California

The Board of Pharmacy voted to pursue legislation in 2021-22 to make the Department of Consumer Affairs (DCA) temporary waiver allowing pharmacists to order and administer CLIA-waived tests for COVID and influenza permanent.

Also in California. The Department of Health Care Services (DHCS) continues to make significant progress and movement toward a full assumption of operations of all pharmacy services on April 1, 2021, to Medi-Cal Rx.

  • To facilitate the transition for Medi-Cal pharmacy providers, DHCS will be transferring previously established Electronic Fund Transfer (EFT) account information from the existing Medi-Cal fee-for-service (FFS) Fiscal Intermediary to Medi-Cal Rx. For those pharmacy providers that do not wish to have their EFT account information transferred over to Medi-Cal Rx for use after April 1, 2021, assumption of operations, an option to “opt-out” is available. Registered users who wish to provide new or modified EFT account information to Medi-Cal Rx for use after the Medi-Cal Rx assumption of operations may do so at the following link: https://medi-calrx.dhcs.ca.gov/.
  • The Medi-Cal Rx website will be fully operational by April 1, 2021. DHCS encourages Medi-Cal providers to sign up for the Medi-Cal Rx Subscription Service (MCRxSS) so that interested parties can receive Medi-Cal Rx updates.

Also in California. Pharmacies can submit batch and hard copy claims for COVID-19 vaccine administration. More information can be found about claims submission can be found here.

Also in California. In 2019, the Department of Health Care Services (DHCS) had temporarily suspended retroactive pharmacy claim adjustments. DHCS will resume retroactive pharmacy claim adjustments beginning in February of 2021. Refer to Frequently Asked Questions on the Medi-Cal Website for additional information.

Also in California. In response to members’ requests, NACDS submitted a joint letter with the California Retailers Association to the San Diego County Health and Human Services Agency urging them to remove the Vaccines-for-Children enrollment barrier so citizens can receive COVID vaccines at their local convenient community pharmacies.

Also in California. The Department of Managed Care provided notice and guidance on Covid-19 vaccine coverage and administration for the Medi-Cal managed care program. Please visit the above link for more information.

Also in California. Gov. Gavin Newsom (D) issued an Executive Order extending liability protections for healthcare providers during state and local emergencies to healthcare providers participating in the state’s vaccine administration program.  The Order applies to both pharmacists and pharmacy technicians.  More information can be found here.

Also in California. The DHCS issued guidance reminding Medi-Cal providers that they are prohibited from illegally discriminating against Medi-Cal members. Also, in the context of the COVID-19 PHE, providers are prohibited from illegally discriminating against Medi-Cal members in determining how to allocate scarce resources for the treatment of COVID-19. DHCS’ Office of Civil Rights has an established discrimination complaint process for Medi-Cal consumers to file grievances of alleged discrimination. More information is available on the DHCS website.

Lastly, in California. The DHCS held a webinar to provide an overview of the relaunch of the California Advancing and Innovating Medi-Cal (CalAIM) initiative.  CalAIM builds upon prior successes in health care delivery and proposes to provide more services and supports for patients with complex needs. Key goals of CalAIM include promoting whole-person care, reducing program complexity, and modernizing systems. For more information, please visit the CalAIM webpage.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2021-01-29T10:56:10-05:00January 29, 2021|California|

California

The Department of Health Care Services (DHCS) Medi-Cal is on track for April 1, 2021, to move from managed care to fee-for-service. DHCS has received approval from the Centers for Medicare & Medicaid Services (CMS) for numerous projects, including the transition of the Medi-Cal pharmacy benefit from managed care to fee-for-service. For more information about Medi-Cal Rx, please visit DHCS’ dedicated Medi-Cal Rx Transition website: Medi-Cal Rx: Transition

Also in California. DHCS submitted a State Plan Amendment (SPA) 20-0046 to CMS, which seeks to set reimbursement for COVID-19 testing administered to Medi-Cal students in schools at 70 percent of the Medicare reimbursement rates. The effective date of this SPA is February 1, 2021.

Also in California. The California Department of Public Health released new guidance on vaccine prioritization on January 7. The guidance recognizes the need to balance the prioritization of scarce vaccine resources to achieve community immunity for all Californians by noting situations in which the health departments and providers may offer doses promptly to people in lower priority groups, including provider flexibility to eliminate vaccine spoilage.

Also in California. The Board of Pharmacy reminded pharmacies that they must register their mobile vaccination clinics/hubs where their pharmacist and pharmacy technicians are providing vaccinations outside the pharmacy. All that is required is the pharmacy name and license, and records related to vaccinations should be kept at the pharmacy to be made available if needed for an inspection. Chain companies can provide one list of all their licensed pharmacies in California where there is a mobile COVID vaccine clinic or COVID vaccine administration outside the pharmacy. For more information contact Amber Dillon at Amber.Dillon@dca.ca.gov.

Also in California. The Board of Pharmacy provided guidance on new compliant security prescription forms for instances where a prescriber may not have utilized a compliant security prescription form for a controlled substance on and after January 1, 2021, as required by Assembly Bill 149 (Statutes of 2019). For additional information, go to the Joint Statement and FAQs from the California Department of Justice, the California State Board of Pharmacy, and the Medical Board of California.

Also in California. On January 7, the Office of Administrative Law (OAL) approved the Pharmaceutical and Sharps Waste Stewardship Program Regulations, which are effective immediately.

Also in California. The Administration’s Medi-Cal reform initiative that got delayed last year due to COVID was revised and released last week. The CalAIM executive summary is attached and here is a link to the website.

Lastly in California. In case you missed it, before the holidays, the California Department of Consumer Affairs (DCA) issued an order waiving restrictions on pharmacy technicians related to administering COVID-19 vaccinations with specific conditions: DCA Waiver DCA-20-103 Order Waiving Restrictions on Pharmacy Technicians Relating to Administering COVID-19 Vaccines.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2021-01-15T10:40:12-05:00January 15, 2021|California|

California

Effective January 1, 2021, only California controlled substance prescription forms that will remain valid and acceptable by pharmacies will be those possessing a 12-character serial number and a corresponding barcode, compliant with the requirements introduced in new state law, AB 149 (Cooper, Statutes of 2019). The requirements do not affect prescriptions that are electronically transmitted from the prescriber to the pharmacy, or prescriptions for non-controlled substances. More information on the new laws can be found here.

Also in California. In response to Gov. Gavin Newsom’s (D) emergency declaration, the Board of Pharmacy extended several COVID waivers that were set to expire this month.

  • Remote Processing – For this waiver, “remote processing” means the entering of an order or prescription into a computer from outside of the pharmacy. Effective through May 31, 2021, or until 30 days after the emergency declaration is lifted, whichever is sooner.
  • Ratio for Pharmacists not Solely Engaged in Immunization-Related Activities – The ratio of pharmacists to intern pharmacists may increase to allow for one additional intern pharmacist for each supervising pharmacist under certain conditions. Effective through September 2, 2021, or until 30 days after the emergency declaration is lifted, whichever is sooner.
  • Ratio for Pharmacists Solely Engaged in Immunization-Related Activities – The ratio of pharmacists to intern pharmacists may increase to allow for two additional intern pharmacists for each supervising pharmacist under certain conditions. Effective through September 2, 2021, or until 30 days after the emergency declaration is lifted, whichever is sooner.
  • Inventory Reconciliation Report of Controlled Substances – A pharmacy must complete the required inventory reconciliation report at least once every six months rather than every three months if determined to be necessary by the pharmacist-in-charge or professional director to ensure continuity of direct patient care activities that would otherwise be impacted. Effective through March 13, 2021, or until 30 days after the emergency declaration is lifted, whichever is sooner.

Also in California. The Department of Health Care Services (DHCS) established new COVID-19 testing codes. More information can be found on the New COVID-19 Testing Codes Established website.

Lastly in California. The Board of Pharmacy’s waiver request to allow pharmacists to independently initiate and administer FDA authorized COVID-19 vaccinations was approved on December 11 by the Department of Consumer Affairs (DCA) (approved waiver) bridging the gap until the new law pharmacies supported is implemented on January 1, 2021. The new law, AB 1710, will allow a licensed pharmacist to independently initiate and administer COVID-19 vaccines approved by the federal Food and Drug Administration (FDA) under the same circumstances that vaccines listed on the routine immunization schedule may initiate and administered.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-12-18T08:19:59-05:00December 18, 2020|California|

California

The Board of Pharmacy is holding a teleconference full Board meeting on December 10, 2020, to discuss the continuation of COVID waivers. More information on the agenda and how to access the meeting can be found here.

Also in California. The Department of Health Care Services (DHCS) published additional COVID-19 emergency guidance for providers, beneficiaries, and the general public. COVID-19 Virus and Antibody Testing additional updates will be posted to the DHCS COVID-19 resource page.

Lastly in California. DHCS announced a new timeline and process changes for the 2021 Medi-Cal Provider Attestation for the enhanced professional dispensing fee. More information can be found here.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-12-04T09:07:13-05:00December 4, 2020|California|

California

The Department of Health Care Services (DHCS) has decided to lengthen the transition time to the full implementation of Medi-Cal Rx by three months. All current Medi-Cal prescription drug services DHCS and Medi-Cal processes and protocols will remain unchanged and in place until Medi-Cal Rx launches on April 1, 2021. Questions should be referred to RxCarveOut@dhcs.ca.gov.

Also in California. On November 19, the Board of Pharmacy held a virtual meeting to discuss seeking a waiver allowing technicians to administer all vaccines, rather than just influenza as was adopted by the Board in October. Unfortunately, the vote was 5-6, defeating the motion for full expansion. This issue of administering all vaccines will be returned to the Licensing Committee for further discussion at their next meeting. The Board then amended their original policy to include COVID vaccines to be administered by technicians when they become available and that motion passed with a vote of 8-3. As it stands right now, the California Board of Pharmacy policy supports both temporary waivers and permanent adoption of a statute change allowing pharmacy technicians to administer influenza and COVID vaccines.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-11-20T08:51:41-05:00November 20, 2020|California|

California

An emergency rulemaking allowing pharmacists to independently furnish HIV Preexposure and Postexposure Prophylaxis was extended to February 26, 2021. The Notice of Approval and the text of CCR section 1747 are posted on the Approved Regulations page.

Also in California. The Remote Processing (BPC section 4071.1(a)) expired on October 31. Although the broad waiver is expiring, pharmacies may request that the Board issue a site-specific waiver. Information on how to request a Pharmacy Law Waiver can be found here.

Also in California. The Department of Health Care Services (DHCS) released two NEW Medi-Cal Rx Subscription Services, for you to share with your respective interested parties: Please see the below resources for additional information.

  1. California Department of Health Care Services (Medi-Cal Rx) – NCPDP Standard Payer Sheet, Version 1.0, dated October 22
  2. Medi-Cal Rx List of Covered Enteral Nutrition Products, effective January 1, 2021.

Also in California. The Assembly Labor and Employment Committee will be holding an informational hearing on November 17, 2020, to discuss “Safeguarding Our Frontline Workers During COVID-19: The Need for Robust Workplace Health and Safety Protections”. More details on the meeting and access to listen to the meeting can be found here.

Lastly, in California. The Department of Managed Health Care published a notice to remind health plans and their delegated entities to exercise maximum flexibility in covering and reimbursing for the acquisition and administration of vaccines, such as the influenza vaccine.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-11-06T12:37:45-05:00November 6, 2020|California|

California

After a lengthy discussion on October 20, the Board of Pharmacy’s Licensing Committee unanimously supported two motions to be considered by the full Board:

  1. order and administer CLIA-waived tests, and
  2. expand pharmacy technician duties to allow for the administration of immunizations.

These proposals will be considered at the full Board of Pharmacy teleconference meeting on October 27 & 28, 2020. The meeting agenda can be found here and additional meeting materials are available here.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-10-23T10:26:22-04:00October 23, 2020|California|

California

Concerned about confidentiality of the Maximum Allowable Ingredient Cost (MAIC) data collected on the quarterly surveys, NACDS and the California Retailers Association (CRA) sought reassurances from the Department of Health Care Services (DHCS) that all survey data will be kept confidential. DHCS provided the below response and requested that the following statement be shared with members.

All invoice information collected through this survey and subsequent surveys will remain confidential. Access to information collected is limited to Mercer employees working on the MAIC program. Mercer will not release or otherwise make public any information that names and/or discloses the business, financial, personnel, or other information provided by pharmacies in the course of completing this survey and subsequent surveys. Mercer will perform the following steps to secure the confidentiality of the information before sharing with either Magellan or DHCS:

  1. Mercer will store and evaluate all invoice information collected on a secure network path, where only Mercer employees working on the MAIC program will be able to access the information.
  2. Mercer will supply to Magellan the results of the statistical analysis, the MAIC rate for each drug grouping level (e.g. aripiprazole 10mg tablet) for Medi-Cal pharmacy claim processing. Mercer will not share survey data with Magellan outside of the MAIC rates calculated.

Also in California. On October 22, 2020, the Board of Pharmacy’s Licensing Committee will hold a virtual meeting that will focus primarily on pharmacy technician immunization administration and expanding the authority for pharmacists to order and administer CLIA-waived tests. NACDS and the California Retailers Association (CRA) submitted a joint letter in advance. Meeting materials can be found here. Members can also log on to the state website for observation and public comments.

Also in California. To encourage greater access to Medication-Assisted Treatment (MAT), the Board adopted a policy statement supporting pharmacists providing direct care and assisting medical providers in caring for patients with opioid addiction. The Board also developed a sample collaborative practice agreement for pharmacists to provide MAT to patients with opioid use disorder (OUD) in collaboration with a medical care provider. According to the Board, pharmacists can use the sample agreement to provide MAT in collaboration with a practitioner who has a DATA 2000 waiver authorizing the practitioner to prescribe medications used to wean patients from opioids.

Also in California. In an effort to prepare for the 2021 legislative session in priority states, NACDS held two separate conference calls with our in-state partners, the California Retailers Association (CRA) and the California Pharmacists Association (CPhA), to discuss NACDS’ policy priorities, identified by member surveys, for both the Reimbursement and Scope of Business Campaigns. Both CRA and CPhA expressed support for working with NACDS to achieve improved reimbursement policies for pharmacies operating in the state and expressed interest in learning more about our scope expansion ideas and business efficiencies. NACDS will continue collaborating with both partners as we move into the 2021 legislative session.

Lastly in California. The Division of Workers’ Compensation (DWC) scheduled its next public meeting of the Pharmacy and Therapeutics (P&T) Committee on October 21, 2020, at 12:30 PM via video/audio conference. The primary focus of this meeting will be to discuss the Medical Treatment Utilization Schedule (MTUS) drug formulary. Members can register for this meeting here. The meeting agenda and related materials can be found on the DWC P&T Committee webpage.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-10-16T09:24:17-04:00October 16, 2020|California|

California

As California prepares for the start of the implementation of SB 212, which requires the pharmaceutical industry to form a stewardship organization and fund a drug take-back program, the California Product Stewardship Council (CPSC) provided stakeholders with an update on the safe disposal drug take-back bin (med bin) “infrastructure” that they have been building since they were awarded the grant in 2018. To find a med bin near you, visit www.takebackdrugs.org.

Also in California. Beginning on January 1, 2021, Medi-Cal pharmacy benefits will be transitioned to and administered through the fee-for-service delivery system for all Medi-Cal beneficiaries (generally referred to as “Medi-Cal Rx”). The Department of Health Care Services (DHCS) has partnered with Magellan Medicaid Administration, Inc. (Magellan) to provide a wide variety of administrative services and supports for Medi-Cal Rx. DHCS is providing critical information regarding the prescriber and pharmacy registration for the secure Medi-Cal Rx Provider Web Portal. This portal will be used to provide regular transitional monitoring supports to help ensure submitting providers and other interested entities will have all necessary information to support efforts related to a smooth and effective transition, including communications, training, and other pertinent resources. DHCS continues to make significant progress towards a successful transition of pharmacy services on January 1, 2021, to Medi-Cal Rx. Medi-Cal Rx transitioning pharmacy services from Medi-Cal managed care to fee-for-service will, among other things:

  • Standardize the Medi-Cal pharmacy benefit statewide, under one delivery system.
  • Improve access to pharmacy services with a pharmacy network that includes the vast majority of the state’s pharmacies and is generally more expansive than individual Medi-Cal managed care plan pharmacy networks.
  • Apply statewide utilization management protocols to all outpatient drugs, as appropriate.
  • Strengthen California’s ability to negotiate state supplemental drug rebates with drug manufacturers as the largest Medicaid program in the country with over 13 million beneficiaries. More information on the Medi-Cal Rx transition and the Provider Portal can be found here.

DHCS/Magellan has also launched the training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies. For detailed registration and training instructions, access the Medi-Cal Rx Web Portal and Training Registration or visit https://medi-calrx.dhcs.ca.gov/provider/ and click Register in the upper right-hand corner.

Also in California. A Medi-Cal Rx subscription service is now available, so pharmacies are encouraged to sign up and receive Medi-Cal Rx updates by email.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2020-10-09T08:31:35-04:00October 9, 2020|California|
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