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.

In an effort to stay connected with Texas state legislators during the interim, NACDS, the Texas Federation of Drug Stores and our chain pharmacists from HEB, Kroger, Walgreens and United have been engaged in Zoom meetings. Over the past couple of weeks, we have met with nine lawmakers — West Texas State Senators Charles Perry & Kel Seliger, Ft. Worth State Senator Beverly Powell, San Antonio State Representative Phillip Cortez, Houston State Representative Garnet Coleman, El Paso State Representative Lina Ortega, Arlington State Representative Chris Turner, Dallas State Senator Nathan Johnson and Wichita Falls State Representative James Franks. During these meetings, we covered a wide range of issues beyond the great work pharmacist and pharmacies are doing during the pandemic throughout Texas to ensure access to medications, promoting our scope regulatory and legislative agenda, — expanding technician duties and eliminating arbitrary ratios, and enhancing access to immunizations without a prescription. We also urged them to tell Gov. Greg Abbott to allow pharmacists to test now for COVID and treat later when the vaccines become available. 

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

Prior to the May 5th quarterly Zoom Board meeting, the Executive Director Allison Benz announced that the discussion on expanding technician duties and eliminating the arbitrary ratio would be postponed until the August 4th in-person Board meeting.  

Also in Texas... The Health and Human Services Commission's Vendor Drug Program (Medicaid) finally submitted their 1115 Waiver on April 22nd, that would allow reimbursement to pharmacies for administering flu vaccines, long acting antipsychotics, and drugs used to treat substance use disorder or opioid dependency. 

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