At the August 3rd Board of Pharmacy, after a lengthy debate, the Board agreed to accept the proposed draft language of concern to chain pharmacies emergency refills of insulin and insulin supplies and new requirements on compounding non-sterile products including flavoring and simple mixture of creams and lotions. The Board will consider adopting final rules at their November 2nd meeting. 

Also in Texas, pharmacies continue lobbying efforts to secure funding for the Prescription Monitoring Program (PMP) through the American Rescue Plan Act (ARPA) of 2021 to prevent any PMP usage interruptions. https://www.nacds.org/ceo/2021/0813/PMP-ARPA-Funding-Letter-8.11.2021.pdf 

Also in Texas, Gov. Greg Abbott (R) announced that the temporary suspension of numerous COVID-19 rules listed on this link will terminate on September 1, 2021. The list includes discontinuing the telephonic counseling waiver in §291.33(c)(1)(B)(iii). https://www.pharmacy.texas.gov/coronavirus/temporary-rule-suspensions.asp 

Finally in Texas, the Governor convened a second 30-day special session on August 7th, but the partisan stalemate continues. On August 10th, House Speaker Dade Phelan (R) signed civil arrest warrants for 52 House Democrats still missing from the state Capitol to regain a quorum needed so that the House of Representatives can begin moving legislation during the second special

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

The 30-day special session Gov. Greg Abbott (R) convened in early July will end on Friday, August 6th without progress on any legislation because of the partisan standoff in the House of Representatives over the election integrity bill. The Governor vowed to call multiple special sessions until the elections bill passes.  

Also in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) updated the Preferred Drug List. 

Finally in Texas, since the Board of Pharmacy failed to secure funding from the Legislature to cover the cost of the electronic health record (EHR) to continue to be seamlessly integrated into the state’s Prescription Monitoring Program (PMP), access through the Appriss PMP Gateway and access to the NarxCare score will end on August 31, 2021. Free access to the PMP remains available at texas.pmpaware.net/login, but it is more cumbersome then the direct connect integration the state began paying for in 2020 when they mandated that both prescribers and dispensers check the system before prescribing opioids, benzodiazepines, barbiturates or carisoprodol. More information is available – News | PMP Changes (texas.gov) 

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

The Department of Health and Human Services (HHSC) announced its submission of an extension application to the Centers for Medicare & Medicaid Services (CMS) for the Texas Healthcare Transformation Quality Improvement Program (THTQIP) waiver under section 1115 of the Social Security Act. The extension request is for approximately 10 years, and reflects the same terms and conditions agreed to and approved by CMS on Jan. 15, 2021. It will allow Texas to continue flexibility to pursue the goals of the existing 1115 waiver:  

• Expand risk-based managed care to new populations and services. 
• Support the development and maintenance of a coordinated care delivery system. 
• Improve outcomes while containing cost growth. 
• Transition to quality-based payment systems for managed care and providers.  

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

The 30-day special session that Gov. Greg Abbott (R) convened on July 8th came to an abrupt halt on July 12th when the many Democrat legislators fled the state breaking a quorum to block a vote on the election integrity bill. Under House rules, all business was suspended because the absent Democrats meant that there were not members present to conduct business.

Also in Texas, the Texas Federation of Drug Stores (TFDS), the Texas Medical Association (TMA), the Texas Pharmacy Association (TPA) sent a joint letter https://www.nacds.org/ceo/2021/0716/PMP-Funding-Letter-vF07.9.21.pdf requesting the legislature appropriate $5.4 million for 2022-23 biennium to fund the Texas State Board of Pharmacy’s Prescription Monitoring Program (PMP).  It is critical that these funds be appropriated before September 1, 2021, to prevent any PMP usage interruptions. Without funding, these critical tools to help slow and prevent the opioid abuse crisis may cease.

Finally in Texas, the state Comptroller Glenn Hegar’s (R) latest revenue estimate released last week in advance of the special session shows the current two-year budget cycle with a general revenue balance of $5 billion for the fiscal cycle that ends on August 31, 2021. 

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

Gov. Greg Abbott (R) convened a 30-day special session of the Legislature on July 8 to address unfinished business, including election integrity, bail reform and several other issues.  

Also in Texas, in advance of the August 3 quarterly board meeting, the Board of Pharmacy is seeking comments by July 27 on several proposed rules: 

• Proposed rule updating the internship hours requirement to reflect the Accreditation Council for Pharmacy Education requirement.  
• Proposed rule increasing the pharmacist initial license fee from $332 to $360 and the biennial renewal fee from $329 to $357.  
• Proposed rule increasing the pharmacy technician initial registration fee from $83 to $84 and the biennial renewal fee from $80 to $81.
• Proposed rule increasing the pharmacy initial license fee from $507 to $538 and the biennial renewal fee from $504 to $535.
• Proposed rule allowing Class A or Class C pharmacies to provide remote pharmacy services using an automated disposing and delivery system.  

Also in Texas, the Department of State Health Services (DSHS) is encouraging vaccine providers to participate in weekly webinars on Tuesdays from Noon-1:30 PM Central time. Preregister for the upcoming July 13 webinar here. Highlights from past webinars are available online COVID-19 Vaccine Providers Webinars page. 

Finally in Texas, the Health and Human Services Commission’s (HHSC) Vendor Drug Program (VDP) maintains a Specialty Drug List (SDL) for Medicaid Managed Care (MCO). Currently, HHSC reviews and adjusts the drug list quarterly. VDP is proposing changing the SDL publication schedule from quarterly to twice a year, giving MCOs more time to finalize contracts with pharmacies in their specialty networks. VDP is soliciting comments on this draft policy change by July 19 at 5:00 p.m. to the VDP Operations.

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

On June 18, 2021, Gov. Greg Abbott (R) chose to let House Bill 1919 become law. Rep. Cody Harris (R) and Sen. Charles Schwertner’s (R) bill will help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and Pharmacy Benefit Managers (PBM’s) from directing patients to use any particular pharmacy provider over another and prohibiting PBMs from exclusively requiring the purchase of pharmacy services through a certain mail-order pharmacy or imposing a monetary advantage or penalty under a health benefit plan that would affect a patient’s choice of pharmacy. The law becomes effective September 1, 2021. 

Also in Texas, Gov. Abbott (R) announced that he will be convening a special session of the legislature on July 8, 2021. The Governor did not disclose what legislative priorities will be included on the special session agenda, only that such items “will be announced prior to the convening of the special session.”  

Finally in Texas, the Board of Pharmacy’s Prescription Monitoring Advisory Committee held a virtual quarterly meeting on June 16th to discuss funding issues and operational improvements to the Prescription Monitoring Program (PMP). HEB’s pharmacist Doug Read serves as the chain representative on the Advisory Council. The state’s vendor Appriss presented the NarxCare version 2.0 program. More information is available at Texas Prescription Monitoring Program (PMP). 

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

NACDS continues to strongly advocate, through social media messaging and pharmacists contacting Gov. Greg Abbott (R) before Sunday, June 20, 2021, that the governor sign into law HB 1919, legislation that would help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and pharmacy benefit managers from “steering” patients to use any in-network pharmacy provider over another. 

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

NACDS sent a letter to Gov. Greg Abbott (R) urging him to sign HB 1919 into law, legislation that would help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and pharmacy benefit managers from “steering” patients to use any particular in-network pharmacy provider over another.  In addition, we have been urging member companies to also contact the Governor’s office.

Also in Texas, the Board of Pharmacy hired a new Executive Director/Secretary Tim Tucker, Pharm.D., replacing Allison Benz who announced earlier this year that she would be retiring on August 31, 2021. The Texas press release can be found here.

Also in Texas, the Board of Pharmacy adopted several rules that became effective June 9, 2021.

• Final rule extends the time that Schedule II prescriptions are valid to 30 days to conform to federal standards and removes a reference to the effective date of the pharmacy responsibility provisions.
• Final rule allows pharmacists to electronically sign the data entry attestation statement. The rule also updates references to the DEA 222 order form requirements for distributing Schedule II controlled substances.
• Final rule extends the time that Schedule II prescriptions are valid to 30 days to conform to federal standards.
• Final rule corrects statutory and regulatory cross-references in the requirements on pharmacy operation.

Also in Texas, the Health and Human Services Commission has several COVID-related upcoming weekly seminars now open for registration.

• Webinar Tuesdays: Actively Administering & Advanced VAOS Users: For COVID-19 vaccine coordinators and providers who have received an order of the COVID-19 vaccine and are actively administering the vaccines. The state will share important news updates, clinical considerations, and advanced user tips on the systems and processes to support you.
  • June 15, 12:00PM-1:30PM CT – Register here
  • June 22, 12:00PM-1:30PM CT – Register here
  • June 29, 12:00PM-1:30PM CT – Register here
• Webinar Thursdays: Basics & Beginners: For providers who are new to the COVID-19 vaccine management program and/or have not yet received an order of the vaccine. We discuss important news updates, how to access VAOS, and how to get started with placing orders.
• June 17, 12:00PM-1:30PM CT – Register here
• June 24, 12:00PM-1:30PM CT – Register here

Lastly in Texas, the Health and Human Services Commission (HHSC) will resume publication of the quarterly Specialty Drug List in July. Please see the stakeholder notice.pdf for more information

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

Prior to the legislature adjourning its biennial regular session on May 31, the legislature approved two bills NACDS supported relating to the contractual relationship between a pharmacist or pharmacy and a Health Benefit Plan Issuer or Pharmacy Benefit Manager.

• HB 1763 by Rep. Tom Oliverson (R) regulates the contractual relationships between a pharmacist or pharmacy and a health plan or PBM. NACDS supported the following provisions of H.B. 1763:
  • Provisions that helped ensure that Texas pharmacies may be fairly and properly reimbursed for the prescription medications they provide and associated pharmacy services such as preventive treatments, immunizations, and helping patients access and take their medications accurately and safely;
  • Provisions that required equal access to all network pharmacies and should help all Texans continue to receive care from the pharmacy of their choice;
  • Provisions that required the terms of pharmacy contracts be clearly defined, especially concerning drug pricing and prohibiting the claw back of pharmacy reimbursement after a claim has been adjudicated at the point of sale.

NACDS submitted a letter urging Gov. Greg Abbott (R)to sign the bill, which he did on May 26 with an effective date of September 1, 2021.

• HB 1919 by Rep. Cody Harris (R) will help maintain patients’ right to choose a pharmacy provider by prohibiting health benefit plans and pharmacy benefit managers from “steering” or otherwise directing patients to use any particular in-network pharmacy provider over another. This bill helps ensure that patients are not penalized for choosing the pharmacy provider that best suits their individual needs. NACDS submitted a letter urging Gov. Abbott to sign the bill into law before the June 20^th

Also in Texas, unfortunately, three bills NACDS supported died.

• HB 678 by Rep. Phil Cortez (D) would have removed the existing administrative barriers requiring a prescription for influenza vaccines given to patients younger than 7 years of age and for any other vaccine given to patients younger than 14 years of age. This legislation proposed to align Texas requirements for vaccines given to younger people with the U.S. Department of Health and Human Services’ declaration under the Public Readiness and Emergency Preparedness Act that “authorizes state-licensed pharmacists to order and administer vaccines to individuals ages three through 18 years.” It passed the House by a vote of 139-7 but died in the Senate; and
• HB 2049 by Rep. Donna Howard (D) would have allowed pharmacists to furnish medications according to the result of a positive Clinical Laboratory Improvement Amendments (CLIA)-waived test for acute conditions such as flu and strep throat passed the House Public Health Committee but failed to be set on the House Calendar.
• HB 2346 by Stephanie Klick clarifying the law that stops the Health and Human Service Commission’s Vendor Drug Program (Medicaid) from proceeding with recent guidance to pharmacies to include discount card and membership program pricing in their calculations for Medicaid reimbursement rates died in the House Human Services Committee.

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