Despite strong opposition from employer groups and insurance brokers speaking out against any PBM enforcement, new proposed rules by the Department of Commerce and Insurance which will enact Public Chapter 998 and allow Tennessee Department of Commerce and Insurance to audit PBMs were approved by the Government Operations joint committee and will take effect on June 25, 2024. Thank you to Tennessee Pharmacy Association (TPA) CEO Anthony Pudlo, who testified before the Joint Government Operations Committee in support of these rules.   

Also in Tennessee, if you would you like to serve on TPA’s new Specialty Pharmacy Committee, please complete this form to express your interest. The Committee Chair will make committee appointments in the coming weeks, so please respond soon. 

Finally in Tennessee, TPA is looking for Champion Advocates across the state to build relationships with their elected officials and help identify physicians who may advocate for the pharmacy profession. Sign up to become a TPA Champion Advocate! 

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

On May 17, CMS approved Tennessee’s request to amend its Medicaid section 1115 demonstration, “TennCare III.” This amendment significantly changes its coverage and benefits, including eligibility for parents and caretaker relatives, introducing a new benefit to cover diapers for infants under the pharmacy benefit, enhancing home and community-based services (HCBS) focusing on employment supports and more. The Tennessee Pharmacy Association will work closely with TennCare leadership as the diaper program logistics are finalized.

Also in Tennessee, the Tennessee Pharmacists Association invites pharmacy teams to learn about the Department of Health (TDH) Health Trailblazers Initiative, a program aimed at enhancing the well-being of adult and perinatal populations by fostering vaccine confidence in clinical settings. This initiative seeks to build a collaborative network of healthcare providers dedicated to improving immunization practices and outcomes. Register now to join an informational session on May 28 from 12:00 pm – 12:30 pm CT.

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

The Board of Pharmacy met on May 7 and provided several key regulatory insights:  

• BOP CE (Continuing Education) Violations Policy has been updated on the website and will be effective July 1, 2024. The new policy clarifies disciplinary action procedures, including signing an Agreed Citation if found to be in violation of the policy. 
• BOP has granted its Executive Director the authority to issue waivers for the rule requiring out-of-state pharmacists to be licensed for 12 months before being eligible for a state license. 
• Licensing fees will increase across the board as the BOP works to resolve its budget. 
• BOP will use the NABP form for conducting GAP analysis during compounding facility inspections. The updated form will be under “Applications” on the BOP website. 
• BOP Town Hall on compounding rules will be August 21. A virtual meeting link will be created, and the public can also attend in-person at 665 Mainstream Drive in Nashville. 

The next BOP Rules Review meeting will be held on June 13 from 10:00 am to 2:00 pm CT. 

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

TennCare distributed an updated Preferred Drug List (PDL) effective May 1. Subscribe to the TennCare Pharmacy Updates newsletter to receive updates directly from TennCare. 

Also in Tennessee, on May 1, Gov. Bill Lee (R) signed SB 869/HB 282 into law. This legislation, which takes effect immediately, will improve efficiencies in the health care system by providing pharmacists with independent prescriptive authority for various medication classes and disease states. The Tennessee Pharmacy Association is developing additional resources and education to assist pharmacists that want to implement this law into their practice settings. 

Finally in Tennessee, the Department of Health will host three free in-person sessions for its Injectable Drug Diversion Workshop for pharmacists at the following times and locations: June 20 in Nashville, July 12 in Jackson, and July 22 in Knoxville. Learn more and RSVP! 

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

The Department of Commerce and Insurance (TDCI) shared a rule filing regarding PBMs. The TDCI regulations on audits of PBMs were approved and will take effect on June 26, 2024. 

Also in Tennessee, congratulations to Dean Bill Gentry of South College School of Pharmacy, who announced his upcoming retirement effective July 2, 2024.  

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

TennCare is continuing the process of reviewing all covered drug classes. Changes to the PDL (preferred drug list) may occur as new classes are reviewed, and previously reviewed classes are revisited. As a result of these changes, some medications your patients are now taking may be considered non-preferred agents in the future. Please inform your patients who are on these medications that switching to preferred products will decrease delays in receiving their medications. We encourage you to share this information with other TennCare providers. The individual changes to the PDL have been in this notice. The new PDL will be posted April 1, 2024. For details on clinical criteria, please visit OptumRx-TennCare.

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

TennCare recently released its latest Provider Notice listing changes to the TennCare Pharmacy Program and PDL (Preferred Drug List), effective March 1. Additionally, TennCare launched a newsletter containing up to date TennCare pharmacy information and details from the Pharmacy Provider Notices. Those interested may subscribe. 

Also in Tennessee, false prescriptions are being called into pharmacies under Francisco J. Soto, MD, MS, FCCP, who sees patients at University Pulmonary & Critical Care. The phone number used to call in these fraudulent prescriptions may appear to come from a UTMC (University of Tennessee Medical Center) phone number. Pharmacies are advised to contact Renae Gibson at Dr. Soto’s office at 865-524-7471 with any questions regarding his prescriptions.  

Finally in Tennessee, prior authorization requirements can be bypassed for certain medications when specific medical conditions exist. The submitted claim should include a Diagnosis Code Qualifier (Field # 492- WE) of “02,” indicating ICD-10, as well as the appropriate Diagnosis Code (Field # 424-DO). For details, please see a list of the preferred agents and the clinical criteria, and see the list of Tennessee OptumRx Provider Liaisons. 

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

The Tennessee House Government Operations Committee met and voted on proposed Board of Pharmacy rules packets as the last step in the approval process. Several presented rules were approved, including those for the provision of ivermectin and accommodations for visually impaired patients, but the Committee disapproved the proposed rule 1140-07 Sterile Compounding. Rules pertaining to complying with USP recommendations will not be enforceable by TN inspectors on March 14 as originally anticipated; however, federal agencies still require compliance. TPA is working closely with the Department of Health on this issue and will share more details as they become available.

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

Tennessee Pharmacy Association (TPA) asked pharmacy technicians to complete TPA’s pharmacy technician survey Survey topics include responsibilities, advanced technician roles, direct patient care roles, well-being, and certifications. Participation will help TPA gain insight into the roles that pharmacy technicians hold within different settings of pharmacy practice.

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