The Health Care Authority (HCA) is publishing quarterly updates to many of the Apple Health billing guides and fee schedules, effective April 1, 2022. 

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

Effective March 12th, Gov. Jay Inslee (D) issued Proclamation 20-25 rescinding face covering requirements in most places except healthcare settings including pharmacies, long-term care facilities, correctional facilities, and jails.

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

The 60-day legislative session ended its regular session on March 10. Prior to adjournment, NACDS chain pharmacy lobbyists, independent pharmacists, the Washington State Pharmacists Association (WSPA), the Northwest Grocers Association (NWG) and the Washington Retail Association (WRA) successfully stopped ESHB 1852 from advancing, legislation that would have required directions for use and auxiliary warnings on prescription labels in both English and at least 15 languages. Rather than have this issue defined by the Legislature, the coalition will be working with the Pharmacy Quality Assurance Commission (PQAC) to adopt rules establishing requirements for the translation of prescription drug information.  

Also in Washington, on March 4, Gov. Jay Inslee (D) signed into law legislation capping insulin at $35. (Chapter 10, 2022/SSB 5546)  

Also in Washington, the Health Care Authority (HCA) will submit to the Centers for Medicare & Medicaid Services by July 15th a request to renew the Section 1115 Medicaid demonstration waiver, called the Medicaid Transformation Project (MTP), which will allow the state to create and continue to develop projects, activities and services that improve Washington's health care system using federal Medicaid funding. The new proposals include: continuous Medicaid enrollment for children; extending coverage for postpartum services; re-entry services for individuals who are exiting jail, prison, or other correctional facility and enhancements to long-term services and supports (LTSS). 

Finally in Washington, HCA efforts aimed at increasing health care cost transparency and controlling health care cost growth include: 

• The Health Care Cost Transparency Board is focusing on reducing health care cost growth and increasing price transparency.
• Prescription drug price transparency focuses on creating an annual report on how prescription drugs affect health care costs. 
• The Washington State All Payer Claims Database (WA-APCD) is a tool used to collect health care claims data for reporting and analytics and to help the public make their health care decisions. The WA-APCD supports health care and payment reform while addressing the need for cost, quality and utilization transparency. 
• Value-based purchasing (VBP) helps us achieve a healthier Washington by containing costs while improving outcomes, patient and provider experience and equity. 

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

The 60-day legislative session ends on March 10th. 

Also in Washington, the Health Care Authority (HCA) will submit to Centers for Medicare & Medicaid Services by July 15, 2022, a request to renew the Section 1115 Medicaid demonstration waiver, called the Medicaid Transformation Project (MTP), which will allow the state to create and continue to develop projects, activities, and services that improve Washington's health care system using federal Medicaid funding. The new proposals include: 

• Continuous Medicaid enrollment for children 
• Extending coverage for postpartum services 
• Re-entry services for individuals who are exiting jail, prison, or other correctional facility 
• Enhancements to long-term services and support (LTSS) 

Finally in Washington, the Health Care Authority (HCA) aimed at increasing health care cost transparency and controlling health care cost growth include: 

• The Health Care Cost Transparency Board is focusing on reducing health care cost growth and increasing price transparency. 
• Prescription drug price transparency focuses on creating an annual report on how prescription drugs affect health care costs. 
• The Washington State All Payer Claims Database (WA-APCD) is a tool used to collect health care claims data for reporting, analytics, and to help the public make their health care decisions. The WA-APCD supports health care and payment reform while addressing the need for cost, quality, and utilization transparency. 
• Value-based purchasing (VBP) helps us achieve a healthier Washington by containing costs while improving outcomes, patient and provider experience, and equity. 

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

Gov. Jay Inslee (D) issued a proclamation removing the statewide indoor mask mandate effective February 18, 2022.

Also in Washington, legislation twice amended that NACDS opposed that mandates prescription label translations, unanimously passed the House earlier this month. This week it was approved by the Senate Health and Long-Term Care and Rules Committees, and now goes to the full Senate for review. (ESHB 1852) 

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

Legislation of concern to pharmacies that mandates prescription label translations was amended for a second time on the House floor and approved by the full House. NACDS will work with other pharmacy groups on the Senate side to get the House Health Care and Wellness Committee Substitute language restored. (HB 1852)

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

The Health Care Authority (HCA) announced that the Human papillomavirus (HPV) vaccine is now a covered benefit under the Family Planning Only programs, effective February 1, 2022. For billing information, please refer to the Family Planning Billing Guide on the HCA website. 

Also in Washington, in advance of the February 3rd House Finance Committee hearing, NACDS sent letters to members of the Committee and leadership stating our opposition to HB 2091, legislation that would increase the Business and Occupation (B&O) tax on prescription drug wholesalers. 

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

Apple Health (Medicaid) covers over–the–counter (OTC) COVID-19 tests with or without a prescription for clients. An adjudicated pharmacy claim is required for reimbursement. Pharmacies may not bill for test administration of an OTC COVID-19 test as these tests should be used by the patient in the home setting.

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

In advance of the January 17th House Health Care and Wellness Committee hearing on HB 1852 / SB 5840 legislation that would require by January 1, 2023, prescription label translations in 15 languages for both the directions for use and the side effects of the drug, the latter which is not currently required to be on the label, NACDS submitted this statement for the record opposing the bill. 

 NACDS has substantial concerns that although well-intentioned, this bill would impose new  requirements for labeling prescriptions in multiple languages that would be redundant to the  ways that pharmacies ensure meaningful access to care for individuals with limited English  proficiency under 45 CFR 92.201. Moreover, we are concerned that the requirements of this bill  go beyond what is practical and could potentially undermine the numerous ways that pharmacies  already provide translation services to their patients. We, therefore, urge Washington lawmakers to reject his impractical legislation. 

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