NP Prescribers Take Note
Posted 1 day ago by Susan Conaty-Buck
From Insurance Commissioner Trinidad Navarro:
Rite Aid has commenced Chapter 11 bankruptcy proceedings, resulting in pharmacy closures in Delaware. These closures may disrupt patient access to medications, making prescription transfers and pharmacy accommodations an urgent priority. Insurance Commissioner Trinidad Navarro issued Bulletin No. 153 in response, building upon actions of the General Assembly, Meyer Administration, and Board of Pharmacy.
“Minimizing disruptions in pharmacy services is vital to ensuring the health and safety of Delawareans. Insurers and PBMs should ensure access to and coverage for emergency prescription refills, streamline the prior authorization and prescription transfer process, ensure fair reimbursement rates for pharmacies absorbing displaced patients, maintain adequate pharmacy networks, and communicate with affected policyholders,” said Insurance Commissioner Trinidad Navarro
“While this bulletin sets forth requirements for insurers and PBMs, I also want to encourage each and every resident and provider to take steps to ensure continued access to necessary medications. Providers and health systems: please contact your patients and encourage them to change their pharmacy selections in your portals or via direct contact to the provider. Patients currently served by Rite Aid: find a local pharmacy to transfer your medications to, and contact your providers or use their portals to make the switch.”
The Bulletin
informs all health insurance carriers and pharmacy benefits managers (PBMs) of their obligations and the Department’s expectations as they relate to pharmacy closures and the Board of Pharmacy Emergency Order. The Department anticipates a significant increase in prescription transfer requests as displaced patients seek new pharmacies.
To maintain continuity of care and prevent disruptions, the Board of Pharmacy authorized one-time emergency prescription refills, which Commissioner Navarro requires to be covered by insurers. Coverage should extend to alternative verification methods such as prescription records, or pharmacy databases when prescriber authorization is unavailable due to pharmacy closures.
Carriers must streamline the prescription transfer process for patients moving from closed Rite Aid locations to new pharmacies. Carriers should notify affected policyholders about pharmacy closures and provide clear instructions on transferring prescriptions. Carriers and PBMs should provide dedicated support methods such as hotlines or web portals to assist individuals navigating prescription transfers.
Prior authorizations tied to a specific pharmacy should be automatically transferred to the patient’s new pharmacy without requiring reauthorization. Specialty medications and controlled substances requiring prior authorization should be expedited to avoid treatment delays. Any documentation requirements should not create undue hardship for pharmacies processing high patient volumes.
PBMs should ensure fair reimbursement rates for pharmacies absorbing displaced patients, preventing financial strain on independent and community pharmacies. Adequate pharmacy networks must be maintained to prevent pharmacy deserts, particularly in rural and underserved areas. Restrictive policies that steer patients toward specific pharmacies or mail-order services are prohibited under Delaware’s Pharmacy Access Act.
Measures specific to the Board of Pharmacy Emergency Order will remain in effect for 120 days from the issuance date unless extended or terminated by the Board with the concurrence of the Secretary of State. The Department will monitor compliance with the Bulletin’s provisions and issue further guidance if needed.
Board of Pharmacy Emergency Order
Governor Matt Meyer signed Senate Bill 180, which gives authority to the Board of Pharmacy to modernize Delaware’s licensure system, including specific provisions to better prepare for and manage emergencies in the State of Delaware. Making it easier for pharmacies to distribute prescriptions efficiently and timely for patients. Provisions of this bill directly address the closures of more than a thousand Rite Aid pharmacies nationwide, including 29 locations in the State of Delaware.
SB 180 amends Chapter 25, Title 24 of the Delaware Code relating to the Board of Pharmacy. This bill will allow out-of-state licensees to practice in Delaware in emergencies, as determined by the Board of Pharmacy and the Secretary of State. The bill also makes it legal for pharmacies to treat faxed prescription transfers of non-controlled medications the same as written transfers, provided all required information is included in the faxed prescription. Additionally, the Board will update its regulations to enable pharmacy technicians to assist in prescription transfers.
“These Rite Aid pharmacy closures will result in thousands of Delawareans transitioning to other pharmacies that will fill their prescriptions and deliver important care,” said Julie Miro Wenger, Executive Director Delaware Association of Chain Drug Stores. “To bolster pharmacies’ capacity to absorb this influx of patients, prescriptions and clinical care. These regulatory and legislative changes offer flexibility that will enhance pharmacy operational efficiencies and enhance their ability to meet increased demand for care in communities throughout the state.”
For questions, please email govcomm@delaware.gov.
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