Activity in the states

NCPA June 27, 2022

Alaska: House Bill 145 cleared both chambers in the Alaska State Legislature and now awaits the governor’s signature. NCPA submitted a letter of support for this legislation which clarifies immunization authority for pharmacists and other services outside of a collaborative practice agreement. Also, the bill includes mandatory coverage from insurers within the state and reimbursement for services within pharmacy scope of practice.

Florida: Gov. Ron DeSantis (R) signed HB 357 into law. If a pharmacy disagrees with the final report of a PBM audit, the act allows the pharmacy to file an appeal with the Agency of Health Care Administration, which will help resolve the dispute. Additionally, the act gives the agency greater enforcement authority to go after PBMs that are not complying with state law.

Illinois: NCPA celebrates the signing of HB 4430 which modifies the pharmacy practice act to allow pharmacists to administer “preexposure prophylaxis” (PrEP) and “postexposure prophylaxis” (PEP) to treat HIV. Earlier this year, NCPA submitted written testimony in support of this legislation which also includes mandatory coverage and compels payers to reimburse pharmacists no less than 85 percent the rate of other providers who provide the same service.

Oklahoma: NCPA congratulates the Oklahoma Pharmacists Association as the governor signs into law a bill that recognizes pharmacists as providers and mandates payment parity for health care services through the state Medicaid program. HB 2322 includes pharmacists in the definition of “essential community providers” and authorizes that the pharmacists and pharmacies shall receive direct payment or reimbursement for services rendered at no less a rate of other providers for the same service.

Tennessee: Gov. Bill Lee (R) signed HB 2661 into law. The act requires PBMs to adopt reimbursement methods that accurately reflect actual acquisition costs and protects patients from being forced to use PBM-owned pharmacies.

Vermont: Gov. Phil Scott (R) signed H. 353 into law. The bill addresses patient steering and also requires the state to look into issues such as reimbursement transparency, spread pricing, and other PBM practices that raise costs for patients and plans.