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Pharmacy Industry Updates: March 2020

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

 

PDMP Updates

Oregon

  • New Data Submission Guide V2.2 effective 01-01-2020 requires Gabapentin Reporting
  • Require Diagnosis Code and “reason for the prescription” if provided on the prescription.

Washington

  • Moving from the Appriss Legacy RxSentry to Appriss PMP AWARxE Platform on 04-20-2020
  • Registration begins on 03-25-2020

Pennsylvania – Effective 02-28-2020 will require submission of

  • Patient Phone Number (PAT17)
  • NCPDP ID field (PHA02)
  • Transmission Form of Rx Origin Code (DSP12)
  • Partial Fill Indicator (DSP13)
  • Prescriber State License Number (PRE04) when available)
  • New Data Submission Guide is available

Utah – Will be moving to NIC’s RxGov in the future

  • 01-15-2020 – Utah still in holding pattern with RxGov
  • Require Gabapentin Reporting as of 04-01-2020 but request it be reported ASAP.
  • Reminder that Butalbital is a state C3 and must be reported.

California

  • 01-01-2021 -Require reporting “as soon as reasonably possible but no more than one working day after a controlled substance is dispensed.” Also requires Schedule V reporting.

 

Legislative/Regulatory Reminders for March 2020
  • Delaware – Updated rules under which plans can apply step therapy to drugs.
  • Iowa – Authorized Expedited Patient Therapy
  • New York – Cannot require prior authorization or copay for substance use disorder drugs under most circumstances

 

New Legislative/Regulatory Highlights
  • Colorado – Cost share for insulin can’t be more than $100 per 30-day supply or $300 per 90-day supply
  • Illinois – Cost share for covered prescription insulin cannot exceed more than $100 for a 30-day supply
  • Kansas – Pharmacist / Technician ratios changed
  • Michigan – Authorizes Remote Pharmacy and rules by which they can occur
Get Involved/Get Informed Spotlight
  • Supreme Court to hear Rutledge v. PCMA on Monday, April 27
  • NCPDP Update
    • Quantity Prescribed
    • Replacement for D.0 Adjudication
    • Patient Specific Denial Notice
    • New Projects
      • Pharmacy Locator for Backordered Medications
      • Pharmacogenomics Project
    • Proposed Rules
      • CMS Proposed Rule for Medicare Advantage and Part D changes to CY 2021-2022
      • FDA Importation of Prescription Drugs Proposed Rule
    • DSCSA – Drug Supply Chain and Security Act
    • Illinois PDMP Checking Requirements

 

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.

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