Pharmacy Industry Updates: March 2019

PDMP Roundup

• Montana – End of next business day reporting as of 09-08-2018 – Data Submission Guide on Website still shows every 8 days. Two notices were mailed to Montana submitters.
• California – New Dispensing Guide as of 01-01-2019
  • New Prescription Forms with 15-character Serial Number
  • Emergency Legislation in in progress to delay enforcement of serial number on prescriptions pads until at least 07-01-2019
• Hawaii – Require Schedule V drug reporting as of 01-16-2019 (Notice on 01-09-19)
• Louisiana – Require reporting of Naloxone 01-20-2019 (Notice on 01-15-19 /  Regulation posted 01-28-2019)
• Rhode Island – Require ASAP V4.2A with ICD-10 as of 01-22-2019 (Notice on 01-17-19)
• Ohio – Report Naltrexone Products to OARRS Effective March 19, 2019 (Notice on 01-16-19)
• Florida – ASAP V4.2 Accepted now, but required as of 12-19-2019

Potential PDMP Changes

• Utah – Finalized rule not yet published in the Utah Bulletin and waiting on final details.
• Nebraska – Pending legislation to require ASAP V4.2A and add additional fields in Q3 of 2019. Including Gender, ID, Sold date. SIG requirement will likely be removed.

Legislative/Regulatory Reminders for March 2019

• Mississippi
  • Pharmacists can dispense up to the total prescribed quantity for non-controlled substances.
• Florida
  • Updated penalties for failing to comply with PDMP checking requirements.
  • Updated rules/definitions for prescribing of controlled substances for acute pain.

New Legislative/Regulatory Highlights   

• Arizona – Delayed Electronic Prescribing of Controlled Substances requirement until 01-01-2020
• Maryland and Utah – Self Administered Hormonal Contraceptives

Get Involved/Get Informed Spotlight

 Initiatives on Prescription Drugs Costs and Reducing Out of Pockets Expenses

• Drug Importation (Congress and States)
• Outcomes based contracts (Congress/CMS)
• Medicare Price negotiations (Congress)
• Removal of Safe Harbor for Rebates (CMS)
• international Pricing Model (CMS)
• Increased Generic Reimbursement (FDA, CMS, VA)
• Price Transparency (States)
• Price Gouging (States)
• Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses

Monthly Opioid/Controlled Substance Update

• Long awaited Quantity Prescribed Rule
• CMS Documentation/Tip Sheets for the New Opioid Policy for Prescribers and Pharmacies
• New York Opioid Stewardship Fund

CMS Updates

• Precluded Provider List
  • Implemented soon whereby a list is kept of all prescribers not able to prescribe for Part D.
  • Plans are to send letters to the affected beneficiaries by Feb 1, 2019 .
  • Plans will reject any new or refilled prescription from prescriber on the list starting 04-01-2019.
  • New and modified rejects should have been part of January 2019 NCPDP ECL implementation.
  • List will not be made available only to plan sponsors, so pharmacies cannot check against this.
  • Prescriber data vendors are looking for a solution.
• Reminder – Pharmacies are also included in this list.

State Legislative Trends

• Prescription Drug Pricing
• Pass Through Pricing for Medicaid Managed Care
• Opioids
• Cannabidiol
• Marijuana – Medical and Recreational
• Oregon – Prescription labelling in any language that is spoken by .02% or more of the population.

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