HB 943 (now Act 67) also known as the “Gag Clause Bill,” which was sponsored by Representative Valerie Gaydos (R) has been signed into law by Governor Wolf (D). HB 943 states that a pharmacy or pharmacist has the right to provide a covered individual with information concerning the cost of a prescription drug. This includes the individual’s cost-share. Additionally, under the new law a pharmacy or pharmacist may not be prohibited from or penalized by a pharmacy benefits manager for discussing the cost share information, disclosing the availability of therapeutically equivalent alternative medications, or selling to the covered individual a more affordable alternative if an affordable alternative is available. The measure applies to pharmacy benefit manager (PBM) and pharmacy services administrative organization (PSAO) contracts and is effective July 23.

Also in Pennsylvania. NACDS reminds members that pharmacies can now provide the influenza vaccine to children aged three and above according to a waiver issued by the Wolf Administration. The current statute sets the age floor at 9 years of age.

Also in Pennsylvania. The Department of Human Services (DHS) announced applicants selected through a Request for Applications (RFA) for Pennsylvania’s HealthChoices program, the Medicaid physical health managed care program. However, DHS is unable to move forward with the selections pending filed protests by three companies that were not selected. DHS may not take any further action on the procurement until the protests are resolved. The following are the managed care organizations (MCO) chosen by zone:

• Southeast: Geisinger Health Plan, Health Partners Plans, UnitedHealthCare, UPMC for You, and Vista Health Plan (Keystone First)
• Lehigh/Capital: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
• Northeast: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
• Northwest: Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)
• Southwest: Gateway Health, Geisinger Health Plan, Health Partners Plans, UPMC for You, and Vista Health Plan (AmeriHealth Caritas)

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate and the House. Commonly referred to as a “gag clause” prohibition, the amended bill is on its way to Governor Wolf (D) for signature.

Also in Pennsylvania. Governor Wolf (D) announced the approval of the Department of State’s request to suspend the age limitation of 9 years old for pharmacist-administered influenza vaccines. The waiver, which specifically allows pharmacists to provide any licensed, age-appropriate flu vaccine to individuals 3 years of age or older, was effective July 2 and will be in effect for 90 days after the current state of emergency related to COVID-19 ends.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Senator Judy Ward (R) introduced SB 1210, legislation that would allow pharmacists to perform independent COVID-19 point of care tests authorized by the FDA by suspending the laboratory work experience required by state law. NACDS drafted the language and is working jointly with the Pennsylvania Association of Chain Drug Stores (PACDS) to push this measure forward.

Also in Pennsylvania. HB 941 sponsored by Rep. Doyle Heffley (R) was amended and reported out of the Senate Health Committee. The bill contains PBM transparency provisions, as well as language intended to set reimbursement rates in managed care. The committee indicated there is more work to be done on this measure over the summer. NACDS will be supporting PACDS efforts to make the reimbursement language more definitive during this process.

Also in Pennsylvania. SB 943, a bill that prohibits PBMs from restricting pharmacists’ ability to discuss cost-sharing amounts and other information regarding drug costs to patients, was amended on third consideration then passed unanimously by the Senate. Commonly referred to as a “gag clause” prohibition, the amended bill is now eligible for concurrence in the House.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Pharmacy Caucus Co-Chair, Sen. Judy Ward (R) issued a co-sponsorship memo for a bill that would exempt a pharmacy or pharmacists from the laboratory experience requirements, clearing a barrier remaining to pharmacists to perform COVID-19 testing.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Pennsylvania pharmacies that would like to participate in receiving COVID-19 vaccinations from the state when they become available should consider completing the Memorandum of Agreement (MOA) available at the PA Department of Health’s Pharmacy MOA webpage on the department’s website. Further information on the MOA and submission instructions can be found there. Although the MOA is specific to a pandemic influenza, DOH intends to draft an addendum to include the upcoming COVID-19 vaccine.  Only one MOA needs to be signed by your company to cover all your in-state stores.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.