The Texas Pharmaceutical Initiative (TPI) Board is meeting on September 23.

Also in Texas, Speaker Dade Phelan (R) appointed Rick Perry (R), former Governor of Texas and Secretary of Energy under the Trump Administration, as a senior advisor to his leadership team.

Also in Texas, the Department of State Health Services (DSHS) resolved the issue of providers receiving errors when submitting Unsolicited Vaccine Updates (VXU) messages through data exchange for influenza vaccines. The seasonal influenza vaccines for 2024–2025 have been updated in ImmTrac2 as of Aug 30, 2024. Please refer to the Fall Season Respiratory Vaccine Codes | Immunization Information Systems (IIS) | CDC for the correct codes to report for influenza 2024–2025 vaccines to ImmTrac2.

Finally in Texas, the Senate Health and Human Services Committee held a hearing focused on expanding access to healthcare services and NACDS submitted a support letter.

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

The Health and Human Services Commission (HHSC) implemented a new STAR+PLUS contract in seven managed care organizations (MCOs) on September 1, 2024. Pharmacy claims billing codes and contact information for these MCOs are available.

Also in Texas, HHSC’s Vendor Drug Program (VDP) revised the Pharmacy Payer Specification Manual, separating them by program. The three separate manuals are the Traditional Medicaid and the Healthy Texas Women Program, the Children with Special Health Care Needs Services Program and the Kidney Health Care Program. The three new manuals are available on the VDP Provider Portal.

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

Speaker of the House of Representatives Dade Phelan (R) appointed Mike Toomey as his new chief of staff, replacing Enrique Marquez. Toomey is a former Texas House member, previously served as chief of staff to former Governors Bill Clements and Rick Perry and was most recently a partner at the Texas Lobby Group.

Also in Texas, PCMA presented at the Texas Pharmaceutical Initiative (TPI) Board’s August 20 meeting, claiming that 90% of the prescription dollar goes to pharmacies and pharmaceutical manufacturers, and that PCMA’s industry creates $155 billion in value each year. The TPI Board also received an update from McKinsey consultants on developing a business plan due to the legislature on October 1, 2024. The TPI was established last session by the Texas Legislature and aims to provide cost-effective access to prescription drugs and other medical supplies to individuals receiving health benefits paid for by the state through the Employee Retirement System of Texas (ERS), Teacher Retirement System (TRS), Health and Human Services Commission (HHSC) including Medicaid, The University of Texas System and Texas A&M University System. The next meeting is September 5.

Also in Texas, the Health and Human Services Commission (HHSC) Vendor Drug Program’s VDP Provider Portal allows pharmacies to retrieve weekly payment files, prescribers to submit prior authorizations, and more. VDP encourages pharmacies and prescribers to register for these valuable tools.

Also in Texas, the state’s economic forecast looks bright as Comptroller Glenn Hegar (R) estimates an $18 billion+ surplus, and about $24 billion in the Economic Stabilization (Rainy Day) Fund.

Finally in Texas, pharmacies can request expedited formulary coverage, an expedited preferred drug list change or notify HHSC about potential drug shortages impacting prescribing choice and pharmacy claim processing by using the Drug Shortage Notification and Expedited Formulary or Preferred Drug List Request (HHS Form 1315). Referrals should recommend an alternative with supply chain in mind so extra demand will not cause another shortage.

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

NACDS Mary Staples, Walgreens pharmacist Aimme Lusson, and Kroger pharmacist Jeff Loesch, met with State Sen. Bryan Hughes (R) and State Rep. Candy Noble (R), two champions for PBM reform legislation, at the Texas Pharmacy Association’s annual meeting in Allen, Texas.

Also in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) delayed the semi-annual Medicaid preferred drug list update until August 8, 2024.

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

Hurricane Beryl made landfall on the Texas coast and caused significant damage and flooding in numerous counties earlier this month, forcing many to evacuate to temporary locations. The Health and Human Services Commission (HHSC) will allow pharmacies to override prescription claims rejected with error codes 79 (Refill Too Soon) or 76 (Plan Limitations Exceeded) for people enrolled in fee-for-service Medicaid, the Children with Special Health Care Needs Services Program and the Kidney Health Care Program that pharmacies identify as affected by Hurricane Beryl. For people enrolled in Medicaid managed care or CHIP, pharmacies should contact the person’s managed care organization (MCO) for instruction. Refer to the MCO Search for each MCO’s contact information and billing codes. Pharmacies can call the Texas Medicaid Pharmacy and Technical Call Center at 800-435-4165, Monday through Friday from 7:00 am to 7:00 pm (central time) to request the override.

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

Acting on behalf of Gov. Greg Abbott (R) while he is out of the country on a trade mission, Lt. Gov. Dan Patrick (R) declared a Disaster Declaration for 121 counties impacted by Hurricane Beryl. The Board of Pharmacy’s Executive Director/Secretary Daniel R. Carroll, PharmD, RPh, has again authorized pharmacists in Texas to dispense up to a 30-day supply of medication (other than a Schedule II controlled substance) for patients affected in the counties of the disaster area. Board rule 291.34(b)(8)(E) outlines the procedures for dispensing medication in emergency situations.

Also in Texas, the next hybrid meeting of the Texas Pharmaceutical Initiative Board will be at 1:00 pm on July 16.

Also in Texas, the Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) will perform the semi-annual update of the Medicaid preferred drug list on July 25, based on the recommendations made at two meetings of the Texas Drug Utilization Review early this year.

Finally in Texas, The Texas Drug Utilization Review Board agenda for July 26 is now available. Refer to the Texas Drug Utilization Review Board Handbook for instructions on submitting written materials to the board before the meeting and public testimony on the day of the meeting. People providing written or public testimony must complete the appropriate testimony form and the Public Comment Registration form linked on the agenda.

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

The Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) will update the Medicaid Preferred Drug List (PDL) on July 25. HHSC is making changes to the PDL based on recommendations agreed to at the January and April Drug Utilization Review (DUR) Board meetings. The April 26, Preferred Drug List recommendations and January 26 Preferred Drug List decisions are available for review.

Also in Texas, in advance of the July 1, 2024 deadline, NACDS submitted comments to the HHSC VDP in support of the draft policy change expanding the list of vaccines included on the Medicaid formulary. Importantly, adopting this updated policy would expand access to a broader portfolio of pharmacy provided vaccines for adults covered under the Medicaid program. NACDS also urged VDP to adjust the Medicaid pharmacy vaccine administration fee to align more closely with the administration fee that CMS has set for pharmacy-provided vaccines covered by Medicare.

Finally in Texas, the Prescription Monitoring Program (PMP) Advisory Committee met on June 27. The PMP Advisory Committee recommends to the Board of Pharmacy operational improvements, identifies data concerns and suggests methods to improve data accuracy, integrity and security.

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

The Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) Medicaid is soliciting stakeholder comments about adding 14 additional vaccines to be a covered benefit for the Adult Vaccines Program. HHSC already covers influenza and COVID-19 vaccines on the Texas Medicaid formulary and proposes adding the additional vaccines listed above for adults ages 19 years and older enrolled in Medicaid. Comments are due on July 1, 2024, and must be submitted using the HHS Form 1342. 

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

The Board of Pharmacy (TSBP) adopted and proposed several new rules at the May 7 Board meeting.

Also in Texas, the Pharmaceutical Initiative (TPI) met this week to discuss how to provide greater, more cost-effective access to prescription drugs and essential medical supplies for the health plans for state employees, retirees, Medicaid and CHIP. The three-member Board focused on developing a business plan and hiring an Executive Director.

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