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.

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.

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.

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.

The Department of Health Care Services (DHCS) recently held a webinar to explain the new Medi-Cal quarter surveys to establish a Maximum Allowable Ingredient Cost (MAIC) program for multi-source generic drug reimbursement. The surveys will be sent to the corporate contact for each chain, not to the pharmacy. MAIC rates will be published by December 1, 2020, and effective January 1, 2021. The meeting was recorded and the slide deck is available on Mercer’s Medi-Cal Rx Website. The webinar recording can be accessed by using the following password:  h5#moJC^

Also in California. The California Department of Public Health (CDPH) has issued guidance to clarify clinical lab licensure requirements for pharmacies, pharmacists, and pharmacy technicians performing COVID-19 testing under the provisions of waivers issued by the Department of Consumer Affairs (DCA).

Also in California. DHCS held a Medi-Cal Rx Public Forum sharing information related to the transition of pharmacy services reimbursement from managed care to Fee-For-Service effective January 1, 2021.  Notably, there is now a Med-Cal Rx website that contains a link for pharmacy providers to “register” for the Medi-Cal Rx provider portal. This portal allows for pharmacies to try out the new system and get more detailed information on training and important information going forward. To register for the provider portal, please go to the secure portal. Pharmacies should also register for the Medi-Cal Rx subscription service.  More information on the forum can be found here.

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

The Department of Health Care Services (DHCS) announced that on October 1, 2020, Magellan Health, the pharmacy claims administrator for Med-Cal will begin quarterly surveys of approximately 600 pharmacies so that they can establish a Maximum Allowable Ingredient Cost (MAIC) for multisource generic drugs. According to the announcement, pharmacies must submit certain invoice information to CAMAICsurvey@mercer.com. The new MAICs will be published in pharmacy provider bulletins 30 days before the effective date of January 1, 2021. More information can be found here.

Also in California. Gov. Gavin Newsom (D) appointed Jason Weisz of San Diego to a 4-year term as a public member to the 13-person Board of Pharmacy.

Also in California. The Department of Public Health Immunization Branch in partnership with the state Immunization Coalition is conducting a survey of Independent Pharmacies to learn about plans for influenza vaccination services this flu season during the COVID-19 pandemic. NACDS is helping develop a different survey for chain pharmacies that will be distributed soon.

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

For the past four months, NACDS jointly with the California Retailers Association, the California Pharmacists Association and Board of Pharmacy, has been urging Governor Gavin Newsom’s Administration to remove existing barriers to allow pharmacies to fully engage in COVID testing. In early May, the Governor granted authority allowing pharmacies to only collect test specimens, due to limited restrictions of requirements to have a laboratory director. Finally, on August 24, the Governor signed an Executive Order increasing the availability of CLIA-waived COVID-19 testing by pharmacies. The order directs the Department of Consumer Affairs, in consultation with the California Department of Public Health, to issue waivers (DCA-20-45) permitting pharmacies with CLIA-waived certificates to have their pharmacists and pharmacy technicians to conduct CLIA-waived COVID-19 tests — order tests, collect specimens, process with the appropriate equipment and quickly provide patients with the results.

Also in California. The Department of Resources Recycling and Recovery has opened the comment period for the third draft of the Pharmaceutical and Sharps Waste Stewardship Proposed Regulations.  The 15-day comment period is opened on August 21 and will close on September 4, 2020.  Written comments can be submitted to pharmasharps@calrecycle.ca.gov.

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

NACDS and representatives from members operating in California met virtually with the Department of Health Care Services (DHCS) Medi-Cal team and the Department of Public Health (CDPH) Immunization Branch to discuss the ways that pharmacies can expedite expanded access to flu and COVID vaccines this fall. Chain members advocated for the use of trained pharmacy technicians to help administer the vaccines, requested that the state’s PPE stockpile be accessible to pharmacies, and identified some potential challenges on reimbursement that should be streamlined. The state pledged to work closely with chain pharmacies to resolve these issues.

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