The Controlled Substance Reporting Act requires that gabapentin dispensing be reported by pharmacies. Gabapentin is not a controlled substance (under federal or North Carolina law), but its dispensing must nonetheless be reported to the Controlled Substances

Reporting System (CSRS). The Drug Control Unit of the Department of Health and Human Services administers the CSRS and has provided questions and answers concerning gabapentin reporting. That guidance is found in the “What information must be reported to the CSRS?” frequently asked questions.

Also in North Carolina, the next Board of Pharmacy election is scheduled to begin November 1, 2024. Two positions on the Board will be filled, the Northeastern District seat presently held by Wallace Nelson and the Central District seat presently held by Ashley Duggins. Board staff will hold Q & A sessions for anyone considering running for one of these positions or for anyone wanting more information about Board service. The first session will be on July 31, 2024, at 7:00 pm, Hampton Inn in Rocky Mount. The second info session will be on August 28, 2024, at 7:00 pm, Hampton Inn in Concord. Complete details will be posted and sent out by the Board next week.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

On July 1, 2024, Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans (or “Tailored Plans”) are a new kind of Medicaid Managed Care health plan. Tailored Plans cover doctor visits, prescription drugs and services for mental health, substance use, intellectual/developmental disabilities and traumatic brain injury in one plan. Tailored plans will launch statewide starting July 1, 2024. Approximately 200,000 beneficiaries will be enrolled into Tailored Plans. For more detailed information, please review the Fact Sheet: What Providers Need to Know Before Tailored Plan Launch. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy President Andy Bowman has announced that he will be leaving Board service before the end of his term, which opens a vacant position in the Board’s Southeastern District that will expire on April 30, 2026. To be eligible to run for this vacant Southeastern District seat, the candidate must be a pharmacist who holds an active North Carolina license to practice pharmacy and who resides (residential address, not work/practice address) in one of the counties comprising the Southeastern District. Interested pharmacists shall submit the following materials to the Board’s Executive Director, Jay Campbell, by 5:00 pm on April 26. For more information for the soon-to-be vacant Southeastern Board Member position, please visit the Board’s website.  

1. a letter of interest and any written materials the pharmacist wishes the Board to consider; and  
2. the signatures, legibly printed/typed names, and North Carolina pharmacist license numbers of ten (10) other pharmacists residing in the Southeastern District supporting the pharmacist’s candidacy. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

North Carolina Drug Control Unit issued an FAQ for dispensing professionals on reporting Gabapentin to the Controlled Substance Reporting System (CSRS) effective March 1. Pharmacists with additional questions should contact the Drug Control Unit. Note that based on a North Carolina Retail Merchants Association amendment, pharmacies are not required to report gabapentin to the CSRS when gabapentin is a component of a compounded prescription that is dispensed in dosages of 100 milligrams or less. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

On February 1, 2024, the Board of Pharmacy proposed Notice of Text for new administrative rules concerning emergency closures of pharmacies due to staffing shortages or other issues. Please see Pages 972-973 (PDF Pages 22-23) of the North Carolina Register, Volume 38, Issue 15. The North Carolina Board of Pharmacy will hold a Public Hearing on March 12 at 9:30 am at the North Carolina Board of Pharmacy and will accept written comments until April 1. Written comments may be submitted to Jay Campbell, 6015 Farrington Rd Ste 201, Chapel Hill, NC 27517 or by email to ncboprulemaking@ncbop.org.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy will be holding a Pharmacy Compounding Summit on March 6-8 at the Friday Conference Center in Chapel Hill. The agenda and details are available online.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Medicaid has been informed that Wellcare and Carolina Complete have experienced an issue with their new PBM (Express Scripts), being set up to pay at 30 days instead of 14 days, resulting in pharmacies not being paid timely.  

Payments for the first week in January are going out in the coming week. Payments for the second and third weeks will be on a 30-day cycle and will come out in mid-February, payments for the fourth week in January will also come out by mid-February. Pharmacies should be “caught up” in mid-February.  

Penalties and interest will be paid in accordance with Section V. H.1.d of the NC PHP Contract. For more information, please see the Medicaid bulletin Prepaid Health Plan Interest and Penalties for Provider Claims.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

During the 2023 Legislative Session, the General Assembly passed, and the Governor signed into law, a statute making gabapentin a drug whose dispensing must be reported to the Controlled Substance Reporting System (CSRS). Gabapentin becomes reportable on March 1, 2024. The Drug Control Unit, which administers the CSRS, has created an FAQ guidance document for dispensers. Pharmacists with additional questions should contact the Drug Control Unit. 

Note that based on an NC Retail Merchants Association amendment, pharmacies are not required to report gabapentin to the CSRS when gabapentin is a component of a compounded prescription that is dispensed in dosages of 100 milligrams or less; see new G.S. 90-113.73(c)(1). 

Also in North Carolina, on January 10, Medicaid released the following concerning pharmacy eligibility to serve as Medicaid providers. All questions should be directed to Medicaid. 

Beginning in May 2021, NC Medicaid started taking additional steps, as outlined in the NCTracks Changes to Provider Verification Process bulletin, to ensure providers meet their contractual obligation to maintain their credentials on their NCTracks provider enrollment record. Multiple bulletin articles were published to notify providers of the change, and providers receive four targeted reminders prior to their suspension notification. Regardless of these efforts to inform and assist providers with this responsibility, we continue to see a fairly large number suspended, and subsequently terminated, from the NC Medicaid program due to their expired credential.

For this reason, and as part of an additional outreach effort, we are notifying NC associations when the number of provider taxonomy suspensions exceeds a defined threshold of unique providers on the report received at the end of each month.

On December 31, 2023, approximately 115 Pharmacist providers were suspended due to an expired credential. These providers have sixty days from the date of suspension to ensure that their license is renewed, and their NCTracks provider enrollment record is updated to avoid termination. Providers may update their NCTracks provider record through the Manage Change Request process. NCTracks User Guides and Fact Sheets offer basic instructions for making the necessary update and any additional questions may be referred to the NCTracks Call Center at 800-668-6696. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy has completed its rulemaking on the authorization for, and regulation of, the use of direct-to-patient (DTP) dispensing systems. Board Rule .1821 provides that authorization and the standards that apply to the use of DTP systems. Board Rule .1616 authorizes limited service permits to be issued for operation of a DTP system when the system is not located on-site at the home pharmacy. 

The board staff has completed programming to implement a limited-service permit application for an off-site DTP system and to allow an existing pharmacy to notify the Board that it will deploy an on-site DTP system.  

Detailed guidance on the rules and standards governing DTP systems, as well as step-by-step instructions to add an on-site DTP system to an existing pharmacy’s services or to apply for an off-site DTP system limited-service permit are found here. 

The general limited-service permit guidance document has also been updated to include information on DTP system permits. 

Also in North Carolina, effective November 1, Medicaid waived the copay for antiretrovirals used to decrease viral load in members living with HIV (Human Immunodeficiency Virus). 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.