At the upcoming quarterly Board of Pharmacy, the Board will discuss proposed rules on eliminating ratios on pharmacy technicians and interns for all classes of pharmacy, as well as expanded certain pharmacy technician duties.  NACDS submitted a support letter and will testify at the public hearing. Members are encouraged to submit support letters to execassist@pharmacy.texas.gov before the Sunday, August 2, 2020, 11:59 PM CST deadline. Agenda materials are posted here, and live stream information available on this page.

Also in Texas. The Board of Pharmacy will be moving compliance inspections to virtual platforms to a new location which can be found here.

Also in Texas. The Board of Pharmacy’s emergency rule §291.30 concerning Medication Limitations expired on July 17. The rule was adopted on a temporary emergency basis in March 2020.

Also in Texas. The Board of Pharmacy will discontinue issuing 15-day renewal reminder letters to licensees after August 31, 2020 but will continue issuing 75-day renewal reminders. More information about the renewal deadlines can be found here. Select the license type to search by first and last name or by license/registration number.

Also in Texas. On July 27, Governor Greg Abbott (R) announced that Cecile Young will lead Texas Health and Human Services Commission’s 37,000-person agency that oversees both Public Health and Medicaid.

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

An Emergency Rule issued on March 20 limiting the dispensing of chloroquine, hydroxychloroquine, and other similar drugs expired on July 17. The Board of Pharmacy does not intend to reissue this emergency rule as it was only meant to prevent the stockpiling of the drugs and to ensure that reasonable quantities were available for all patients that require therapy with the drugs, including patients with a COVID-19 diagnosis. The expired language can be found here and guidance issued during the rule’s effective dates here.

Also in Texas. NACDS participated in the Texas Prescription Monitoring Program (PMP) Advisory Council virtual meeting on July 20. The PMP vendor Appriss provided data on the number of users, queries, integration, and recent enhancements to the system.

Also in Texas. To stay connected with legislators, NACDS, along with our in-state partner, the Texas Federation of Drug Stores, and chain pharmacists from HEB and Brookshire met virtually with Brenham State Senator Lois Kolkhorst, Chair of the Senate Health and Human Services Committee, and her staff. During the meeting, discussions focused on several priority issues, including pharmacy staffing, COVID testing, and expanding access to all FDA-authorized immunizations to anyone 7 years and older without a prescription but under a protocol.

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

The Drug Utilization Review Board announced that they will be performing a clinical review anticonvulsant, antihemophilic, antineoplastic, antiretroviral, and medications used to treat multiple sclerosis at the October 23, 2020 meeting. These are protected drug classes not currently reviewed on the Texas Medicaid Preferred Drug List. All medications within these drug classes will be preferred and continue to be available without prior authorization. For more information, contact vdp-formulary@hhsc.state.tx.us.

Also in Texas. Health and Human Service Commission’s Vendor Drug Program plans to publish the semi-annual update of the Medicaid preferred drug list on July 27, 2020. The new preferred drug classes are Glucagon Agents, Immunomodulators, Asthma and Sickle Cell Anemia Treatments.

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

NACDS, and our in-state partner, the Texas Federation of Drug Stores, initiated two Zoom conferences with state legislators this week. Walgreens pharmacist Ahmed Jallad participated on the call with El Paso State Senator Jim Moody, and HEB pharmacists Doug Read, Jay Bueche and Carlos Villareal joined the call with Sen. Judith Zaffarini of Laredo to discuss our pharmacy agenda: enhancing technician duties and ratios, expanding access to immunizations, and our efforts to make some of the temporary COVID Executive Order’s permanent. Both legislators were very interested expanding access to immunizations. 

Also in Texas. The following rules approved by the Board of Pharmacy went into effect on June 18th. 

• Final rule of the Board of Pharmacy amends regulations under 22 TAC 283 to remove references to pharmacist intern-trainees.  
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 283 concerning the pharmacist-pharmacy intern relationship and duties to remove references to pharmacist intern-trainee. 
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 295 to remove the change of name fee for pharmacists.  
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 295 to require mental health awareness continuing education and clarify the continuing education requirements for pharmacists during their initial license period.  
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 283 concerning pharmacy interns to remove references to pharmacist intern-trainees and certain requirements for a pharmacist intern, and correct grammatical errors.  
• Final rule of the Board of Pharmacy adopts regulations under 22 TAC 281 to establish provisions for the temporary suspension or restriction of a pharmacy license or registration based on the determination of a disciplinary panel.  
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 297 to remove the change of name fee for pharmacy technicians and pharmacy technician trainees.  
• Final rule of the Board of Pharmacy amends regulations under 22 TAC 283 to remove references to a pharmacist intern-trainee, clarify that a pharmacist preceptor must be certified by the board, and remove a fee for a duplicate or amended certificate.  
• Final rule of the Board of Pharmacy repeals regulations under 22 TAC 291 to remove provisions on Limited Prescription Delivery Pharmacies (Class H), which no longer exist.  

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

On June 10th, the Board of Pharmacy posted on their website COVID-19 testing guidance for pharmacists and pharmacies.  

Also in Texas... The Health and Human Services Department Vendor Drug Program (VDP) Medicaid Pharmacy Provider Procedural Manual recent update includes payment providers algorithms stating that the VDP pharmacy claims systems consider usual and customary price to include discount cards….. “Pharmacies cannot exclude discount prices given to customers from its determination of the most frequently charged price for the same drug when reporting the UAC price to Texas Medicaid on a claim transaction.  If a discount price is advertised for a drug then the discount price must be reported to Texas Medicaid as the UAC price for the same drug, unless the most frequently charged price is lower.”

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

NACDS, the Texas Federation of Drug Stores, and H-E-B pharmacists Doug Read and Jay Bueche, met with New Braunfels Sen. Donna Campbell, an emergency room physician. During the Zoom meeting, we promoted our scope regulatory and legislative agenda, including expanding technician duties and eliminating arbitrary ratios, expanding access to immunizations without a prescription. We also asked the Senator to urge Gov. Greg Abbott to allow pharmacists to test now for COVID and treat later when the vaccines become available.  

Also in Texas... Continuing to advocate for the removal of the remaining barrier to pharmacist COVID-19 testing, NACDS, the Texas Federation of Drug Stores, and other Texas pharmacy organizations with the help of the Executive Director of the Board of Pharmacy (BOP) Allison Benz and the Board president, Julie Spier with Albertsons, finally convinced Gov. Greg Abbott to acknowledge that the federal HHS April 8th guidance document and May 19th advisory opinion clearly authorize pharmacist ordering and administration of COVID-19 testing without any physician involvement. Texas BOP FAQ‘s that provide official guidance on pharmacist testing have been updated to that effect.   

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

NACDS is drafting expanded scope legislation for the 2021 session.

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

NACDS also continues to try to remove the remaining physician order requirement in Texas that poses a barrier to pharmacies expanding COVID-19 testing. NACDS, the Texas Federation of Drug Stores and the Texas Pharmacy Association provided requested updates to the Board of Pharmacy FAQ on COVID-19 testing for pharmacists and pharmacies.  The updates included reference to the most recent advisory opinion from the U.S. Department of Health and Human Services (HHS) concluding that the federal PREP Act, in conjunction with HHS’ April 8th guidance, preempts any state or local requirement that prohibits or effectively prohibits a pharmacist from ordering and administering a COVID-19 test that the Food and Drug Administration has authorized.

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

NACDS, the Texas Federation of Drug Stores, and the Texas Pharmacy are all continuing to work with the Board of Pharmacy to urge Gov. Greg Abbott to allow all licensed pharmacies with CLIA-waivers to order and administer all FDA-authorized CLIA-waived tests that can detect COVID or the presence of antigens or antibodies produced in response to the virus. 

Also in Texas... On May 15th, the Board of Pharmacy issued the following guidance to pharmacists when dispensing prescriptions for Chloroquine, Hydroxychloroquine, Mefloquine, or Azithromycin in compliance with Emergency Board Rule 291.30. 

The rule does not prevent a physician from prescribing one of these drugs for an off-label use. Please note, the intended use for the drug is not required if the practitioner determines the furnishing of this information is not in the best interest of the patient in accordance with Board rule 291.34 (b)(7).  

o   The intent of Rule 291.30 is to prevent the stockpiling of the drugs and to ensure that reasonable quantities are available for ALL patients that require therapy with the drugs, including patients with a COVID-19 diagnosis. 

o   It was not the Board’s intent to hinder the use of the drugs on patients that are in need of drug therapy, but rather to prevent unreasonable quantities that would otherwise be representative of hoarding or stockpiling tactics. 

o   In addition, the Rule does not apply to a prescription issued for a patient already established on the medication (e.g., prescription to treat rheumatoid arthritis or lupus for already established patients).

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