health care icon pattern medical innovation concept background design

health care icon pattern medical innovation concept background design

Pharmacy Industry Updates: June

Every month, our Industry Relations Director, LeAnn Lewis provides an in-depth industry update to customers. Below, you will find the agenda for the industry update for June. If you have any questions regarding any of the points, contact us here.

 

PDMP Roundup

PDMP Reporting

  • New Hampshire — Moving to ASAP 4.2A on 05-01-2019 (Appriss)
    • Will error on missing Treatment Type starting 06-01-2019
    • Data Submission Guide available as of 04-18-2019
  • Maryland – Changing from Appriss to NIC’s RxGov as of 06-01-2019
    • Reporting within 24 hours of
    • Dispensing Guide is
  • Iowa — Require Prescription Origin Code to be reported (DSP 12) as of 05-15-2019
  • Nebraska — Passed LB556 – Effective 05-02-2019
    • Requires ASAP V4.2 with additional fields Including Gender, ID, phone number
    • Working with the state to delay the requirements but submit new fields as soon as possible
    • Sept/Oct – Will send notice when contracts are finalized
      • Require ASAP 2A
      • Changing from Dr. First to a new vendor
  • California – Require Serial Number to be reported — Still waiting
    • Delayed until no later than 01-01-2020.
    • Allows dispensing of prescriptions written on old pads until 01-01-2021
    • DOJ/BOP are still discussing the length/format of the serial number and type of
    • It does not address the PDMP reporting
  • Florida – ASAP V4.2A Accepted now, but required as of 12-19-2019

Potential PDMP Changes 

  • Utah – Will be moving to NIC’s RxGov in the
    • Updated spreadsheets with zero reporting are
  • Oregon HB 3315 –Introduced March 4, 2019, Adds to the reporting
    • method of payment used to purchase the prescription drug
    • diagnosis or other information related to a prescription
    • Whether the patient is required to obtain prescriptions from a designated practitioner or prescription drugs from a designated pharmacy

 

Legislative/Regulatory Reminders for June/July  2019

  • Idaho (H 182) Expand pharmacist prescriptive authority
  • Indiana (HB 1248) Expands pharmacist prescriptive authority
  • Maine (LD6 / SP 10) Prohibit Cost Share > Cost and Gag Orders
  • Mississippi
    • SB 2996 – Require Medication Synchronization with prorated copay and full dispensing fee
    • SB 2365 – Allow biosimilar substitution with 5 day notification to prescriber
  • Montana (SB 270) – Prohibit Cost Share > Cost and Gag Orders
  • New Mexico (SB 394) Imposes new restrictions on PBM Audits
  • South Dakota (HB 1137) Prohibit Cost Share > Cost and Gag Orders
  • Utah
    • HB 370 – Prohibit Cost Share > Cost and Gag Orders
    • HB 499 – Moves Tramadol to Schedule IV
  • Virginia
    • HB2158 – Update naloxone administering and dispensing rules
    • Requires e-Prescribing for all prescriptions containing opiates as of 07-01-2019 with some
  • West Virginia
    • HB 2768 – New prescribing limits on initial prescriptions of opioids, and new lock-in requirements
    • HB 2525 – Expands pharmacist prescriptive authority under collaborative practice
    • Various – PBM Regulations including copay accumulator plans, timely payment of claims, permitting pharmacy to dispense full prescribed amount of a

 

New Legislative/Regulatory Highlights

  • PBM Reforms – Arizona, Georgia, Maryland, North Dakota, Nebraska, Oklahoma, South Carolina
  • Expanded Pharmacy Scope of Practice Authority – Indiana, Montana, New York, Oregon, South Carolina
  • Electronic Prescribing of Controlled Substances — Indiana , Kansas

 

Get Involved/Get Informed Spotlight

NCPDP Annual Conference and Workgroup Update

Rules/Guidance Updates

Administrative Simplification: Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Standard NCPDP D.0 (CMS-0055-P)

Medical Loss Ratio (MLR) Requirements Related to Third-Party Vendors

Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses

Fraud and Abuse: Removal of Safe Harbor Protection for Rebates Involving Prescription Pharmaceuticals and Creation of New Safe Harbor Protection for Certain Point-of-Sale Reductions in Price on Prescription Pharmaceuticals and Certain Pharmacy Benefit Manager Service Fees

New NCPDP Task Group formed for guidance and discussions. Signup at dms.ncpdp.org

Overview of USP 800 – Handling Hazardous Drugs – Handling in Healthcare Settings

December 1, 2019: USP General Chapter <800>

 

Contact us to ask questions or get more information about these updates.

Bio and photo of Leann Lewis

Disclaimer:

The organizer of this call is not an attorney, and the presentation on this call does not constitute legal advice.  It contains only the opinions and observations of the organizer and its participants.  Any use of information contained in this presentation is at the user’s own risk. The organizer will not be available for depositions or testimony in case of litigation.

Leave a Reply

Your email address will not be published. Required fields are marked *