The Board of Pharmacy issued notice that licensing of non-resident pharmacies will become available in the coming months. At least one pharmacist at each non-resident pharmacy must hold a Massachusetts pharmacist license. (This pharmacist does not have to be the store’s pharmacist-in-charge.) In preparation for non-resident pharmacy licensing, it is strongly recommended to begin the licensing process for the pharmacists as the process can take 30-60 days. Applications and instructions can be found online. Please see the FAQ document for other information regarding non-resident pharmacy licensing.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

The Massachusetts Board of Registration in Pharmacy posted its August newsletter. Included in this newsletter is information about pharmacy license renewals.

Also in Massachusetts, the formal legislative session ended early in the morning on August 1. The legislature failed to pass a conference report for S2520, an Act relative to pharmaceutical access, costs and transparency. The bill would have included reporting to the Health Policy Commission, PBM licensure, audit regulations, prohibition of spread pricing and other fees and required drug rebates returned to consumer. As both chambers have unanimously passed their versions of the bill, there is a slight chance the legislature could advance the bill during informal sessions; however, only one member of a chamber is needed to prevent floor action. NACDS will continue to advocate for PBM policy principles in Massachusetts during the informal legislative session for the remainder of the year and prepare for the new session in 2025.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On July 22, the House Committee on Ways and Means released H4891, an act relative to pharmaceutical access, costs and transparency, that includes PBM reforms. The bill was brought to the floor of the House on July 24. NACDS worked with the Massachusetts Chain Pharmacy Council to offer several friendly amendments to improve the bill. NACDS will continue to work to ensure final passage of PBM reform in the Massachusetts legislative session that ends on July 31. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On June 25, MassHealth published its regular pharmacy facts update that includes revisions to the MassHealth Drug List.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

NACDS will be joining the Massachusetts Chain Pharmacy Council and other members of the Patients Not PBMs coalition in support of PBM reform legislation at the Massachusetts State House on Wednesday, June 26, 2024, at 11:00am.  The event will include speakers from the pharmacy and patient communities.  NACDS encourages members to send as many pharmacists and associates as possible.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

MassHealth published its June “All Provider Bulletin 391” with orders ALL 361, ALL 376 and ALL 380 announcing the start dates for enforcing the ordering, referring and prescribing (ORP) requirements. With the exception of the information in the bulletin, all information in ALL 361, ALL 376 and ALL 380 remains in effect. Opportunity for payment of claims initially denied due to unenrolled ORP provider as described in ALL 376, billing providers should take certain steps to avoid claim denials due to unenrolled ORP providers. If a claim is denied because of an unenrolled or unauthorized ORP provider on or after June 9, 2024, the claim will be placed in suspense status. The claims system will continue to check to see if the ORP provider has enrolled with MassHealth for up to 90 days after the first date of service on the claim. Once the ORP provider is enrolled, the claim will then be payable. This will allow billing providers time to follow the steps related to unenrolled ORP providers outlined in ALL 376. If the ORP provider is not enrolled by 90 days from the first date of service on the claim, the claim will be denied. Also, effective June 9, 2024, billing providers can resubmit claims that were previously denied due to an unenrolled or unauthorized ORP provider if the first date of service on the claim is no earlier than September 1, 2023. If the ORP provider is enrolled with MassHealth within 90 days of the first date of service on the claim, the claim will be payable. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

On May 23, the Senate passed its version of the Fiscal Year 2025 budget. The budget bill will now advance to a legislative conference to work out differences before the end of the fiscal year, June 30, 2024. The relevant issue to pharmacies is language included in the House, but not in the Senate, that would authorize a registered pharmacist to administer a prescription for testosterone for gender-affirming care and for the treatment and prevention of sexually transmitted infections including the prevention of HIV infections. The administration of these therapies shall be in accordance with regulations promulgated by the Department of Public Health in consultation with the Board of Pharmacy and the Department of Mental Health. This proposed change amends the current law which authorizes pharmacists to administer drugs for the treatment of mental health and substance abuse disorders. NACDS will continue to monitor the budget process. 

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

MassHealth posted a bulletin that MassHealth will not pay for certain high-cost drugs if purchased through the 340B Drug Pricing Program. This change applies to claims for MassHealth members in Fee-for Service, the Primary Care Clinician (PCC) Plan and Primary Care Accountable Care Organizations. Providers serving MassHealth members enrolled in Accountable Care Partnership Plans (ACPPs), Managed Care Organizations (MCOs), One Care plans, Senior Care Organizations or the MassHealth behavioral health vendor should refer to Managed Care Entity Bulletin 7 for additional information regarding payment policies applicable to those plans.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

MassHealth issued the following two updates on March 26: 

• Transmittal Letter ALL-246 – This letter transmits updates to 130 CMR 450.000: Administrative and Billing Regulations. Subsection 130 CMR 450.130 has been amended to reflect that MassHealth members will no longer be required to make copayments. Copayments have been temporarily eliminated since May 1, 2023; this update extends this policy indefinitely. These regulations are effective April 1, 2024.  
• Managed Care Entity Bulletin 112 – This bulletin relates to certain drugs that may be used for the treatment of obesity that a provider purchased through the 340B Drug Pricing Program (340B stock). The bulletin applies to Accountable Care Partnership Plans (ACPPs), Managed Care Organizations (MCOs), One Care Plans and Senior Care Organizations (SCOs) (collectively referred to as “Managed Care Entities”). In MCE Bulletin 109, the Executive Office of Health and Human Services (EOHHS) directed Managed Care Entities not to pay for specified GLP-1 agonist drugs if those drugs were purchased through the 340B Drug Pricing Program, effective April 1, 2024. Through this Bulletin, EOHHS is delaying the effective date of this policy until July 1, 2024.  

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.