of the Committee and leadership stating our opposition to HB 2091, legislation that would increase the Business and Occupation (B&O) tax on prescription drug wholesalers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
The newest Medicaid ALERT regarding COVID-19 “At Home” Tests billed through pharmacy can be found here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Board of Pharmacy distributed the following:
- COVID-19 Vaccine Updates for Pharmacists
- Joint Statement on Western States Recommendation of Expanded Pfizer – BioNTech Booster Eligibility for 12- to 15-Year Olds
- Statement Regarding Dispensing Prescriptions Not Transmitted Electronically
- Information and Additional Resources Regarding e-Prescribing Requirements
Also in California, the following alerts have been posted to the Medi-Cal Rx Web Portal:
- Medi-Cal Rx Coverage of OTC COVID-19 Antigen Test Kits (January 26)
- Prior Authorization Required: Reject Code 75 (January 26)
Finally in California, the Office of Administrative Law has approved amendments to the following regulations:
- Pharmacists Initiating and Administering Vaccines. (Effective immediately)
- Address Change Notification. (Effective April 1)
- Ownership, Management, and Control of Pharmacies and Other Regulated Business Entities. (Effective April 1)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
On February 14, the Board of Pharmacy is holding a Joint Stakeholder meeting to allow interested parties to provide feedback on the proposed revisions to the Statewide Protocol for Prescribing Hormonal Contraceptive Patches and Oral Contraceptives, and the Colorado Self-Screening Contraception Risk Assessment Questionnaire
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Illinois
The Illinois Department of Healthcare and Family Services has posted a new Provider Notice regarding Emergency Instructions for COVID-19 Home Test Kits. You may view the new Notice here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
Currently the Health Commissioner of the State Department of Health or the Commissioner's designated public health authority can issue standing orders, prescriptions, or protocols to administer or dispense certain immunizations for individuals who are at least 11 years old. SB 3, a bill that includes a provision that would lower the age limit to five years old, passed Third Reading in the Senate and now advances to the House for further consideration.
Also in Indiana, legislation that would have allowed pharmacists to prescribe hormonal contraceptives failed to get heard in the Senate Health and Provider Services Committee. (SB189)
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Public Health published the COVID-19 Therapeutics Information Brief (1.25.22) including the following updates:
- Bamlanvimab/Etesevimab and REGEN-COV no longer authorized for use by FDA
- Allocations for mAbs, PrEP and Antivirals
- Disposal of extra doses of Nirmatrelvir from blister packs for patients with low eGFR
- COVID-19 treatment guidelines when there are logistical or supply constraints
- Patient prioritization for outpatient Anti-SARS-CoV-2 therapies with supply constraints
- FDA expands use of REMDESIVIR
- COVID-19 treatment guidelines for Evusheld
The next Therapeutics Information Brief will be February 2.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Board of Pharmacy’s Regulation Revision Committee will meet in Baton Rouge on February 2nd to consider several legislative proposals including changing the age thresholds in pharmacy immunization law to match age thresholds in PREP Act. [01-12-2022] Consideration of Legislative Proposal 2022-H ~ Immunizations (Draft #1) If approved by the Committee, the items will be considered by the full Board on February 17th.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
Gov. Hogan (R) has issued an Executive Order that provides for staffing flexibility to pharmacies as they engage in COVID-19 vaccinations and testing.
Also in Maryland, the Department of Health has published an Advisory regarding Epidolex prescriptions due to a conflict between the federal and state scheduling process.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
MassHealth has released its most recent Fact Sheet to reflect recent modification in regulations regarding oral contraceptives and 340 drugs.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The Board of Pharmacy filed a revised emergency rule effective February 4, 2021, that will allow Missouri licensed interns and technicians located in other states to perform remote data entry.
Also in Missouri, due to system limitation, MO HealthNet will reimburse pharmacy providers $0.01 for the full course of the therapeutic and the full dispensing fee. Pharmacy providers must submit a cost to MO HealthNet in excess of the Professional Dispensing Fee (PDF) to receive full reimbursement of the PDF. MO HealthNet will also cover home tests currently payable at $12 per test plus the PDF.
Finally in Missouri, MO HealthNet in partnership with Missouri Board of Pharmacy's Rx Cares for Missouri Program and the Missouri Department of Health & Senior Services (DHSS), kicked off the "Safe At Home" Patient Safety Opioid Initiative. It allows MO HealthNet to reimburse pharmacy providers who dispense at-home medication disposal packets to eligible MO HealthNet participants who are at risk of experiencing an opiate-related overdose. MO HealthNet has selected DisposeRx® packets as the preferred medication disposal packet. These convenient at-home medication disposal packets will allow MO HealthNet participants to dispose of unused opioids safely and easily, preventing accidental overdoses.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services announced the next COVID-19 Medicaid Provider call will take place on February 2 at noon (Central).
Also in Nebraska, the Department of Health and Human Services made available the new COVID-19 Ad Hoc Fee Schedule (1.1.2022), including adjustments to payments for administration of COVID-19 vaccines.
Also in Nebraska, the Department of Health and Human Service posted the revised fee schedule for injectables effective January 1, 2022 REVISED.
Also in Nebraska, the Department of Health and Human Services issued Provider Bulletin 22-05A to notify providers that effective January 15, 2022, OTC COVID at-home tests will be covered by Medicaid. The reimbursement policy is up to $12.00 for a kit containing one test or up to $24.00 for a kit containing two tests is allowed.
Finally, the Department of Health and Human Services issued Provider Bulletin 22-06 announcing changes to the Tobacco Cessation Program. Effective December 26, 2021, enrollment in the Nebraska Tobacco Free Quitline is no longer required to be able to receive tobacco cessation products; enrollment is still encouraged.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
Effective January 1, 2022, all controlled substance prescriptions MUST be transmitted to a pharmacy by electronic prescribing, except for the following prescriptions:
- a) Issued by a veterinarian;
b) Issued under circumstances where:
Electronic transmission is unavailable due to technologic or electronic failure; or
2. The drug will be dispensed at a pharmacy located outside of this State;
c) Issued by a practitioner who will also dispense the drug;
d) For which electronic prescribing is prohibited by federal law;
e) Issued pursuant to a protocol for research; or
f) Issued under circumstances in which the practitioner determines that:
1. The patient is unable to obtain the drug in a timely manner if the prescription is given by electronic transmission; and
2. Delay will adversely affect the patient's medical condition.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Hampshire
Medicaid is ready to process at home COVID antigen tests. The necessary changes to be able to process the tests were completed last Friday (1/21/22), the pharmacy fax blast was sent out Friday afternoon as planned and is also posted online. Medicaid has issued a notice along with a standing order from DHHS for the at home tests that pharmacies may use. Dr. Ballard’s NPI number is on the order.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New Jersey
The Board of Pharmacy has finalized three regulations dealing with patient counseling documentation requirements, increased out of state permit fees, and removal of waiting period to retake pharmacist exams.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.