The Health and Human Services Commission announced that effective September 1, 2020, the Vendor Drug Program (VDP) will implement a uniform opioid policy across fee-for-service and managed care programs to encourage appropriate use and reduce opioid over-prescribing. The opioid policy does not apply to people receiving hospice care or palliative care, treatment for cancer, residents of a long-term care facility or another facility for which residents receive opioid substitution therapy for the treatment of opioid use disorder (OUD), or other people they elect to exempt based on an objective, confirmable physical pathology known to cause severe chronic pain not ameliorated by other therapies and for which opioid treatment is appropriate. According to the announcement, if diagnoses are not available in the medical data, exemptions will be handled on a case-by-case basis through the prior authorization process. More information can be found here.

Also in Texas. The Department of Insurance adopted an emergency rule that requires health benefit plans to extend established prior authorization approvals for drugs by 90 days and requires plans to authorize payment for a one-time additional 90-day supply of a covered drug. The rule also requires plans to cover prescription drugs from out-of-network pharmacies with no additional cost-sharing when the enrollee cannot obtain them in-network, requires plans to make alternative drugs available in the event of shortages, and prohibits plans from requiring an enrollee signature at the point of delivery. Also, the rule prohibits plans from refusing or reducing payment for a prescription drug based on the fact such a drug was delivered by a local pharmacy. The rule expires on September 27, 2020 (see page 2378 in the link: https://www.sos.state.tx.us/texreg/pdf/backview/0410/0410is.pdf).

Also in Texas. On August 8, Governor Greg Abbott extended his Disaster Declaration for all Texas counties in response to COVID-19 for another 30-days. Originally issued on March 13, 2020, the Disaster Declaration provides the state with a variety of resources to effectively serve Texans as the Lone Star State continues to mitigate the spread of COVID-19.

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

On August 4, the Board of Pharmacy agreed to adopt proposed rules from the November 3, 2020 board meeting that would expand pharmacy technician duties(accepting oral prescriptions, transferring a prescription, and contacting the prescriber to clarify information on an existing prescription order)for all classes of pharmacy except Class C hospital pharmacies. The Board also agreed to adopt proposed rules increasing the pharmacists-to-pharmacy technician ratio for Class A retail pharmacies from 1:4 to 1:6.

Also in Texas. Effective October 15, 2020, Samuel M. Poloyac will serve as the next dean of the University of Texas College of Pharmacy. Dean-designate Poloyac currently serves as the associate dean for graduate and postdoctoral programs at the University of Pittsburgh School of Pharmacy. Retiring Dean Lynn Crismon will support Dr. Poloyac throughout the transition.

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

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.