Broad reform legislation regulating PBMs, 2SSB 5213, that was supported by the Insurance Commissioner, the Washington State Pharmacy Association, and pharmacies, which would have prohibited requiring the use of mail-order pharmacies except for specialty drugs, reimbursing pharmacies below costs and excluding pharmacies from the network, died on the Senate floor on March 8.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
NACDS sponsored the Washington State Pharmacy Association’s successful Pharmacy Days at the Capitol on January 25 and February 13. More than 120 students and pharmacists participated in 60 appointments with legislators advocating for PBM reform and, in general, for the profession of pharmacy, promoting convenient access to healthcare services. Pharmacist James Lin from Kroger-QFC met with Sen. Javier Valdez (D).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
In advance of the February 7 hearing in the Senate Committee on Health and Long Term Care on PBM reform, SB 5213, NACDS registered in support and urged chain members to do so as well. The bill is awaiting further action in Executive Session and must be reported out of the committee of origin by February 17. Because there is a modest fiscal note, it will be sent to the Ways and Means Committee. House companion bill is HB 1253.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The legislature convened on January 9, 2023.
Also in Washington, legislation creating a new stand-alone chapter for regulating PBMs was filed this week. SB 5213 and HB 1253 were designed by the Office of the Insurance Commission (IOC) and the Washington State Pharmacy Association (WSPA) to regulate PBMs directly regardless of whether the contract is with a state-regulated plan or a self-funded plan. The bill prohibits requiring the use of mail-order pharmacies (except for specialty drugs), reimbursing pharmacies below costs and excluding pharmacies from the network.
Also in Washington, the Washington State Pharmacy Association (WSPA) Legislative Days are January 25 and February 13. These events will allow all pharmacists, pharmacy students and pharmacy technicians from all practice settings to connect with legislators and colleagues across the state.
Also in Washington, the Health Care Authority recently updated its provider billing guides and fee schedules for Apple Health (Medicaid).
Finally in Washington, the Department of Health (DOH) is developing a campaign in 2023 to encourage families to catch up on immunizations. To accomplish this goal, DOH is surveying health care providers for guidance on what materials and resources are needed.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
NACDS provided comments in advance of the Washington State House Health Care and Wellness Committee’s December 1 workshop meeting on “Pharmacy Benefit Manager Impacts on Prescription Drug Cost and Regulatory Developments.” In our letter, NACDS urged legislative action to curb harmful pharmacy benefit manager (PBM) practices including patient-steering, limiting pharmacies’ participation in provider networks and reimbursement practices that result in below-cost reimbursement to pharmacy providers.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The House Health Care and Wellness Committee is holding a work session on December 1 to take written and virtual testimony on pharmacy benefit manager impacts on prescription drug costs. NACDS will provide members with the agenda and our comment letter before the hearing.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Pharmacy Quality Assurance Commission (PQAC) is conducting a survey to assess current pharmacy practices pertaining to accessible labeling for both patients with visual and/or print disabilities and patients who require that prescription information be translated into another language besides English. The survey also includes whether such options are already made available, and what technological, financial or resource-based obstacles prevent such options from being offered. Any licenses are strongly encouraged to participate in the survey.
Also in Washington, the fourth quarter Preferred Drug List (PDL) has been posted to the Reports webpage. This PDL is used by Uniform Medical Plan and the Department of Labor and Industry.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Pharmacy Quality Assurance Commission (PQAC) is conducting an accessible labeling capability assessment survey to assess current pharmacy practices around providing accessible labeling options to patients, including whether such options are already made available, and what technological, financial, or resource-based obstacles prevent such options from being offered. PQAC filed a rulemaking inquiry (CR-101) to consider new and amended rules related to prescription label accessibility standards on issues pertaining to both visual/print disability access and the translation of prescription drug information for individuals for whom English is not a primary language.
Also in Washington, the Health Care Authority (HCA) is publishing quarterly updates to many of the Apple Health billing guides effective October 1, 2022.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Health Care Authority (HCA) has made the following updates to its COVID-19 monoclonal antibody policy concerning HCPCS code Q0222:
See Apple Health Monoclonal Antibody Treatment COVID-19 clinical policy, under COVID-19, Policies, and billing guidance for more information regarding the policy and procedure codes involved.
HCA revised the COVID-19 Fee Schedule. See HCA’s Provider billing guides and fee schedules, under COVID-19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.