The Board of Pharmacy has posted the Agenda for its March 15 meeting. Please note they will consider a Guidance Document on Pharmacy Working Conditions that you can find on page 101 of the agenda. Also on the agenda is a proposed rule on Pharmacist Initiation of Treatment that was a result of 2021 legislation that added authority for pharmacists to provide vaccines; Tuberculosis testing; HIV prevention medications; and paraphernalia, supplies and equipment to adults. The Board previously approved an emergency regulation on the same subject as well as protocols that were both effective in December 2021 and can be found on the Board website.  

Also in Virginia, on April 4, the Department of Medical Assistance (Medicaid) will be switching from its Legacy Medicaid Management Information System (MMIS) to the Medicaid Enterprise System (MES) for fee-for-service. As a result, the MediCall and Activated Voice Response System (AVR) eligibility systems will be down from March 30 through April 3. Please see this notice for more detail. DMAS will be sending a series of Medicaid Memos detailing the impact of these system changes on the Provider community, the latest can be found here. You can find training videos and user manuals for MES here.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Pharmacy Channel Team at the Department of Health have published a recent version of the Vaccine Standing Order, which reflects recent CDC updates on COVID-19 vaccination guidance with additional information to help vaccinators determine the optimal interval between the first and second dose of an mRNA vaccine series, based on the individual patient.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Legislature’s crossover deadline for bills to pass one chamber to be eligible for further consideration was met on February 15. The following bills of interest to pharmacy met the deadline: 

• HB 1323 and SB 672 – both bills expand pharmacy personnel immunization and testing authority to mirror the PREP (Public Readiness and Emergency Preparedness) Act; SB 672 also expands the state’s current allowances on conditions pharmacists may test and/or treat. NACDS has been actively supporting both bills, which are headed for consideration in conference committee 
• HB 1324 – this bill requires the Board of Pharmacy to adopt regulations for work environment requirements for pharmacy personnel by September 1, 2022. The regulations must include addressing pharmacy staffing and breaks; state standards that ensure adequate time to complete professional duties; and limit productivity or production quotas to the extent that such factors interfere with the ability to provide appropriate professional services to the public. The bill was amended to remove language that would have allowed it to be promulgated as an emergency measure, thus ensuring stakeholders’ ability to participate in the regulatory process 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

HB 1323, sponsored by Del. Orrock (R) was reported from the House Health, Welfare, and Institutions Committee this week. The bill, a priority for NACDS, would continue the immunization authority extended to pharmacies by the PREP Act when the Federal Public Health Emergency expires. The bill was amended in committee with language negotiated with the pediatric community regarding physician notification and providing patient follow up in the rare event of an adverse reaction. The bill now goes to the full House for consideration.  

Also in Virginia, to increase accessibility of at-home COVID-19 test kits, VDH has developed a Standing Order to help pharmacies be able to adjudicate test kit claims and receive reimbursement. It has also been posted on the VDH website. Please note that DMAS published their coverage of at-home COVID-19 test kits policy at the end of last week. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department of Health has issued a Standing Order to help pharmacies adjudicate test kit claims and receive reimbursement. It has been posted on the VDH website, but here is the direct link as well. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy issued the following clarification regarding pharmacy technicians’ authority to administer vaccines:  

As part of his COVID Action Plan, Governor Glenn Youngkin signed Executive Order 11, to give flexibility and support to healthcare providers, hospitals and other healthcare facilities. Paragraph 13 of Executive Order 11 increases the number of persons performing the duties of a pharmacy technician that a pharmacist may supervise to five (5) and exempts pharmacy technicians performing COVID-19 administrative tasks from being counted in the ratio. Please be advised that the administration of a CLIA-waived test or vaccine does not constitute an administrative task.  Additionally, the decision regarding the number of pharmacy technicians a pharmacist will supervise, and whether any other duty constitutes a COVID-19 administrative task, is a decision that must be made by the Pharmacist-in-Charge or pharmacist on duty, pursuant to 18VAC110-20-112(A) and 18VAC110-20-110(C).  The Executive Order shall remain in effect until February 21, 2022, unless sooner amended or rescinded by further executive order or directive.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

On January 20, Governor Youngkin (R) declared that a limited state of emergency exists in the Commonwealth due to COVID-19 and issued Executive Order 11 to provide relief for hospitals and healthcare workers. The Order is effective until February 21, 2022. Among other provisions, the order allows healthcare providers, pharmacists, pharmacy interns, and pharmacy interns with active licenses in other states to practice in Virginia; increases the pharmacy technician ratio to 5:1 and exempts pharmacy technicians performing only administrative functions from the count. Additionally, it permits licensed practical nurses to administer COVID-19 vaccines without the supervision of a registered nurse or licensed medical practitioner. It also provides certain liability protections to providers who act in good faith to protect patients.  

Following the release of the Executive Order, the Board of Pharmacy emailed a communication to licensees waiving restrictions around pharmacy central/remote processing and the utilization of pharmacists and pharmacy technicians located in other states. 

 Also in Virginia: The Department of Health has issued an updated Naloxone Standing Order signed by Dr. Colin Greene.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Virginia Department of Health (VDH) has issued an updated COVID-19 standing order to include the latest CDC recommendations.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy has published final emergency regulations authorizing pharmacists to initiate treatment with certain drugs, devices, controlled paraphernalia, and other OTC supplies and equipment for adult patients became effective December 22, 2021. Pharmacists may now utilize the new statewide protocols to initiate treatment for vaccines, TB, HIV PeP and PrEP, and over-the counter medications when they decrease a patient’s out-of-pocket expenses. The regulations are a result of legislation that members, allies and NACDS worked on in the 2021 legislative session. 

Also in Virginia: The Department of Health has published a Revised COVID-19 Vaccine Standing Order has been updated and posted here. Also refer to the revised Summary of Legal Authorities for Pharmacists to Administer COVID-19 Vaccine. The updates to the Standing Order include: 

Allowing any COVID-19 vaccine booster to be administered at an interval of 5 months, rather than 6 months, after completion of the Pfizer-BioNTech primary series (any COVID-19 vaccine booster remains recommended 6 months after a Moderna vaccine primary series and 2 months after Johnson & Johnson vaccine) 

1. Children 12-17 years old are recommended to receive a Pfizer booster vaccine 5 months following their primary series
2. Children 5-11 years old who are immunocompromised are recommended to receive a 3rd Pfizer dose as part of their primary series 28 days after 2nd dose

For more information, contact NACDS’ Jill McCormack at 717-592-8977.