In response to a request from the State Board of Pharmacy Executive Director Kimberly Grinston, NACDS and the Missouri Retailers Association submitted several pharmacists and pharmacy technicians’ names for consideration to serve on the new task force to study working conditions.

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

Gov. Mike Parson (R) signed SB 63 into law, which makes it the 50^th state to create a statewide prescription drug monitoring program. The bill establishes the Joint Oversight Task Force of Prescription Drug Monitoring, responsible for collecting and maintaining the prescription and dispensation of prescribed controlled substances to patients within the state. It also extends the expiration date of the RX Cares for Missouri Program to August 28, 2026.

Also in Missouri, the Department of Social Services, MO HealthNet Division, issued two new proposed rules requesting comments by July 1, 2021. Both are currently in effect as emergency rules expiring February 24, 2022.

• Proposed rule removes obsolete provisions and references new provisions establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid.
• Proposed rule establishes the payment methodology for covered entities under the 340B drug pricing program that chooses to carve in Medicaid.

Also in Missouri, the Board of Pharmacy issued a final rule effective June 30, 2021, removing the limit on the number of intern pharmacist practice hours that may be earned per week.

Also in Missouri, the Department of Commerce and Insurance issued a proposed rule to establish the license application process and a $1,000 application fee for pharmacy benefit managers. The rule replaces a September 15, 2020, proposed rule. Comments are due on June 16^th, and a public hearing will be held on June 17, 2021.

Also in Missouri, the Board of Pharmacy is soliciting comments on two proposed rules:

• Proposed rule rescinds regulations regarding pharmacy operating procedures during declared disasters. A concurrent proposed rule would readopt the provisions to address both disasters and state/federal emergencies. Comments are due June 16, 2021.
• Proposed rule adopts regulations establishing guidelines for temporary pharmacy operations during an emergency or declared disaster. The rule would replace pharmacy disaster operation procedures that are proposed for repeal concurrently.

Also in Missouri, the Board of Pharmacy recently approved two final rules 20 CSR 2150-5.025 and 20 CSR 2220-6.050 which allows pharmacy technicians to administer vaccines under the supervision of a state-licensed pharmacist according to a written protocol with a licensed physician who is actively engaged in the practice of medicine. The rule is issued in response to the COVID-19 pandemic effective July 30, 2021.

Lastly in Missouri, the Department of Social Services, MO HealthNet Division issued three final rules effective July 30, 2021.

• Final rule adds an exception to the 31-day supply maximum restriction on medications reimbursed by the division on behalf of participants eligible for the fee-for-service programs, and an exception to allow for a 90-day supply requirement for select medications established in a concurrent rule. The rule also replaces references to “recipient” and “patient” with “participant.”
• Final rule adopts a 90-day supply requirement per dispensing on select medications reimbursed by the division on behalf of participants eligible for Medicaid fee-for-service programs.
• Final rule revises the amount of the professional dispensing fee reimbursable for MO HealthNet covered prescriptions by pharmacy providers.

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

Gov. Michael Parson (R) may soon call a special session to address one critical piece of the budget, the Federal Reimbursement Allowance (FRA) or provider tax extension. FRA is a key funding mechanism for the Missouri Medicaid program for pharmacy, hospitals, nursing homes, and ambulance districts. Failure to extend these provider taxes will create a multi-billion dollar shortfall in Medicaid funding when the new federal fiscal year begins on October 1, 2021.

Also in Missouri: before adjournment, the legislature finally passed SB 63, a Prescription Drug Monitoring Program (PDMP) bill, making it the 50^th state to adopt a statewide program.

Lastly in Missouri, unfortunately, although a PBM reform bill HB 834 by Rep. Dale Wright (R) did pass the House 126-8, it failed to advance in the Senate.

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

Last week, the Missouri Legislature passed legislation SB 63 establishing the framework for a statewide PDMP. Once operational, this new program will preempt any local PDMP program such as the one set up by St. Louis County that numerous other municipalities throughout the State of Missouri have opted to participate in. Initially, the statewide program will require pharmacies to report dispensing data for schedule II, III & IV controlled substance prescriptions into the PDMP every 24 hours, but the reporting timeframe will phase over to real-time reporting by 2024. The legislation next goes to the Governor to be signed into law. Once enacted, Missouri will become the last state in the nation to establish a PDMP.

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

The Department of Social Services HealthNet Division (DSSHD) issued a rule removing obsolete provisions in addition to referencing new provisions establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. DSSHD also adopted regulations establishing the payment methodology for covered entities under the 340B drug pricing program that choose to carve in Medicaid. These rules are effective July 1, 2021, and expire on February 24, 2022.

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

The Board of Pharmacy approved a final rule effective May 30, 2021, allowing pharmacy technicians to administer vaccines authorized by the federal Department of Health and Human Services during the coronavirus (Covid-19) pandemic. The rule currently is in effect as an emergency rule, expiring June 8, 2021.

Also in Missouri, the Department of Commerce and Insurance announced that the pharmacist’s statewide standing orders for naloxone dispensing as well as the COVID-19 vaccines (Pfizer and Moderna) previously signed by Dr. Williams have been rescinded because he resigned. The new statewide standing orders are signed by the authorizing physician, Dr. George Turabelidze, MD. The revised orders are available on DHHS’s website and the Board’s COVID-19 webpage.

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

The Board of Pharmacy held a two-day meeting this week. Among the items discussed were updated on pending legislation that impacts pharmacies and a general discussion on pharmacy workforce conditions.

Also in Missouri, on March 3, CMS approved a SPA to allow pharmacists to bill MO HealthNet for all services within their scope of practice.  The effective date was retroactive to January 1, 2021.  More information can be found here.

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

NACDS sponsored the Missouri Pharmacists Association’s Day at the Capitol. MPA’s priority bill, HB 834 by Rep. Dale Wright (R) that regulates PBMs, passed the House and was referred to the Senate Government Accountability and Fiscal Oversight Committee rather than the Senate Health Committee. More information can be found here.

Also in Missouri, the Board of Pharmacy issued a final rule effective May 30, 2021, that allows additional time to fulfill prescription transfer requests from parties other than the patient. The rule requires transfer requests to be completed in a timely manner and ensures no interruption in patient therapy.

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

NACDS sponsored the Missouri Pharmacists Association’s Day at the Capitol. MPA’s priority bill, HB 834 by Rep. Dale Wright (R) that regulates PBMs, passed the House and is pending referral to a Senate Committee.  More information can be found here.

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