Quantity limits for albuterol inhalers and nebulizer solutions went into effect on August 28. Adults are now limited to 3 albuterol inhalers (300 rescue doses) every 180 days. Participants of all ages are limited to 120 vials every 2 months. If a provider feels a patient needs albuterol inhalers or nebulizer solutions more than these limits, a letter of medical necessity and progress notes will need to be submitted. 

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

The Board of Pharmacy is soliciting comments due October 15 on a proposal establishing requirements for authorized pharmacists dispensing HIV post-exposure prophylaxis as authorized by section 338.730, RSMo.

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

The Board of Pharmacy next Lunch with the Chief Inspector online seminar is taking reservations for the October 13th compliance update.

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

The Board of Pharmacy mailed all Missouri pharmacies the regulatory sign that is now required to be posted in the pharmacy.

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

Pharmacies need to establish policy and procedures, quality assurance programs, and validate the technology prior to the initial use for two new product verification rules that go into effect on August 30, 2022.  

• 20 CSR 2220-2.011 Electronic Final Product allows pharmacists to use an electronic verification system (EVS) to verify the accuracy of a final prescription. EVS allows the pharmacist to see an exact, clear, and unobstructed visual image of the filled prescription contents and the label affixed to the container. No further manipulation of the prescription occurs after the pharmacist’s electronic verification is complete other than applying the required container lid or seal. Manipulation does not include preparing a finished prescription/medication order for mailing, delivery, storage or bagging the prescription. 
•  20 CSR 2220-2.012 Technology Assisted Prescription/Medication Order Verification for Interns Pharmacists and Pharmacy Technicians allows an “authorized pharmacy technician” or an “authorized intern pharmacist” to verify a final prescription using a Technology Assisted Verification System (TAVS) for non-controlled medications only. TAVS is an electronic system that utilizes barcode technology or another electronic process to electronically verify the final medication prescription or medication order has been properly dispensed and to electronically verify the prescription/medication order has been properly labeled for the correct patient. 

Additional summaries of newly revised and recently promulgated pharmacy rules are available in the Board’s latest newsletter. 

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

Effective 8/30/2022, all pharmacies located in the state must post physically or electronically a sign at the pharmacy indicating that the pharmacy is licensed and regulated by the Missouri Board of Pharmacy including the Board’s address, telephone number, and email address. The Board will be mailing each pharmacy a sign at no cost prior to August 15th. An electronic version of the sign will also be available for copying after August 1^st. The required sign must be prominently posted near the pharmacy in a manner and location that is easily viewable and readable by the public.

Also in Missouri, the New Preferred Drug Searchable Database for MO HealthNet Pharmacy Program is now live.

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

On July 14, the MO HealthNet Pharmacy Program transitioned the Preferred Drug Searchable Database to a new vendor. If the new database is unavailable, providers may use the Pharmacy Clinical Edits and Preferred Drug Lists webpage. 

Also in Missouri, MO HealthNet Division (MHD) will begin desk audits of providers to ensure proper billing units are used for drugs billed to MO HealthNet. Providers are responsible for proper billing of claims as outlined in Section 15 of the Pharmacy Provider Manual. Providers must have adequate documentation and these records must be made available to MO HealthNet upon request. 

Also in Missouri, announced provider rate increases contingent on CMS approving the State Plan amendment (SPA). Until then, current rates remain in effect. 

Finally in Missouri, Gov. Mike Parsons (R) signed into law two opioid bills effective August 28, 2022. HB 2162 expands the definition of opioid antagonists that can be dispensed under a prescriber’s protocol or standing order to include addiction mitigation medications, and MO HB 2331 allows a pharmacist to dispense and opioid antagonist under a protocol or standing order. 

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

Pharmacy technician licenses expired May 31, 2022. Any technician that did not renew cannot work until the Board office has renewed their license. While the online renewal option ended on May 31st, a paper renewal is available online.  

The Department of Commerce and Insurance’s (DCI) Department of Health and Senior Services (DHSS) is opening its application portal for pharmacies to receive and dispense the oral antivirals Paxlovid and Lagevrio (Molnupiravir) to COVID-19 patients with prescriptions.

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

The legislature adjourned on May 13. Prior to adjournment, HB 3010, legislation that provides funding for the distribution of naloxone passed both houses and was sent to Gov. Mike Parsons (R). Also sent to the Governor for his signature was HB 2162, that will allow pharmacists to sell and dispense opioid antagonists under a physician protocol or statewide standing order.

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