Last week, the State Assembly passed an amended version of SB 966, PBM Reform legislation, and the State Senate concurred with the amended version. Upon passage, the bill was ordered to “engrossing and enrolling” after which it will be presented to Gov. Gavin Newsom (D) for signature. The governor has until September 30 to act. The bill requires PBMs to apply for a licensure from the California Department of Insurance by January 1, 2027; clarifies the State Attorney General retains all authorities to maintain or restore competitive, fair and honest markets and prosecute state and federal antitrust and unfair competitive violations; prohibits retroactive fees; and would allow a pharmacy that is not owned by the PBM to participate in a PBM network as a preferred provider if the pharmacy is willing to accept the same terms and conditions. NACDS sent a letter to Gov. Gavin Newsom (D) urging him to sign SB 966 to help preserve and expand patient access to pharmacists, pharmacies of all sizes and the Californians they serve.

Also in California, last week, AB 3063 passed the state legislature and was ordered to “engrossing and enrolling” after which it will be presented to Gov. Gavin Newsom (D) who has until September 30 to act. This legislation states the addition of a flavoring agent to a conventionally manufactured product is not considered compounding if certain conditions are met. It also requires the addition of the flavoring agent to be documented in the prescription record.

Also in California, the Department of Health Care Services posted the following alerts and weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal. Please note the MAIC 30-day pharmacy provider notice; rates will be effective October 1, 2024, and were to be posted to the Mercer Medi-Cal Rx website no later than September 1, 2024.

• COVID-19 Vaccines and Vaccine Administration Coverage for Family PACT End-Dated
• COVID-19 Antigen Over-the-Counter Test Coverage Updates, Effective October 1, 2024
• Updates to the List of Contracted Enteral Nutrition Products, Effective October 1, 2024
• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice
• Medi-Cal Rx Monthly Bulletin for September
• Changes to the Medi-Cal Rx Contract Drugs List
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations
• Updates to the Medi-Cal Rx Provider Manual
• Vaccines for Children Program Policy and Billing Guidance for Pharmacy Providers
• Medi-Cal Rx Weekly Wrap-up for August 23-29

Finally in California, the Board of Pharmacy posted the agenda and meeting materials for the Full Board Meeting on September 12, 2024. Please note the discussion and action related to awarding a contract for medication error reporting.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

This week the Assembly passed SB 966, PBM Reform legislation. The bill returns to the Senate for concurrence with the Assembly amendments. The legislature will adjourn no later than midnight on August 31.

Also in California, the Department of Health Care Services posted the following alerts and weekly notices on the Medi-Cal Rx Web Portal:

• State of Emergency Override Activation: Submission Clarification Code 13
• Medi-Cal Rx Weekly Wrap-up for August 16-22
• Mass Adjustment for Impacted Blood Factor Claims with a Date of Service October 1, 2021, through December 31, 2021
• Medi-Cal Rx Weekly Wrap-up for August 9-15
• CalAIM Justice-Involved Reentry Initiative Implementation for Inyo, Santa Clara, and Yuba Counties
• Vaccines for Children Program: Medi-Cal Reference Guide
• Coming Soon: Medi-Cal Reimbursement for Vaccines for Children-Enrolled Providers

Also in California, effective for dates of service on or after September 1, 2024, the Department of Health Care Services has updated the List of Contracted Incontinence Creams and Washes.

Also in California, the Board of Pharmacy proposed the following rules:

• Pharmacy Technician Certification Program Documents
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • 45-Day Comment Period: August 23, 2024, to October 7, 2024
• Quality Assurance Programs
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • 45-Day Comment Period: August 9, 2024, to September 23, 2024
  • Please send your company’s comments on the proposed rule to Sandra Guckian by September 10.
• Pharmacy Technician Fee Schedule
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • 45-Day Comment Period: July 26, 2024, to September 9, 2024

Finally in California, the Board of Pharmacy’s Licensing Committee added an additional meeting on September 4, 2024, to continue its work on the Standard of Care Model. The agenda, meeting materials and written comments received were posted to the Board’s website.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Services posted the following alerts, weekly notices and monthly bulletin on the Medi-Cal Rx Web Portal:

• Medi-Cal Rx Weekly Wrap-up for July 26-August 1
• State of Emergency Override Activation: Submission Clarification Code 13
• Medi-Cal Rx Monthly Bulletin for August
• Changes to the Medi-Cal Rx Contract Drugs List
• Changes to the Medi-Cal Rx Contract Drugs List – Over-the-Counter Drugs and Cough/Cold Preparations
• Changes to the Medi-Cal Rx Family Planning, Access, Care and Treatment Pharmacy Formulary
• Updates to the Medi-Cal Rx Provider Manual
• Medi-Cal Rx Weekly Wrap-up for July 19-25
• CalAIM Justice-Involved Reentry Initiative and Medi-Cal Rx

Also in California, this week, SB 966, PBM reform legislation, including provisions prohibiting the use of spread pricing, requiring 100% pass-through of manufacturer rebates to plan sponsors, and prohibiting the steering of patients to PBM-affiliated pharmacies, was placed on the Assembly Appropriations Committee suspense file and must be voted off the suspense file by August 16 to advance to the Assembly floor.

Finally in California, this week, the following bills were placed on the Senate Appropriations Committee suspense file and must be voted off the suspense file by August 16 to advance to the Senate floor:

• AB 1794, legislation clarifying that the value of all property taken over the course of distinct but related acts may be aggregated even though the thefts occurred in different places or from different victims and authorizing counties to operate a program to allow retailers to submit details of alleged shoplifting, organized retail theft or grant theft directly to the county district attorney through an online portal to the district attorney’s internet website.
• AB 82, legislation prohibiting a retail establishment from selling dietary supplements for weight loss or over-the-counter diet pills to any person under 18 years of age without a prescription. Amendments to the introduced language lowered the civil penalties from $1,000 to $250 for each violation and changed the effective date to January 1, 2026.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

NACDS submitted a letter to the Assembly Appropriations Committee in support of SB 966, PBM reform legislation, including provisions prohibiting the use of spread pricing, requiring 100% pass-through of manufacturer rebates to plan sponsors, prohibiting the steering of patients to PBM-affiliated pharmacies and requiring PBMs to obtain a license to operate in the state. 

Also in California, the Department of Health Care Services (DHCS) announced it will host its quarterly Hearing Aid Coverage for Children Program (HACCP) webinar for medical providers and hearing professionals on August 15 from 12:00 noon to 1:00 pm PDT. For more information and to pre-register, please visit DHCS’ HACCP webpage. 

Also in California, the Department of Health Care Services posted the following:  

• July 2024 Pharmacy Medi-Cal Update Bulletin  

• July 2024 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin  

Also in California, the Board of Pharmacy posted the agenda and meeting materials for the Full Board Meeting being held July 31-August 1. Please note the inclusion of compounding regulations. 

• Agenda 

• Board Meeting Materials 

Finally in California, the Department of Health Care Services posted the following alert on the Medi-Cal Rx Web Portal: Reminder: Quantity Limit Restrictions for Anti-Obesity Preparations. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for July 5-11.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Servies posted the following alerts, weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal.

• State of Emergency Override Activation: Submission Clarification Code 13
• Medi-Cal Rx Weekly Wrap-up for June 28-July 4
• Medi-Cal Rx Monthly Bulletin for July
• Changes to the Medi-Cal Rx Contract Drugs List
• Changes to the Medi-Cal Rx Contract Drugs List – Authorized Drug Manufacturer Labeler Codes
• Updates to the Medi-Cal Rx Provider Manual

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Servies posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for June 14-20.

Also in California, as part of Gov. Gavin Newsom’s (D) Master Plan for Tracking the Fentanyl and Opioid Crises, California will make its own private label branded over the counter (OTC) naloxone hydrochloride (HCL) nasal spray (CalRx®). It will be available for free to eligible organizations through the California Department of Health Care Services (DHCS) Naloxone Distribution Project (NDP) or for sale for $24 per twin-pack. The state is also working on an option for individuals to buy CalRx OTC naloxone nasal spray directly.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Servies posted the following alerts and weekly notice on the Medi-Cal Rx Web Portal.  

• Mass Adjustment for Enteral Nutrition for Impacted Claims Submitted December 27, 2022, through March 13, 2023 
• Mass Adjustment for Blood Factors for Impacted Claims Submitted January 1, 2022, through October 25, 2022 
• Mass Adjustment for Diabetic Lancets for Impacted Claims with a Date of Service January 1, 2022, through December 31, 2022 
• Mass Adjustment for Disposable Insulin Delivery Devices for Impacted Claims Submitted April 1, 2022, through April 28, 2022 
• Code I Diagnosis Requirement for Chronic Weight Management 
• Medi-Cal Rx Weekly Wrap-up for June 7-13 

Also in California, the Department of Health Care Services posted the following: 

• June 2024 Pharmacy Medi-Cal Update Bulletin 
• June 2024 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin 
• Rate Update for Select Durable Medical Equipment (DME) Codes  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Department of Health Care Servies posted the following alerts, weekly report and monthly bulletin on the Medi-Cal Rx Web Portal.

• New Medi-Cal Rx Web Portal Resource Pages: FDA Drug Recall Notifications
• New Medi-Cal Rx Web Portal Resource Page: Mass Adjustment Notifications
• Medi-Cal Rx Weekly Wrap-up for May 31-June 6
• Billing Tips for Diabetic Test Strips and Lancets and Dual Eligible Beneficiaries

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.