On July 6, Gov. Mike Parson (R) signed into law three bills enacting the largest pharmacy scope of practice expansion (HB 115 / SB 157 / SB 45 & 90). The bills allow pharmacists to independently administer all vaccines approved by the FDA as of January 1, 2023. The law also expands the services pharmacists can provide through physician protocols, and it creates framework for statewide standing orders for the testing and treatment of COVID, Flu and Strep.  

Also in Missouri, effective July 30, MO HealthNet will no longer allow automatic refills or automatic shipments of medications, devices, or supplies. MO HealthNet does not pay for any
prescription without an explicit request from a participant or the participant’s responsible party, such as a caregiver, for each refilling event. Participants and providers cannot waive the explicit refill request requirement and enroll in an automatic refill program. 

Also in Missouri, MO HealthNet also reported that due to the increase in the Missouri Pharmacy Reimbursement Allowance (Pharmacy Tax), the adjustment to account for the Professional Dispensing Fee for Medicaid-reimbursed prescriptions was increased effective July 1, 2023.  

Also in Missouri, the Department of Commerce and Insurance’s (DCI) Department of Health and Senior Services issued a revised naloxone HCL standing order that now lists the nasal spray generically, allowing pharmacists to dispense the brand name or generic product.  

Also in Missouri, starting July 17, MO HealthNet announced that the Pharmacy Help desk’s NEW hours for drug prior authorizations will be Monday through Friday, 8:00 a.m. to 7:00 p.m. Central; weekend hours will remain the same 8:00 a.m. to 6:00 p.m. 

Finally in Missouri, the MO HealthNet Division recently moved all provider forms regarding MO HealthNet benefits to a new Provider Forms page.  

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

Prior to the Legislature adjourning on May 12, the pharmacy practice act language pharmacies had promoted that allows pharmacists to administer all FDA authorized and approved vaccines to anyone 7years of age and older passed in two bills, SS/HCS/HBs 115 & 99 and HCS/SS/SCS/SBs 45 & 90. These bills also include language that allows pharmacists with a certificate of medication therapeutic plan authority to provide under a statewide standing order medications to treat flu, strep and COVID. Lastly, the omnibus bills included a provision amending the definition of “opioid antagonist” in a statute that is currently defined as naloxone hydrochloride; this act adds any other drug or device approved by the FDA that blocks the effect of an opioid overdose. (CCS HCS SS SCS SBs 45 & 90 and HBs 115 & 99)

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

Pharmacy technicians immunizing under the Board’s statutes and rules must complete an initial and annual documented competency assessment. A sample Technician Immunization Assessment Checklist template is intended for guidance purposes only to assist licensees and should be modified as appropriate for your practice setting. 

Also in Missouri, the 2023 Practice Guide contains updated compliance tips and information on recent statutory/rule changes, including, new/revised sections on Pharmacy Working Conditions, Technician Supervision & Expanded Technician Activities, Electronic Final Product Verification by Pharmacists, Technology-Assisted Product Verification by Interns & Technicians, and Quality Assurance. 

Finally in Missouri, the 2023 Missouri Pharmacy statutes and rules law book is available here. 

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

The Department of Commerce and Insurance (DCI) extended the COVID-19 vaccine and testing standing orders until May 11, 2023. Revised standing orders may be found at: 

• Vaccines: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/statewide-orders.php 
• Testing: https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/testing-resources.php 

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

The 2023 Pharmacy Practice Guide containing updated compliance tips and information on recent statutory/rule changes, including new/revised sections on Working Conditions, Technician Supervision & Expanded Technician Activities, Electronic Final Product Verification for Pharmacists, Technology-Assisted Product Verification for Interns & Technicians and Quality Assurance is currently available.  

Also in Missouri, Section 338.013, RSMo, provides that all individuals who assist a pharmacist with the practice of pharmacy must be registered with the Board as a pharmacy technician, including anyone involved in the handling of a filled prescription that is not ready for sale or delivery to the patient without further packaging, bagging, or manipulation, including cashiers or delivery staff handling a filled prescription (patient vial/container, unit of use package, bubble card, etc.) that is not packaged/bagged for final sale or delivery to the patient are required to be registered as a technician.

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

Prior to the legislature taking a week off for Spring Break, HB 41 passed the Senate and was referred to the House for further action. The bill allows a pharmacist to order and administer vaccines approved or authorized by the FDA, or by the state or federal government during a state or federally declared public health emergency. The bill also permits certain qualified pharmacists to provide influenza, group A streptococcus, and COVID-19 medication therapy services pursuant to a statewide standing order issued by the Director of the Department of Health and Senior Services or a physician licensed by the Department.

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

SB 41 by Sen. Holly Thompson Rehder (R) repeals the physician protocol requirement and adds language allowing pharmacists to order and administer certain FDA-approved or authorized vaccines to persons at least seven years of age or older, pursuant to rules promulgated by the Board of Pharmacy and the Board of Registration for the Healing Arts, or rules promulgated under a state of emergency. The bill is pending on the Senate floor.

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

The revised 2023 Pharmacy Practice Guide is available on the Board’s website. It contains updated compliance tips and information on recent statutory/rule changes, including: 

1. Pharmacy Working Conditions
2. Technician Supervision & Expanded Technician Activities
3. Electronic Final Product Verification (Pharmacists)
4. Technology-Assisted Product Verification (Interns & Technicians), & 
5. Quality Assurance  

Also in Missouri, the Department of Health and Senior Services recently issued a revised naloxone standing order. 

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

The legislature convened on January 4, 2023. Several PBM reform bills have been filed, including SB 402/HB 198 and SB 26/HB 197. Also filed were two bills expanding the Pharmacy Practice Act related to the administration of medication by pharmacist including HB 331 and SB 41.

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