This week, Sen. Scott Weiner (D) introduced two bills in what he calls “the prescription drug affordability package, or PDA,” aimed at reducing the cost of prescription drugs for Californians.

• SB 40: Would cap monthly insulin co-pays at $35 a month for most private health plans.
• SB 41: Would
• Require PBMs to be licensed by the Department of Insurance by January 1, 2027.
• Impose duties and reporting requirements on PBMs, with violations subject to civil penalties.
• Prohibit a contract between a PBM and a health care service plan or insurer that is executed, amended or renewed on or after January 1, 2026, from authorizing spread pricing.
• Prohibit a health care service plan contract or health insurance policy issued, amended or renewed on or after January 1, 2026, from calculating an enrollee’s or insured’s cost sharing at an amount exceeding the actual rate paid for the drug and require the contract or policy to include cost-sharing provisions.

Also in California, the Department of Health Care Services posted the following alerts, weekly notice and monthly bulletin on the Medi-Cal Rx Web Portal.  Please note the maximum allowable ingredient cost notice with rates effective January 1, 2025. Also, on January 31, 2025, the Transition Policy will be retired and reinstatement of prior authorization (PA) requirements and other claim utilization management (UM) edits for members 21 years of age and younger will apply to both new start and continuation of therapy claims.

• Maximum Allowable Ingredient Cost 30-Day Pharmacy Provider Notice
• Medical Supplies: Updates of the List of Contracted Pen Needles, Effective January 1, 2025
• Updates to the List of Contracted Enteral Nutrition Products, Effective January 1, 2025
• Diabetic Supplies: Updates to the Contracted Disposable Insulin Delivery Devices, Effective January 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Diabetic Testing Supplies, Effective January 1, 2025, and March 1, 2025
• Diabetic Supplies: Updates to the List of Contracted Continuous Glucose Monitoring (CGM) Systems, Effective January 1, 2025
• Updates to the List of Contracted COVID-19 Tests, Effective January 1, 2025
• Medi-Cal Rx Monthly Bulletin for December
• Changes to the Medi-Cal Rx Contract Drugs List
• Updates to the Medi-Cal Rx Provider Manual
• 60-Day Countdown: Pediatric Integration of Members 21 Years of Age and Younger
• Mass Adjustment for TPOXX Drug Reimbursement for Impacted Claims with a Date of Service August 20, 2022, through October 1, 2024
• Mass Adjustment for Mpox Vaccine Reimbursement for Impacted Claims with a Date of Service August 17, 2022, through October 11, 2024
• Medi-Cal Rx Weekly Wrap-up for November 15-21

Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy distributes a list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. This information is available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers.

Questions or comments about the prescribers listed should be directed to the Medical Board of California.

Finally in California, the Board of Pharmacy issued a reminder. Starting January 1, 2025, licenses that are eligible for renewal will be processed online. Those who are eligible include:

• Pharmacist
• Advanced Practice Pharmacist
• Pharmacy Technician
• Designated Representative – Wholesaler
• Designated Representative – Veterinary Food-Animal Drug Retailer
• Designated Representative – 3PL (Third-Party Logistics)
• Designated Representative – Reverse Distributor

The Board of Pharmacy (Board) will no longer mail out a paper renewal application for the above licensees. In its place, a postcard reminder will be sent approximately six weeks prior to the license expiration date and the licensee will renew by going to www.pharmacy.ca.gov. The postcard is only a reminder, if the licensee does not receive a postcard, they are still required to submit their payment on-time to avoid a delinquency fee and possible cancellation of the license.

Renewal payment transactions must be completed prior to 5:00 pm Pacific Time on the date the license expires to avoid the delinquency fee. The Board recommends printing the payment confirmation at the end of this transaction for recordkeeping. Once the online payment is submitted, please allow two business days for processing.

The Board must be notified of any change in address within 30 days. Change of address may take between 7-10 business days to update in the system. If the correct address is not in the system at the time of renewal, the process may be delayed. Address changes can be made on-line or in writing to the board.

Fees are changing on January 1, 2025. The updated fee schedule with the new fees has been posted on the website.

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

The Department of Health Care Services posted the following:

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

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

• Mass Adjustment for COVID-19 Vaccine Incentive Fee for Impacted Claims with a Date of Service October 1, 2022, through December 31, 2023
• Medi-Cal Rx Weekly Wrap-up for November 8-14
• State of Emergency Override Activation: Submission Clarification Code 13

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

• Discontinuation of Business
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • 45-Day Comment Period: November 15, 2024, to December 30, 2024
• Quality Assurance Programs
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Proposed Text
  • Notice of Modified Text
  • Modified Text
  • 15-Day Comment Period: November 15, 2024, to December 2, 2024
  • Please send your company’s comments on the modified text to Sandra Guckian by November 25, 2024.
• Compounded Drug Preparations
  • Notice of Proposed Action
  • Initial Statement of Reasons
  • Repealed Text
  • Proposed Text
  • Notice of Modified Text
  • Modified Initial Statement of Reasons
  • Modified Regulation Text

• • Board Requested Format for Submitting Comments
  • 30-day Comment Period: November 8, 2024, to December 9, 2024

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

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

• Reminder: Dual Eligible Special Needs Plan Deeming Periods
• Medi-Cal Rx Weekly Wrap-up for November 1-7
• Medi-Cal Rx Finance Portal “Download All Files” Error – Issue Resolved
• How to Resolve Reject Code 16 – M/I Prescription/Service Reference Number
• Medi-Cal Rx Weekly Wrap-up for October 25-31
• Medi-Cal Rx Monthly Bulletin for November
• Changes to Medi-Cal Rx Contract Drugs List
• Updates to Medi-Cal Rx Provider Manual
• 90-Day Countdown: Pediatric Integration of Members 21 Years of Age and Younger

Also in California, Proposition 36, The Homelessness, Drug Addiction and Theft Reduction Act, passed resulting in various changes to criminal and drug laws, including increasing penalties for some offenses, and providing treatment programs for people with drug addictions. Proposition 36 increases punishment for some theft and drug crimes in three ways: 1) turns some misdemeanors into felonies; 2) lengthens some felony sentences; and 3) requires some felonies be served in prison.

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

A licensee is required to notify the Board of Pharmacy when ceasing to act as a pharmacist-in-charge (PIC), designated representative-in-charge (DRIC) or responsible manager (RMG). Disassociation forms are available on the website and intended to assist licensees in providing the required notification to the Board. No fee is required for the notification of disassociation. Completed forms may be submitted to the Board via mail or e-mail by using the email address provided on the form.  

Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy is distributing this list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. The Board of Pharmacy is making this information available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers. Names with a strikeout indicate the restriction is no longer effective. Names in bold indicate there has been an update to the action the Medical Board of California took. Questions or comments about the prescribers listed should be directed to the Medical Board of California. 

Also in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for October 18-24. 

Finally in California, the Board of Pharmacy posted the agenda for its Full Board Meeting on November 6-7, 2024. 

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

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

• Activation of Reject Code 16 – Medi-Cal Rx Program Integrity Update
• Medi-Cal Rx Claim and Prior Authorization Request System Outage – Issue Resolved
• Update: Medi-Cal Rx Claim and Prior Authorization Request System Outage
• Medi-Cal Rx Claim and Prior Authorization Request Submission Outage
• Medi-Cal Rx Weekly Wrap-up for October 11-17
• Commercial JYNNEOS® Vaccine Reimbursement
• Medi-Cal Rx Weekly Wrap-up for October 4-10
• Reminder: Verification of Member Name on Medi-Cal Rx Claims
• Revolved: Medi-Cal Rx Provider Portal Prior Authorization Attachments
• Justice-Involved Reentry Initiative Now Implemented in Inyo, Santa Clara, and Yuba Counties
• Coming Soon: Commercial JYNNEOS® Vaccine Reimbursement Correction
• State of Emergency Override Activation: Submission Clarification Code 13
• Medi-Cal Rx Weekly Wrap-up for September 27-October 3
• Deactivation of Override Code “55555” for All Drugs/Products – Medi-Cal Rx Program Integrity Update
• Medi-Cal Rx Monthly Bulletin for October
• 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 Contract Drugs List – Authorized Drug Manufacturer Labeler Codes
• Changes to the Medi-Cal Rx Pharmacy Reimbursable Physician Administered Drugs
• Changes to the Medi-Cal Rx Family Planning, Access, Care, and Treatment Pharmacy Formulary
• Updates to the Medi-Cal Rx Provider Manual

Also in California, effective September 17, the opioid antagonist protocol was amended. The approved regulation text with changes has been posted by the Board of Pharmacy.

Also in California, starting January 1, 2025, personal license renewal applications will no longer be mailed and licenses that are eligible for renewal will be processed online.

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

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

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