North Carolina
The January 18th Board meeting will be conducted via Microsoft Teams. You will be able to join the meeting either by downloading the Microsoft Teams app or you may open the link in a web browser. Simply click on this link at the start of the meeting. If you prefer to attend the meeting by phone, call (336) 604-5350. The conference ID is 907 040 796#. You may view the agenda here.
Also in North Carolina, NC Medicaid is increasing the reimbursement for COVID vaccine administration from $40 to $65. The effective date of the rate change will be retroactive to April 1, 2021. All claims previously submitted with dates of service from April 1, 2021, through the NCTracks implementation date of the rate change will be systematically reprocessed. No action will be required by providers to receive the retroactive rate increase.
Finally in North Carolina, the Board of Pharmacy issued the following guidance regarding the role of pharmacists in oral therapeutics to treat COVID-19.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
Blue Cross Blue Shield of North Dakota is providing coverage to the Medicaid expansion population effective January 1, 2022. See the Medicaid Expansion Provider Manual for information to submit claims for pharmacist administered vaccines.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The Board of Pharmacy ‘s January 19, 2022, Board Meeting will be shown via YouTube. The meeting will begin at 9:00 am. View the agenda here.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Dakota
The Board of Pharmacy published its January 2022 Newsletter, including information about the new Prescription Drug Monitoring Program NarxCare Report called “Tile View”, an update on the drug take-back program, and other information of interest to pharmacies and pharmacists.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Virginia Department of Health (VDH) has issued an updated COVID-19 standing order to include the latest CDC recommendations.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The State Health Care Authority (HCA) issued a statement that while they are not able to implement at this time, HCA is working to create a process to meet these legislative mandates in a law passed last year, Substitute Senate Bill 5195. The law requires HCA to reimburse hospitals, behavioral health agencies, or pharmacies who dispense opioid overdose reversal medication to uninsured individuals by January 1, 2022. The plan will include a process to back-dated opioid reversal medication claims to January 1, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The 2022 list of 100 most used generic prescribed drugs has just been released. Each Wisconsin pharmacy must provide notice to the public on how it may access the Pharmacy Examining Board list.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alabama
Effective January 1, 2022, the Alabama Medicaid Agency will have contracts with eight companies that offer Medicare Advantage coverage in Alabama: Aetna Better Health, Inc., Arcadian Health Plan, Inc. (Humana), Centene Venture Company Alabama Health Plan, Inc. (Ascension Complete), HealthSpring Life & Health Insurance Company, Inc. (CIGNA), Simpra Advantage, Inc., UnitedHealthcare of the Midlands, Inc., VIVA Health, Inc., and WellCare of Alabama, Inc.
Providers are encouraged to check Medicaid's Eligibility Verification File, under the Managed Care Section, to determine if capitation payments have been made for recipients during a particular month. If a capitation payment has not been made, providers should refer to Chapter 5 of the Provider Billing Manual, Sections 5.6.1 – 5.6.2, for claims filing instructions. Questions may be directed to Shari Rudd at (334) 353-3403 or shari.rudd@medicaid.alabama.gov.
Also in Alabama, the Board of Pharmacy is reporting that only 35% of licensed technicians have renewed their licenses. Please be aware that the submission of a renewal by the December 31 deadline does not mean that individuals are clear to work on January 1. The renewals must be processed, not just submitted. We recommend that you renew your license NOW, with plenty of lead time to handle any issues that may come up.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
The Division of Medical Services rules allowing six refills per month, add certain medications that do not count toward the monthly prescription cap, and allow up to nine medically necessary prescriptions per month for Living Choices Assisted Living Program clients went into effect on January 1, 2022. The rule also specifies that patients must pay for their own medications beyond the maximum benefit, remove the extension of benefits provisions, and revise refill requirements.
Also in Arkansas, the Division of Provider Services and Quality Assurance (DPSQA) issued a COVID-19 Response Manual.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Medi-Cal Rx was implemented on January 1, 2021. The Monthly Bulletin for January has been posted to the Medi-Cal Rx Web Portal.
Also in California, Medi-Cal Rx issued a Share of Cost bulletin to clarify that the process will be unchanged by the implementation of Medi-Cal Rx.
Also in California, Medi-Cal Rx issued an alert announcing that reject code 16 M/I Prescription/Service Reference Number is temporarily suspended. Pharmacy providers may resubmit claims if they receive this rejection.
Also in California, the Board of Pharmacy published its January 2022 monthly update. Note the last item about pharmacy laws effective in 2022.
Finally, the Board of Pharmacy also published a reminder of the new e-prescribing laws effective January 1, 2022.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Department of Health has issued a Notice of Meeting/Workshop Hearing. The Board of Pharmacy will conduct a workgroup meeting to discuss white bagging and brown bagging pharmacy practices, February 9, 2022, 1:00 p.m. ET at the DoubleTree by Hilton Hotel Deerfield Beach – Boca Raton, 100 Fairway Dr., Deerfield Beach, FL 33441.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
The Idaho Administrative Rules Special Edition Bulletin, Volume 21-12SE, December 22, 2021, has been published. The following rules have been adopted by the respective agency and are now pending review by the 2022 Idaho State Legislature for final approval.
- Office of the Attorney General – See "Rules of Administrative Procedure for Consideration of Cooperative Agreements Filed by Health Care Providers" on pages 527-41.
- Department of Health and Welfare – Medicaid Basic Plan Benefits
- See "664. PRESCRIPTION DRUGS: PROVIDER QUALIFICATIONS AND DUTIES" on pages 1778-9;
- "665. PRESCRIPTION DRUGS: PROVIDER REIMBURSEMENT" on pages 1779-83 and
- "666. PRESCRIPTION DRUGS: QUALITY ASSURANCE" on page 1783.
- The Division of Occupational and Profession Licenses pending fee rule – See pages 3350-1 for the Idaho State Board of Pharmacy fees.
Also in Idaho, the Board of Pharmacy published the "Idaho State Newsletter" – December 2021. Below is an outline of its contents. Note the Idaho PDMP (Prescription Drug Monitoring Program) requirement effective November 1, 2021.
- Remaining CPE (Council for Pharmacist Education) credits for 2021
- "Culture of Safety" – Medication events and process improvements in 2021
- Requirement for "Date Sold" in Idaho PDMP
- Technician registration assistance
- 2022 Board Meeting Schedule
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
The Department of Health issued a new statewide naloxone standing order.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Human Services, Iowa Medicaid Enterprise (IME) published INFORMATIONAL LETTER No. 2301-MC-FFS regarding a variety of listening sessions for providers scheduled for January and February. IME’s goal for these sessions is to hear from providers with experience related to assorted topics and who have ideas for ways to improve processes and policies associated with these topics.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
At the Regulation Revision Committee (RRC) meeting on January 5th, members revised and approved several proposed legislative bill drafts of interest to chain pharmacies, including (1) amending the prescription monitoring program law to provide limited access to audit trail information to designated representatives of Louisiana Medicaid; (2) require Pharmacy Benefit Managers to obtain a permit from the Board of Pharmacy; (3) revising the definition of collaborative practice and authorizing pharmacists to provide certain patient care services in accordance with statewide protocols developed by the Board's Public Health and Pharmacy Protocol Advisory Committee and approved by the Board of Pharmacy; and (4) changing the definition of collaborative practice and adding a definition of a collaborative practice agreement authorizing pharmacists to engage in collaborative practice in accordance with rules promulgated by the Board of Pharmacy. The RRC also approved a draft CLIA (Clinical Laboratory Improvement Amendments) Waived Testing Policy statement confirming pharmacist's authority to perform these tests under federal law. The full Board of Pharmacy will be considering all these issues at their February 16th meeting.
Also in Louisiana, the Department of Health (LDH) issued a new Naloxone standing order. They also issued Louisiana Medicaid Pharmacy Point of Sale (POS) Diagnosis Code Requirement and Bypass Diagnosis Codes – Effective January 1, 2022; Louisiana Medicaid Pharmacy Point of Sale Clinical Authorization and Criteria Updates – Effective January 1, 2022; and Louisiana Medicaid Pharmacy Point of Sale Quantity Limits – Effective January 1, 2022
Finally in Louisiana, in advance of the December 28, 2021, Board of Pharmacy's Public Hearing, NACDS submitted comments in support of proposed rules that make permanent certain authorities for pharmacy technicians and interns authorized under the PREP (pre-exposure prophylaxis) Act. Specifically, the proposed rules would codify authority for pharmacy technicians and interns to administer vaccines, in addition to making other changes to the existing rules that simplify existing administrative requirements for vaccines provided by pharmacy providers. We anticipate that the final rule will be published on March 20, 2022, Louisiana Register, and become effective immediately.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
This week, Governor Hogan announced a 30-day State of Emergency in response to rising COVID-19 metrics in Maryland. The announcement includes Authorization of Booster Shots for 12- to 15-Year-Olds. Gov. Hogan’s press release is also available here.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy is seeking comments by January 14, 2022, on proposed rules removing geographic restrictions on remote data entry sites and allowing pharmacy technicians and intern pharmacists to perform remote data entry from a site located in another U.S. state or territory.
Also in Missouri, the National Association of Insurance Commissioners (NAIC) selected the Missouri Department of Commerce and Insurance Director Chlora Lindley-Myers as President-Elect for 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Montana
The Dept. of Public Health and Human Services issued a Notice of Public Hearing on proposed amendments to ARM 37.85.105, updating effective dates of Medicaid fee schedules; see the relevant section related to outpatient drugs located on pages 1888-9. The public hearing will be held on January 13 and comments are due January 22.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nebraska
Gov. John Peter "Pete" Ricketts (R) signed Executive Order 21-18, facilitating hospital planning, and ensuring additional healthcare workforce capacity, on December 20, 2021. This extends the current Executive Order 21-15, allowing "pharmacists to have any number of pharmacist interns and pharmacy technicians under their supervision insofar as they determine it necessary within their professional discretion when administering vaccinations", until March 31, 2022.
Also in Nebraska, the 471-000-540 Nebraska Medicaid Practitioner Fee Schedule for Injectables was updated effective January 1.
Also in Nebraska, the Dept. of Health and Human Services issued a Health Alert Network Update: Omicron Predominant in Nebraska and Therapeutics Updates that includes an update on the Omicron variant of SARS-CoV-2 in Nebraska, NIH's criteria for identifying and prioritizing those expected to benefit the most from receiving the limited supply of COVID-19 therapeutics currently available and the NIH's treatment algorithm.
Also in Nebraska, the Board of Pharmacy will meet on January 10 and have posted the meeting agenda. Also, the November 8, 2021, meeting minutes are available.
Finally in Nebraska, the Dept. of Health and Human Services has posted the DUR (Drug Utilization Review) Board January 11, 2022, meeting agenda and DUR Policy Statements (as of July 2021).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On New Year's Eve NYS Governor Kathy Hochul (D) signed into law two pieces of legislation supported by NACDS. The first S3556 strengthens state anti-mandatory mail order (ammo) law. Legislators, concerned that the AMMO law was not operating as intended, passed S3566 to ensure that patients can get their prescriptions at their local pharmacy rather than be directed to mail order by their PBM. In addition, Governor Hochul signed into law S.3762 which provides for licensure and registration of pharmacy benefit managers. The bill also sets forth duties and obligations that PBMs must follow when performing services and allows the department of financial services to enforce the law and receive complaints from consumers, pharmacies, and healthcare providers. Unfortunately, Governor Hochul did veto S6603 which would have provided Medicaid pharmacy payment parity citing the fiscal note as her reasoning.
Also in New York: The State Education Department published its Notice of Adoption of their regulation related to Licensure Examination, Licensure by Endorsement, and Continuing Education Requirements in the Profession of Pharmacy The regulation is effective January 1, 2022 and eliminates the Part III exam requirement. Also commencing with registration periods beginning on or after January 1, 2023, a new requirement for a licensee to complete as part of the 45 hours of formal continuing education at least three hours of formal continuing education acceptable to the department in compounding, among other changes.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Here are the links to the latest North Carolina information on COVID vaccinations including the latest statewide standing order issued by Dr. Betsey Tilson on December 22, 2021. COVID-19 Vaccine Provider Guidance Updated December 22, 2021 and Link to Summary Update.
Dr. Tilson has also issued four updated statewide standing orders regarding the administration of the COVID-19 vaccine. These changes were in light of the CDC recommending the administration of Pfizer booster doses for 12–15-year-old.
- Statewide Standing Order for FDA Approved Pfizer/COMIRNATY COVID-19 Vaccine Administration in Patients Ages 5-11 Years (Jan. 6, 2022)
- Statewide Standing Order for FDA Approved Pfizer/COMIRNATY COVID-19 Vaccine Administration in Patients Ages 12 Years and Older (Jan. 6, 2022)
- Statewide Standing Order for FDA Authorized Moderna COVID-19 Vaccine Administration (Jan. 6, 2022)
- Statewide Standing Order for FDA Authorized Johnson and Johnson (Janssen) COVID-19 Vaccine Administration (Jan. 6, 2022)
Also in North Carolina, the Board of Pharmacy published proposed administrative rules concerning pharmacy interns. These rules can be found beginning on Page 1049 (PDF Page 57) of the North Carolina Register at this link. The Board will hold a public hearing on these rules on February 8, 2022. The public hearing will be held remotely. The public can participate on Teams at https://tinyurl.com/jsuk4bjk or may call 336-604-5350, conference ID 903 191 899#. Written comments will be accepted by the Board until February 14, 2022, and should be submitted to Jay Campbell, 6015 Farrington Road, Suite 201, Chapel Hill, NC 27517; fax (919) 246-1056; email ncboprulemaking@ncbop.org.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The Medicaid Provider e-Newsletter — December 2021 includes articles with information related to pharmacists being able to bill for smoking cessation and continuous glucose monitoring services. Also, the Medicaid Provider Call Center will be unavailable from 12:15 to 2:45 p.m. Central Time on many Fridays in 2022 for staff training; see schedule in the newsletter.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The Department of Health has published updated Guidance for Ohio Vaccine Providers for Administering Booster Doses.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Board of Pharmacy adopted the following permanent rules.
| Permanent Rule | Effective Date |
| Division 007/041/045/065 – related to USP, Labeling, Repackaging | December 16, 2021 |
| Division 010 – related to Board Administration & Policies | December 16, 2021 |
| Division 019/021 – related to Pain Management CE | January 1, 2022 |
| Division 019/139 – related to Remote Dispensing Site Pharmacy/Telepharmacy | January 1, 2022 |
| Division 041 – related to Telework | December 16, 2021 |
| Division 041 – related to TCVP (Technician Checking Validation Program) | October 1, 2022 |
| Division 041/080 – related to Pseudoephedrine/Ephedrine | January 1, 2022 |
| Division 043 – related to SPDO/DPDO/CHC | January 1, 2022 |
| Division 043 – related to SPDO (Supervising Physician Dispensing Outlet) | March 31, 2022 |
| Division 060/110 – related to PDMP Fee Increase | January 1, 2022 |
Also in Oregon, as a reminder, effective January 1, 2022, drugs containing pseudoephedrine and ephedrine may be purchase without a prescription. See item above regarding the permanent rule related to pseudoephedrine/ephedrine. For information about the use of the National Precursor Log Exchange (NPLEx) system, please refer to the Board of Pharmacy's November 2021 newsletter.
Also in Oregon, the Board of Pharmacy issued a notice requesting fiscal impact estimates from stakeholders for temporary and permanent pharmacy closures. Note: any information provided to the Board becomes a public record.
Finally in Oregon, the Board of Pharmacy's CE Rules Advisory Committee will meet on January 18. Details to participate in the meeting via phone conference are available in the agenda.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Office of Medical Assistance Programs (OMAP) has announced by bulletin that they will now reimburse pharmacies a $10 administration fee for any vaccine provided to adult Medicaid patients consistent with the Pharmacy Practice Act, retroactive to Nov. 1, 2021, in both FFS and MC. Historically OMAP has only paid for ingredient costs. Billing codes are in the bulletin. Pharmacies cannot bill for vaccines covered under the VFC program.
Also in Pennsylvania: The Pennsylvania Prescription Drug Monitoring Program (PDMP) will be transitioning PDMP system vendors. This change will bring new enhancements to the PDMP that are based on feedback from PDMP users, including a single platform for pharmacists to search patients, and upload and edit data. Starting on January 10, 2022, PDMP users will need to transfer their accounts to create new login credentials and establish their SFTP credentials (if applicable) within the LogiCoy PDMP platform. Pharmacies using a third party for data submission must ensure their vendor also transfers their accounts. Transitioning accounts takes an average user less than two minutes, as registration has been streamlined to pre-populate information based on the user's license information. The transfer account period begins on January 10. During this time all PDMP users must, by February 14:
- Click "Transfer Account or Register"
- Follow the prompts and enter their information
- Ensure the information is correct and submit
Pharmacists (or their data submission vendor) will be able to test their data submission during this time. Please note, before February 14, PDMP users will continue to use PMP Aware to search patients and PMP Clearinghouse to upload data. On February 14, PDMP users will begin using the LogiCoy PDMP to search patients and upload data. Users who search patients through their organization's pharmacy management system will not need to change how they search patients and will not experience any changes to their pharmacy management system's connection to the PDMP. For more information about the PDMP, please visit: www.doh.pa.gov/pdmp. For assistance with account transfer, please contact LogiCoy technical support at 844-939-0999 or email papdmp@logicoy.com.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.