1. Texas Legislative Update on Pharmacy Issues
The Pharmacy Agenda During the 2017 Texas Legislative Session

3. Who Represents Pharmacy in Texas
Texas Society of Health System Pharmacists
Texas Federation of Drug Stores
Texas Pharmacy Association
Texas Pharmacy Business Council
Academy of Independent Pharmacists
Texas Independent Pharmacy Association
Texas True Care

4. 2017 - Pharmacists Standing Shoulder-to-Shoulder
Problem for TSHP…..
Did too good a job of sounding the Alarm

5. In the Past…. Not so much !!!
More Voices in the Choir…..

6. Diversity within Pharmacy Workplace led to less Collaboration…
Problem for TSHP…..
Did too good a job of sounding the Alarm

7. Preparing for the 2017 Legislative Session….
Problem for TSHP…..
Did too good a job of sounding the Alarm

8. Pharmacy groups participating
Problem for TSHP…..
Did too good a job of sounding the Alarm

9. Collaboratively developing proposals for…
Enhanced Access for Patient Services;
Protocols for CLIA Waived Tests
Collaborative Practice Agreements
Expanded pharmacist services
PBM Reforms;
Increased regulation of marketing practices
Reimbursement transparency
Transaction fees
Medicaid Managed Care
Formularies
Technician Training: PTCB 2020
No legislative Recommendations….
Problem for TSHP…..
Did too good a job of sounding the Alarm

10. Game Changer…..
Chaired by;
Sen. Leticia Van de Putte

11. The Texas Legislative Session Began…
So… In January of 2017
The Texas Legislative Session Began…

12. 2017 Pharmacy Legislation…
These are the major pharmacy related bills being considered…

13. New Pharmacy Issues… Expansion of Pharmacist scope of practice.
Providing meds for CLIA waived tests,
Providing Smoking cessation and travel drugs,
Provider status for insurance payments.

14. New Pharmacy Issues… Medicaid Managed Care. Adopts NADAC drug pricing,
Requires dispensing fee study,
Sets minimum dispensing fee,
Requires generic drug utilization.

15. New Pharmacy Issues… Regulation of PBMs
defines PBMs as “insurance entity”
Regulates contracting provisions
Prohibits transaction fees
Prohibits “Claw-back fees”

16. New Pharmacy Issues… Medication Synchronization Telepharmacy
Allowing a pharmacist to synchronize a patients refills.
Telepharmacy
Expanded automated dispensing sites tied to a Class A pharmacy located in rural areas,
Remote supervision of Techs accessing a pharmacy “system” from home.

17. Other New Pharmacy Issues…
Enhanced Penalties for Pharmacy Theft
Doctor Dispensing
Allowing a physician to sell drugs to patients.
Co-Prescribing
Requires the TMB to set standards for physicians prescriptions for Opioids.

18. Other New Pharmacy Issues…
E-Prescribing
Requiring physicians and pharmacists to use e-prescribing for all schedule II drugs.
Nurse Practitioner Prescribing & Dispensing
Independent practice by ANPs

19. Other New Pharmacy Issues…
Prescription Monitoring Program
Mandatory registration for doctors and pharmacists,
Mandatory look-up for both prescribers and dispensers for opioids, benzodiazepines, barbiturates, and carisoprodols, (20 million scripts)
Start date - ???

20. Other New Pharmacy Issues…
Pharmacy Sunset Bill
Reauthorization of the TSBP
Pharmacy Clean-up Bill
Discipline of pharmacy - Shortage
Definition of compounding,
Required technician training,
Closed pharmacy rules

21. The Session ended May 29th….
So …. What Happened

22. Here’s what PASSED… Pharmacy Sunset Bill
Reauthorized the TSBP, but also added…
Prescription Monitoring Program Changes;
Dispensing reported next business day,
Four categories of drugs …
Mandatory look-up for both prescribers and dispensers – STARTING SEPTEMBER 1st, 2019,
Push notifications,
Wholesalers must now report.
Unused Drug Donations to Medical Facilities

23. Here’s what PASSED… Pharmacy Sunset Bill (Cont.)
Pharmacist Exclusive Authority – to dispense or not.
New Tele-Pharmacy Laws;
Allows a Class A pharmacy to create a “remote dispensing site” in medically underserved areas staffed by only a technician under “remote supervision.” (Rules to be developed.)
Technicians may access the pharmacy system from “outside the pharmacy” while under constant supervision.
Authorizes the TSBP to establish CE requirements for technicians.

24. Here’s what PASSED… Medication Synchronization
Guidelines for Co-Prescribing
Enhanced Penalties for Theft
Irma Rangel School of Pharmacy

25. Here’s what PASSED… Step Therapy Prohibited
Insurance “Clawback” Prohibited
Medicaid Drug Formulary stays with the state.

26. Here’s what DID NOT PASS…
Independent Practice for APNs,
Physician Dispensing of drugs,
Expanded Practice for Pharmacists,
E-Prescribing of Sch. II Drugs,
Clean-up of Compounding Definition – Hospitals
Immunizations by pharmacists for students,

27. Here’s what DID NOT PASS…
Medicaid Drug Pricing – MAC to NADAC,
PBM Reforms – TDI Registration as “entity”,
PBM Reforms – Transparency of pricing.

28. A Special Session Starts Next Week
So …. What will Happen

29. A Special Session Starts Next Week
… Important Stuff
Medical Board Sunset, then
Bathroom Bill,
Property Tax Relief
School Finance Reform,
Abortion funding,
Austin Tree Ordinances,
City Annexations….

30. We Need New Friends….
Please…. Let us know if you know a pharmacist-friendly legislator who is serving in the legislature !!!

31. Time to invest in your profession…
The most regulated profession on Earth… is under attack Get involved NOW !!!

32. Time to invest in your profession…
Freedom isn’t free…
Please Give the TSHP-PAC