On April 20, the Department of Consumer Affairs issued an order waiving the staffing ratio of pharmacist to pharmacy technicians related to the administration of COVID-19 vaccinations.  The following language is included in the order: Accordingly, for pharmacists engaged exclusively in initiating and administering COVID-19 vaccines, and pharmacy technicians engaged exclusively in administering COVID-19 vaccines under the direct supervision and control of such pharmacists, the Director waives Business and Professions Code section 4115, subdivision (f)(1) to the extent it limits pharmacies with only one pharmacist to having no more than one pharmacy technician working, subject to the condition that such pharmacies may have no more than two pharmacy technicians working.

Also in California, the Medi-Cal Update Bulletin 989 – April 2019 includes the following items of interest.

• REMINDER: On April 1, the online attestation period opened for fee-for-service Medi-Cal pharmacy providers seeking the higher of two professional dispensing fees as part of the reimbursement for covered outpatient drugs. The attestation period for the 2020 calendar year is open until 11:59 pm April 30, 2021, and no attestations will be accepted after that time.
• Effective for dates of service on or after March 1, 2021,pen needles quantity limits without authorization have been updated to allow 100 pen needles per claim with no more than three (3) claims in 90 days. Pen needles are billed on a pharmacy claim using the contracted product’s National Drug Code (NDC).

Also in California, the Medi-Cal Update – Part 1 – Program and Eligibility Bulletin – April 2021 highlights information related to drug code limitations and Medi-Cal suspended and ineligible provider list among other program elements and eligibility requirements and updates.

Also in California, Medi-Cal announced a System Update beginning at midnight on April 25, 2021, continuing through 6:00 a.m.  Point of Service (POS) network Leased line Eligibility and Share of Cost (SOC) transactions may not be available during this time.

Lastly in California, additional agendas have been posted for the following Board of Pharmacy teleconferenced meetings:

• Legislation and Regulation Committee’s April 29, 2021
• Communication and Public Education Committee’s April 29, 2021
• Full Board’s April 29 and 30, 2021

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

NACDS and the California Retailers Association submitted a joint letter to the Assembly Business and Professions Committee in support of AB 1328, legislation allowing pharmacists to perform all CLIA-waived tests.

Also in California, the Board of Pharmacy’s teleconferenced Licensing Committee’s April 21, 2021, meeting agenda and meeting materials have been posted along with information to participate.  Also, the teleconferenced Enforcement and Compounding Committee’s April 22, 2021, meeting agenda has been posted along with information to participate.

Also in California, the Division of Workers’ Compensation’s Pharmacy and Therapeutics (P&T) Committee will meet on April 21, 2021, from 12:30 to 2:30 p.m. via video/audio conference only. To attend the meeting via video conference, please use the P&T Meeting Link. To join the meeting via teleconference, please use the call-in phone number: 1 (619) 407-9860 and enter phone conference ID: 520 391 953#.

Also in California, on April 1, the online attestation period opened for fee-for-service Medi-Cal pharmacy providers seeking the higher of two professional dispensing fees as part of the reimbursement for covered outpatient drugs. Medi-Cal pharmacy providers should have received a communication that includes the URL for the online attestation portal, as well as a unique login ID and password, by email, fax, or mail. If you have not received this communication, please call the Attestation Survey Hotline at 1-844-294-9982 or email CODSurvey@mercer.com.  The attestation period for the 2020 calendar year is open until 11:59 pm April 30, 2021, and no attestations will be accepted after that time. The attestation for the 2020 calendar year reporting period determines the professional dispensing fee component of the pharmacy claim reimbursement for claims with dates of service from July 1, 2021, through June 30, 2022. For additional information, providers can refer to the Pharmacy Provider Self-Attestation FAQs or may call the Attestation Survey Hotline at 1-844-294-9982, or email their questions to CODSurvey@mercer.com.

Also in California, Medi-Cal Rx Transition and Resources Training announced three sessions covering important Medi-Cal Rx changes for pharmacy providers and prescribers. For registration, all the training sessions are posted on the Education & Outreach Calendar within the Saba Learning Management System (LMS); you must be logged into the User Administration Console (UAC) to access the Education & Outreach Calendar in Saba.

Lastly in California, the Board of Pharmacy is beginning the development of its new strategic plan and is seeking stakeholder feedback. The Department of Consumer Affairs, SOLID Planning Solutions (SOLID), is assisting the Board with its strategic planning process.  Completed surveys will provide input as to how the Board is doing by identifying strengths, challenges, and current trends to consider for the future direction of the Board. All responses are anonymous. This survey will be open until April 30, 2021. For your convenience, NACDS is providing a PDF file of the survey.

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

NACDS and the California Retailers Association (CRA) submitted a joint letter to the Assembly Business & Professions Committee to register our “oppose unless amended” position on AB 1430, legislation requiring pharmacies to dispense Schedule II prescription drugs in lockable vials.  NACDS requested the bill be amended to be voluntary and to remove the onerous administrative requirements (i.e. maintaining patients’ combination codes for locking-cap closure mechanisms).  The bill also fails to extend the same liability protection against failure of a particular lockable vial to prevent unauthorized access and/or a particular patient’s inability to access medication in a lockable via that is otherwise afforded to prescribers under the bill; we requested his omission must be remedied.

Also in California, NACDS and CRA submitted a letter to the California Senate Appropriations Committee opposing SB 362 due to the fiscal pressure on the state created by new enforcement costs for the Board of Pharmacy. This is in addition to a similar recent joint letter to the California Senate Business, Professions & Economic Development Committee voicing opposition to this bill which would prohibit community pharmacies from utilizing metrics to evaluate the performance of employees.  While SB 362 may be well-intentioned, it contains ambiguous and onerous requirements that are impossible for pharmacies to meet and may ultimately threaten access to pharmacy services and jeopardize patient safety.

Also in California, SB 409, legislation permitting pharmacists to perform SARS-CoV-2 and influenza testing and adding pharmacist-in-charge in the definition of a laboratory director, passed the Senate and was read for the first time in the Assembly.

Also in California, the Department of Consumer Affairs (DCA) issued the following waivers via authority under Governor Gavin Newsom’s Executive Orders N-39-20. A list of current waivers is available on the DCA website.

• DCA Waiver DCA-21-139 Order Waiving Restrictions On Healthcare Students Administering COVID-19 Vaccines In Association With State or Local Vaccination Efforts
• DCA Waiver DCA-21-140 Order Waiving Restrictions On Healthcare Providers With Expired, Inactive Or Lapsed Licenses Ordering And Administering COVID-19 Vaccines In Association With State or Local Vaccination Efforts

Also in California, due to the delayed Go Live date for Medi-Cal Rx, the following events have been postponed.  Also, the Department of Health Care Services (DHCS) anticipates providing further information about the Medi-Cal Rx implementation in May.

• The April 14 public forum is being postponed. The next scheduled Medi-Cal Rx public forum is May 19 via webinar. Information will be posted on the DHCS website. For questions or comments related to Medi-Cal Rx, please email RxCarveOut@dhcs.ca.gov.
• The March 22 Medi-Cal Rx Advisory Workgroup meeting was postponed. The next scheduled meeting for this workgroup is May 28 via webinar. These sessions are intended to help facilitate and further inform DHCS’s ongoing efforts to implement pharmacy services improvements through Medi-Cal Rx. Information on how to participate in the next webinar will be provided on the DHCS website.

Also in California, on April 7, 2021, the DHCS posted this Provider Registration and FAQs bulletin on the Medi-Cal Rx Web Portal.

Lastly in California, the Board of Pharmacy is beginning the development of its new strategic plan and is seeking stakeholder feedback. The Department of Consumer Affairs, SOLID Planning Solutions (SOLID), is assisting the Board with its strategic planning process.  Completed surveys will provide input as to how the Board is doing by identifying strengths, challenges, and current trends to consider for the future direction of the Board. All responses are anonymous. This survey will be open until April 30, 2021.

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

The Department of Managed Health Care announced All Plan Letter 21-011 to provide an overview of new guidance from the federal Departments of Labor, Health and Human Services, and the Treasury that address the implementation of the Families First Coronavirus Response Act (FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), and other health coverage issues related to COVID-19. The letter discusses coverage of diagnostic testing, especially public health surveillance testing.

Also in California, The Board of Pharmacy posted its monthly news roundup.  Among the items of interest are the March 2021 issue of “The Script” with articles about new pharmacy laws, new requirements for controlled substance prescription forms and for reporting to CURES, tips on how to avoid processing delays for pharmacy technician license applications, and a reminder that pharmacists-in-charge are required to complete a self-assessment of the pharmacy’s compliance with state and federal laws before July 1 of each odd-numbered year. Current forms and draft versions under review for possible adoption are available online under “Facility License Information/Renewal.” Effective April 1, 2021, the CURES fee will increase from $6 to $11 annually for two years in which most licensees will see a $22 CURES fee due to the biennial renewal cycle.

Also in California. The Board of Pharmacy posted “Guidance on Eligible Personnel for Vaccines Administered in Pharmacies.” Please visit the above link for more information.

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

Effective July 1, 2021, the Board of Pharmacy will adopt amended regulations to consolidate the renewal license types into two categories: (1) a premises or facility license, and (2) a license issued to an individual, other than a pharmacist or an advanced practice pharmacist.  This regulatory action amends and repeals regulations under 16 CCR 1702, 1702.1, 1702.2, and 1702.5 to consolidate standards for various board license types. The rule also requires disclosure of all continuing education requirements to renew a pharmacist or advanced pharmacist license as required by section 1732.5.

Also in California, the Board of Pharmacy readopts regulations originally adopted in emergency action 2020 – 0420 – 02E relating to the independent initiation and furnishing of HIV pre-exposure and post-exposure prophylaxis to patients as authorized by Statutes 2019, chapter 532 (SB 159). The rule is effective February 25 and expires August 24, 2021.

Also in California, NACDS and the California Retailers Association (CRA) submitted a joint letter to the California Senate Business, Professions & Economic Development Committee in opposition of SB 362 which would prohibit community pharmacies from utilizing metrics to evaluate the performance of employees.  NACDS and CRA commented that while SB 362 is well-intentioned, it contains ambiguous and onerous requirements that are impossible for pharmacies to meet and maya ultimately threaten access to pharmacy services and jeopardize patient safety.

Also in California, NACDS and the California Retailers Association (CRA) submitted a joint letter to the California Senate Business, Professions & Economic Development Committee supporting AB 671, which will require the Department of Health Care Services (DHCS) to provide disease management or similar payment to DHCS contracted pharmacies dispensing specialty drugs to Medi-Cal beneficiaries.

Also in California, the Department of Health Care Services issued the Medical Rx Pharmacy Provider and Prescriber Readiness Survey to survey pharmacies on their current process to conducting business for Medi-Cal pharmacy services. The data in the survey will be held confidential and the results will be used by the Education & Outreach team to design training offerings for Medi-Cal Rx to prepare providers for the upcoming Medi-CAl Rx Transition.

Also in California, the Department of Justice, Office of the Attorney General announced the Office of Administrative Law’s (OAL) approval of new rules to strengthen the language of the California Consumer Privacy Act (CCPA) regulations approved by OAL in August 2020, including protecting consumers from unlawful business practices that may be deceptive or misleading.

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

In response to Gov. Gavin Newsom’s emergency declaration and consistent with the authority of the Board of Pharmacy to waive Pharmacy Law or the regulations, the Board president Greg Lippe extended the previously approved limited waiver on pharmacists initiating and administering vaccines through May 29, 2021. More information can be found at the following link. Pharmacists Initiating and Administering Vaccines, CCR section 1746.4(d)

Also in California, On March 24, 2021, CalRecycle staff will conduct a webinar to present the statutory and regulatory requirements, submittal process, and timing for covered drugs and home-generated sharps waste stewardship plans and initial program budgets as required by the Pharmaceutical and Sharps Waste Stewardship law and its implementing regulations.

Also in California, The Senate Budget Subcommittee #3 on Health and Human Services held a hearing this week to review the Governor’s proposal to provide $12 million in funding Medi-Cal coverage of continuous glucose monitors. NACDS is part of a Coalition supporting Medi-Cal coverage of CGMs.

Also in California, The Board of Pharmacy created a voluntary online registry to help consumers find specific health care services that qualified pharmacists may provide to patients without a prescription.

The health services are:

1. Self-administered hormonal contraception.
2. Emergency contraception.
3. Vaccinations.
4. Travel medications.
5. Nicotine replacement therapy.
6. Naloxone.
7. HIV preexposure prophylaxis (PrEP).
8. HIV postexposure prophylaxis (PEP).

Also in California, The Medi-Cal web portal Provider Registration and Training FAQs are now available and can be accessed here.

Also in California, The Board of Pharmacy will hold a Teleconference Public Meeting on Thursday, March 18, 2021.  The agenda includes discussion and consideration of Title 16 CCR Section 1747, related to HIV Prep and PEP, and proposed regulations related to pharmacy technician application, training requirements, and certification programs.

Also in California, The Board of Pharmacy adopted a final rule that modifies the Pharmacy Technician Application (Form 17A – 5) to add information regarding expedited licensure for applicants who meet certain criteria regarding their immigration status and military service. This change without regulatory effect was filed on February 8.

Also in California, the Department of Health Care Services’ Education & Outreach team is surveying providers to learn more about how pharmacies currently conduct business for Medi-Cal Pharmacy Claims. The results of the Medi-Cal Rx Pharmacy Provider and Prescriber Readiness Survey will be used to tailor training offerings for Medi-Cal Rx to ensure pharmacies are prepared for the upcoming transition.

Also in California. Beginning March 15, healthcare providers may use their clinical judgment to vaccinate individuals age 16-64 who are deemed to be at high risk from COVID-19 as the direct result of certain conditions and settings:

• Individuals with one or more severe health conditions
• Individuals with developmental or other severe disabilities or illness
• Individuals who live or work in a high risk congregate residential setting
• Public transit workers

Healthcare providers should thoroughly read the California Department of Public Health’s Provider Bulletin, Fact Sheet, and COVID-19 Vaccine Allocation Guidelines. Additional information is at California’s COVID-19 vaccine website here.

Also in California. Effective April 1, 2021, the Controlled Substance Utilization Review and Evaluation System (CURES) fee will increase from $6 to $11 annually for two years for all the Board’s that prescribe, order, administer, furnish, or dispense Schedule II, Schedule III, Schedule IV, or Schedule V controlled substances. More information is available here.

Lastly in California, NACDS and the California Retailers Association submitted a joint letter to the Senate Business, Professions & Economic Development Committee in support of SB 409 with proposed amendments to include pharmacy technician testing authority as well as authority for pharmacists to initiate treatment according to the test result.

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