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Clark County Commission Chairwoman Marilyn Kirkpatrick pushed for more progress on the long-awaited UNLV School of Medicine building during a board meeting...The vexed commission chair expressed concern about project delays, saying her constituents haven’t gotten what was promised, including space for the UNLV Ackerman Autism Center. She asked for monthly updates to the commission’s management team...“I need more than a commitment. I need a hard date, a hard timeline, a hard communication expectation, because what I will tell you is that for me, I am super-frustrated with this whole thing,” Kirkpatrick said. “I have been waiting for financing for 10 years. That’s where we’re at.”...READ MORE

Collaborative Practice Agreements

Finally, Registered Pharmacists Can Collect Specimens!

National Pharmacy Compliance News

FDA Launches Pilot Program to Improve Security of Drug Supply Chain With an Innovative Approach

FDA Announces New Efforts to Increase Oversight and Strengthen Regulation of Dietary Supplements

Trump Administration Releases National Drug Control Strategy to Reduce Drug Trafficking and Abuse

• Prevention
• Treatment and recovery recommendations
• Reducing availability

New Study Predicts Opioid Epidemic Will Worsen Over the Next Decade

FDA Warns of Potential Blood Pressure Medication Shortages Due to Recalls

FDA Releases Two Draft Guidances Related to REMS Programs

• REMS Assessment: Planning and Reporting Guidance for Industry
• Survey Methodologies to Assess REMS Goals That Relate to Knowledge
  Guidance for Industry

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No one loved a bill heard in committee...that would keep emergency room patients from getting socked with surprise medical bills from an out-of-network provider that treats them...But no one hated the bill enough to oppose it...The bill...would bar an out-of-network provider treating an ER patient with “medically necessary emergency services” from charging more than the patient’s insurance co-payment, co-insurance or deductible. It also establishes procedures for insurers and third-party providers to work out payments between them, without putting the patient in the middle, and for transferring patients from an out-of-network facility where they were initially treated to one within their network within 24 hours of becoming stable...READ MORE

Three vending machines in Las Vegas are now providing the opioid overdose reversal drug Narcan for free...The newest vending machine, installed March 14 at the Center for Behavioral Health...offers the drug along with clean needles, personal hygiene and first-aid kits, safe sex information and pregnancy tests...“The vending machine provides easy access that does not require a medical appointment,”...Trac-B Exchange, part of the Harm Reduction Center in Las Vegas, offers infectious disease consulting to community members. Its existing needle exchange vending machines, which also dispense Narcan, are at the Huntridge Family Clinic, 1830 E Sahara Ave., and The Center, 401 S Maryland Parkway...READ MORE

Twenty of the biggest generic prescription drug makers are accused of committing a multi-billion dollar fraud on U.S. consumers. The states, including Nevada, and Puerto Rico filed a complaint...alleging the companies coordinated to inflate prices and reduce competition on more than 100 generic prescription drugs...The drug companies deny engaging in any illegal collusion saying prices go up with drug shortages and market forces....the Association for Accessible Medicines...says it and its member companies are "committed to supporting policies that promote competition."...“Generic drugs are intended to create competition in the marketplace and make treatment more affordable and accessible for patients with acute and chronic conditions,” said Attorney General Aaron Ford. “In the United States, 9 out of 10 filled prescriptions are for generic drugs patients rely on for care, making these alleged anti-competitive practices even more troublesome. Many Nevadans, especially our seniors, struggle with the skyrocketing cost of prescriptions, and my office will aggressively pursue drug companies who take advantage of patients’ need for health care. This unified and targeted action illustrates my Bureau of Consumer Protection’s continued dedication to holding these companies and individuals accountable for the consequences their actions have had on the American people and our health care system.”...READ MORE

Nevada leads the nation in a dubious category — the rate of syphilis infections....The state’s rate of the primary and secondary form of the sexually transmitted disease was highest in the nation in 2017, and the rate of congenital syphilis, life-threatening infections spread to an infant during pregnancy, was second highest...It’s an alarming trend because syphilis, particularly the congenital form, is preventable, said the district’s chief health officer, Dr. Joe Iser. State law requires prenatal screening for the disease during the first and third trimesters of pregnancy...‘Totally unacceptable’...READ MORE

SB262: Asthma drug pricing transparency

...Democratic Sen. Yvanna Cancela...has introduced a bill that would apply the same standards toward drugs that treat asthma...SB262 largely copies provisions of Cancela’s 2017 legislation on diabetes drug transparency, which requires the drug manufacturer to submit information to the state related to the cost of the pricing of the drug, and explain to the state whether the drug has undergone a substantial price increase in the past two years...SB262

SB378: Drug pricing board

Proposed by Democratic Sen. Yvanna Cancela, this measure would establish a statewide Prescription Drug Affordability Board, charged with identifying certain prescription drugs with pricing that creates challenges for insurers and patients and that would recommend an upper price and payment limit on the drug...The bill lays out the structure, make-up and abilities of the board, funded by taxes on prescription drug manufacturers based on their market share and the required costs of the board. It also lays out a process for setting upper recommendations on prescription drug prices, including requiring the suggested limits become mandatory after 2024...SB378

AB303: Regulation of kratom products

Sponsored by Assembly Republican Leader Jim Wheeler, this bill would require the state pharmacy board to regulate and oversee the sale of kratom, a Southeast Asian tropical tree with leaves that contain psychotropic effects...The bill would also prohibit the sale of kratom products to children under the age of 18, or to sell any kratom products that have been altered to become “injurious” to a consumer. It sets a $1,000 fine and separate civil penalty up to $1,000 for violations...AB303

AB239: Opioid clarification bill

...this bill would make changes to the opioid prescribing law passed in the 2017 legislative session that prompted complaints by physicians in the interim. The legislation would, among other things:
- Codify certain definitions from pharmacy board regulations, including course of treatment and acute pain
- Allow providers to still prescribe a controlled substance after reviewing a patient utilization report if they determine the prescription is medically necessary
- Allow providers to prescribe a longer initial prescription for a controlled substance for the treatment of acute pain than normally allowed by law if medically necessary
- Remove a requirement that a provider make a good faith effort to attempt to review a patient’s medical records before issuing an initial prescription of a controlled substance for the treatment of pain unless the initial prescription is for more than 30 days or the medical records are relevant to the prescription
- Repeal requirements that providers consider certain factors — including whether there is reason to believe the patient is not using drugs as prescribed, the number of attempts by a patient to obtain an early refill of a prescription and the number of times a patient claims a prescription has been lost or stolen — before prescribing a controlled substance...AB239

New hospitals or medical centers that offer or advertise emergency services in Clark County will need to accept Medicare and Medicaid, starting this summer...Hospitals that obtain a business license after June 1 will be subject to the new rule. They must also be certified by the Centers for Medicare and Medicaid Services and be in compliance with federal law that requires emergency departments to treat patients without regard for insurance or ability to pay...The new stipulations...come amid concerns over the emergence of freestanding ERs, or microhospitals, that are not part of existing hospital networks. Those medical facilities are licensed through the state, but lack accreditation, do not accept Medicare and Medicaid and are not subject to the same reporting requirements and other standards...READ MORE

A Democratic-controlled Senate rejected...an amendment backed by their Republican colleagues that would have removed a carveout in state trade secret law long opposed by the national drug lobby...Senate Republican Leader James Settelmeyer framed the amendment as an attempt to codify an agreement reached between drug companies and the state following a lawsuit over Nevada’s first-in-the-nation diabetes drug pricing transparency law...As part of that agreement, the state mapped out a process in regulation to protect information that drug companies believe to be trade secret protected from public disclosure...“The framework for protection of trade secrets in the regulations adopted for diabetes transparency reporting applies to disclosures under statute but were written by referencing the specific bill that created those sections,”...Pharmaceutical Research and Manufacturers of America said in a statement opposing the asthma bill. “The confidentiality language in the regulations for the diabetes transparency bill should be adopted in SB 262 to clarify that the requirements and considerations apply to disclosures required by those sections of statute generally and not just pursuant to any specific bill.”...Sen. Yvanna Cancela, who sponsored both the diabetes and asthma drug pricing bills, said on the floor that she believed the proposed amendment would weaken the state’s drug pricing transparency statute and pointed to the existing regulatory framework in place...READ MORE

Elite Medical Center...Since it opened...its business model has been based on providing emergency care to tourists...The federally-run Medicare program for the elderly and the state-run Medicaid program for low-income residents just isn’t lucrative and therefore isn’t part of its business model...The rest of Nevada’s hospitals use their privately insured patients to subsidize the cost of treating those covered under Medicare and Medicaid. Hospitals argue that the rates paid by government insurance programs don’t come close to the actual costs of providing care, so they must carefully balance the number of patients they take under each type of insurance in order to stay financially solvent....the other hospitals believe that Elite is siphoning off the well-insured patients at their expense and without shouldering any of the burden for treating those on Medicare or Medicaid. That’s why the state hospital association is pushing for lawmakers to pass AB232, which would require essentially all Nevada hospitals to accept Medicare and Medicaid...READ MORE