The Department of Health briefed pharmacy stakeholders, sharing recent data by age group on COVID vaccinations administered. 

Also in Washington, the first of two Pharmacy Legislative Days at the Capitol that NACDS sponsored was held last week and was a huge success. Pharmacists and students were briefed on the priority issues before meeting with legislators. 

Also in Washington, changes to the long-acting insulin class on the Preferred Drug List (PDL) go into effect on April 1.  

Also in Washington, HB 2116, sponsored by pharmacist legislator Rep. My-Linh Thai (D), was heard in the House Committee on Health Care and Wellness last week and is now dead because it failed to be voted out of the policy committee before the January 31 deadline. This bill would have expanded prescriptive authority for pharmacists.  

Also in Washington, the state’s Health and Human Services Enterprise Coalition, a group of Washington state health and social service agencies, published an annual update to its Washington State Action Plan for Removing Barriers to Health and Human Services. 

Also in Washington, Apple Health (Medicaid) updated several client booklets. 

Finally in Washington, effective February 1, the Health Care Authority, Apple Health Fee-For-Service (FFS) is increasing the morphine milligram equivalent (MME) conversion factors used to determine total daily MME under the Apple Health Opioid Policy to the following: 

• Hydromorphone MME conversion factor of 5 (increased from 4) 
• Tramadol MME conversion factor of 0.2 (increased from 0.1) 

The Apple Health MME calculator conversion factors are based on the Washington State Agency Medical Directors’ (AMDG) and CDC guidelines for prescribing opioids for pain. 

Opioids are limited to 120 MMEs per day. Pharmacy claims for opioids will reject if a single prescription or a combination of prescriptions exceed the MME limit. If a pharmacy claim rejects for exceeding the MME limit, request a prior authorization. 

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

In advance of the January 24 House Health and Wellness Committee hearing, NACDS registered in support of HB 2116, legislation expanding prescriptive authority for pharmacists. We also submitted the attached support statement for the record.  

Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) is scheduled to meet on February 1. The meeting materials will be available online soon. 

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

On January 24, pharmacy professionals and students will gather at the Capitol in Olympia for the first of two legislative days which NACDS is proud to sponsor. The advocacy event allows pharmacists, students and pharmacy technicians to educate legislators about the importance of pharmacies as a convenient, accessible community healthcare destination, as well as an opportunity to promote pharmacists and technicians as vital members of the healthcare team.  

Also in Washington, Health Care Authority (HCA) created a new flyer that pharmacies can distribute to help reach Medicaid patients encouraging them to update their contact information and apply for or renew coverage. Pharmacies can order the free flyers in both English and Spanish. 

Also in Washington, the Heath Care Authority’s (HCA) first quarter Preferred Drug List (PDL) used by Uniform Medical Plan and the Department of Labor and Industry is available online. 

Finally in Washington, legislation expanding prescriptive authority for pharmacists, HB 2116, will be heard in the House Committee on Health Care & Wellness on January 24. Take action today to register your support for the bill. If you reside in the state, register your support with your legislator by filling out this form. To share your support with all Committee members, use this link to submit a supporting statement or testimony.  

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

The legislature convened on January 8. Lawmakers will need to agree to a supplemental budget.

Also in Washington, legislation to expand pharmacists’ prescriptive authority was filed in both chambers. HB 2116 by Reps. My-LinhThai (D) and Vandana Slatter (D) was referred to the Health and Wellness Committee, and SB 6019 by Sen. Ron Muzzall (R) was referred to the Senate Health Long-Term Care Committee. 

Also in Washington, SB 5213 by Sen. Patty Kurderer (D), pharmacy’s PBM reform bill, was carried over from the 2023 session. 

Also in Washington, in compliance with the Settlement Agreement in the case of National Association of Chain Drug Stores, et al., v. Health Care Authority (Washington State Court of Appeals No. 51489-3-II), the Health Care Authority (HCA) updated the professional dispensing fees for pharmacies and began issuing adjusted dispensing fee payments December 29, 2023. For more information regarding the updated professional dispensing fees for pharmacies and adjusted dispensing fee payments, the HCA provided a FAQ. Questions can be emailed to applehealthpharmacypolicy@hca.wa.gov. 

 Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) filed for Emergency Rulemaking to codify in rule the FDA’s approval of certain naloxone hydrochloride nasal sprays as over the counter. The rule was effective immediately and will remain in effect for 120 days but will be refiled as needed while permanent rulemaking is in progress. 

Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) adopted rules on Opioid Use Disorder (OUD) Remote Dispensing Sites implementing SSB 6086 (Chapter 244, Laws of 2020) allowing a pharmacy to extend its pharmacy license to a remote dispensing site where technology is used to dispense medications used for the treatment of OUD or its symptoms, effective January 18. 

Also in Washington, the Pharmacy Quality Assurance Commission (PQAC) issued an FAQ in response to questions regarding health care entities (HCEs) and the 72-hour dispensing limitation.  

Finally in Washington, the five-member Prescription Drug Affordability Board (PDAB) that was enacted to reduce Rx costs to consumers issued its 2023 Annual Report. 

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

Gov. Jay Inslee (D) hosted a roundtable this week to discuss the fentanyl crisis and laid out his proposals for the upcoming legislative session. The governor’s budget adds over $50 million in new funding to take down opioids for the 2023–25 biennium, augmenting the investments from the state’s $82 million opioid settlements with drug manufacturers and pharmacies responsible in part for the opioid crisis and general fund investments within the 2023–25 biennial budget. The biennial budget allocated over $200 million for substance use disorder (SUD) treatment facility operations, rental subsidies for people with SUD, treatment subsidies, criminal diversion programs, peer support services, Tribal SUD grants and more.

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

The Department of Health’s Pharmacy Quality Assurance Commission (PQAC) filed a rulemaking inquiry to consider possible amending language on prescription transfers requested by the patient.

Also in Washington, the Health Care Authority (HCA) published a new Medicaid program integrity training for providers which includes pharmacy, COVID-related issues and general program integrity overview and activities. The information provided in this educational intervention is not intended to be a comprehensive detailed account of all legal requirements relevant to compliance with Medicaid program integrity laws and regulations and satisfies the law requiring annual training in RCW 74.09.195.

Also in Washington, the HCA updated the Prescription Drug Program Billing Guide, effective for dates of service on and after December 1, 2023. Revisions include added vaccines that can be billed through the point-of-sale pharmacy system, updated pharmacy billing information for vaccines and vaccine administration, and updated professional dispensing fee allowances for pharmacies to align with recently filed emergency rules.

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

CMS approved the Washington State SPA (State Plan Amendment), implementing the new updated July 1, 2023, dispensing fees based on the Oregon dispensing fee tiers. Washington Medicaid will soon be paying pharmacies the higher dispensing fees as well as making retroactive payments.  

Also in Washington, the Pharmacy and Family Planning Programs within the Clinical Quality Care Transformation division at the Health Care Authority is requesting pharmacy staff complete this pharmacy contraceptive access survey about barriers and solutions in prescribing and dispensing contraception. 

Also in Washington, in observance of Thanksgiving, the Health Care Authority’s offices will be closed on November 23 and 24. Provider payments for the week of November 20 will be made on November 22, including the delivery of Remittance Advices (RAs) and HIPAA (Health Insurance Portability and Accountability) 835 remittance files. 

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

Since the settlement and dismissal of our six-year-old lawsuit against the State of Washington for its below cost dispensing fees, NACDS, NCPA (National Community Pharmacists Association) and the Washington State Pharmacy Association have been monitoring the state’s compliance with its obligations. In terms of the state’s obligation to pursue a cost of dispensing study, the state issued a “work request” for a vendor to do the study on September 19, with the deadline for responses due October 21. The cost of dispensing study is supposed to start November 1. In terms of the retroactive payments to pharmacies for April 2017 through June 2023, the state reports that the process is in place and payments should be starting very soon. As for implementing the adjusted dispensing fees effective July 2023, the state needs CMS’ approval of the state plan amendment (SPA) pending before CMS with those new dispensing fees first. The state anticipates such approval to be forthcoming.  

Also in Washington, the State Department of Health Office of Health Professions is hosting a Vaccine Fatigue Webinar on November 3.  

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

The five-member Prescription Affordability Board (PDAB) held its first hybrid meeting on October 20.  

Also in Washington, the State Chief Science Officer Dr Tao Sheng Kwan-Gett signed an updated statewide standing order to dispense naloxone. 

Also in Washington, the Department of Health (DOH) Immunization Division is hosting a COVID-19 and RSV Vaccine Updates Webinar (online registration) on Tuesday, October 24 from 12:00 PM – 1:00 PM Pacific. Topics will include COVID-19 vaccine updates and RSV vaccine recommendations for older adults and pregnant persons, as well as recommendations for infants. The online seminar will be recorded. 

Finally in Washington, the Health Care Authority’s Health Care Cost Transparency Board met on October 18. 

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