Pharmacy Industry Updates: May 2019

View the video recap below:

PDMP Roundup

PDMP Reporting

• New Hampshire — Moving to ASAP 4.2A on 05-01-2019 (Appriss)
  • 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.
  • Dispensing Guide is available.
• California – Require Serial Number to be reported
  • 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 barcode.
  • It does not address the PDMP reporting aspect.
• Florida – ASAP V4.2 Accepted now, but required as of 12-19-2019

Potential PDMP Changes 

• Utah – DAR File No. 43353 Proposed Rule published 11-15-2018,  Finalized 12-27-2018.  Added new fields.  No updated information from Utah PDMP.
• Nebraska LB 556– Pending legislation
  • Requires ASAP V4.2A with additional fields Including Gender, ID, Sold date.
  • Change from Dr. First to a new vendor
  • Aug/Sept timeframe
  • Notice will be sent once contracts are finalized.
• 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 April/May  2019

• Rhode Island (SB2529 -2018)– Require PBMs to allow and reimburse for the  full amount of contraceptives to be dispensed up to 365 days.  05-01-2019
• Utah – (HB 370 – 2019) A pharmacy benefit manager
  • (a) may not require a pharmacy to collect the amount of a customer’s cost share for a prescription drug or device solely from the customer or the customer’s agent;
  • (b) shall permit a pharmacy to cover all or part of the amount of a customer’s cost share for a prescription drug or device; and
  • (c) may not reduce or deny a claim for a prescription drug or device more than 90 days after the day on which the claim is submitted to the pharmacy benefit manager

New Legislative/Regulatory Highlights  (More details below in Roundup)

• Colorado – EPCS Required by 01-01-2021
• Utah – Make Tramadol a Schedule IV
• Montana – Any performance based fee may only be applied to the dispensing fee and not cost of goods.
• Virginia – New Audit Rules
• North Dakota – Added Cannabidiol Drugs and Gabapentin to Schedule V

Get Involved/Get Informed Spotlight

Medicare Part D Provider Preclusion List – Any impact?

NCPDP Annual Conference and Workgroup May 5-8 in Scottsdale.   

Controlled Substance Prescriptions

• Watch your state for changes for pharmacist responsibility
• CVS penalized $535,000 for filling invalid prescriptions

Oregon SB 698

Current Version requires  by  01-01-2021 that labels and information be available in  at least the 14 languages listed in the bill in communities as determined by the Board of Pharmacy.

SCRIPT V2017071 Implementation – Brief Overview

• New Messages and functionality
• What to expect
• Timelines

PBM Update

• Senate Finance Committee Hearing – Drug Pricing in America: A Prescription for Change Part III
• House Energy and Commerce Committee Hearing –Priced out of a Lifesaving Drug: The Human Impact of Rising Insulin Costs

Federal Rules Updates

• 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
  • Over 25,000 comments received
  • Wholesalers Weigh in

• EPA’s Final Rule on Management Standards for Hazardous Waste Pharmaceuticals – Eff. 08-21-2019
  • Link to EPA Webinar on the final rule

• ONC: 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program
  • Affects IT developers of ONC certified technology with an expansive definition of “Providers”
  • Affects EHI – Electronic Protected Health Information
  • Comments Due: May 3, 2019 June 3, 2019

• Medicare and Medicaid Programs: Patient Protection and Affordable Care Act; Interoperability and Patient Access for Medicare Advantage Organization and Medicaid Managed Care Plans, State Medicaid Agencies, CHIP Agencies and CHIP Managed Care Entities, Issuers of Qualified Health Plans in the Federally-facilitated Exchanges and Health Care Providers

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

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.