California
Gov. Gavin Newsom (D) signed AB 1587 (Chapter 69), legislation allowing a pharmacist to provide a 30-day supply of a dangerous drug or device without prescriber authorization if the prescriber is unavailable and the pharmacist determines that failure to refill would disrupt care and harm the patient. The pharmacist is also required to notify the patient and, if a prescriber is identified, inform the prescriber within a reasonable period of time of any refill issued under this provision.
Also in California, Gov. Gavin Newsom (D) vetoed AB 2575, legislation aimed to protect direct patient care workers who choose to override or decline clinical AI recommendations. It would have prohibited employers from penalizing or retaliating against healthcare workers for overriding unsafe AI tools or following employer-approved technology in good faith. Gov. Newsom stated in his veto message that the anti-retaliation provisions did not protect workers as intended. He noted that the bill would improperly place the Labor Commissioner in the position of adjudicating complex clinical standards of care requiring medical expertise.
Also in California, the State Assembly passed HR 110, a resolution calling upon the Department of Health Care Services (DHCS) to direct Medicaid managed care plans to prioritize coverage for medically supportive food and nutrition interventions until these services can become fully covered, permanent Medi-Cal benefits. DHCS will also regularly update the implementation guidance, undertaking ongoing data collection and publishing evaluation reports, and actively soliciting stakeholder feedback to inform these updates. Also, the State Senate passed SR 123, a related resolution recognizing the benefits of medically supportive food and nutrition services in improving health outcomes, reducing chronic disease, advancing health equity and lowering healthcare costs.
Finally in California, the Board of Pharmacy is requesting your assistance in completing an important Job Analysis Survey regarding the duties and responsibilities you perform as a pharmacist practicing in California. The Board's examination committee will develop examination items based on the information collected from the survey responses. Such surveys enable examination items to reflect current technologies, methods and practices. All information obtained will remain confidential. You are eligible to receive two hours of continuing education credit for completing the survey.
You may access the survey at https://www.surveymonkey.com/r/CABOPJA26.
Your input is needed by October 18.
If you have questions, send an email to CABOP_JASurvey@psionline.com.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
On October 1, the Colorado State Board of Pharmacy finalized rules implementing HB 26-1336, establishing the Technician Product Verification (TPV) framework. Under these new rules, certified and trained pharmacy technicians and pharmacy interns can perform final product verification for non-controlled substances under pharmacist supervision. Key elements of the TPV framework include:
- Pharmacists may delegate final product verification for non-controlled substances.
- Pharmacies must maintain a continuous quality assurance program.
- Delegated activities may include technician-to-technician verification and barcode-assisted verification.
- Clinical judgment and therapeutic review remain the pharmacist's responsibility.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Board of Pharmacy posted an important notice regarding prescription refill procedures during Hurricane Isaias. Pharmacies operating in affected areas should review the guidance for applicable emergency dispensing provisions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
The Division of Occupational and Professional Licenses announced that significant changes to the license renewal process will take effect beginning October 30, which may impact licensees’ renewal cycles. The Division also published an updated Naturopathic Provider Prescriptive Authority Chart.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) issued several pharmacy bulletins.
Also in Louisiana, LDH issued a Pharmacy Provider Notice: 2026-2027 COVID Vaccine Medicaid reimbursement for enrolled pharmacies to Medicaid recipients who are nineteen years of age and older when the administering pharmacist is an enrolled Medicaid provider.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Prescription Drug Affordability Board’s (PDAB’s) Stakeholder Council will meet virtually on October 26 at 2:00 pm. The agenda and other meeting materials will be available on the Stakeholder Council page of the PDAB’s website prior to the scheduled meeting. Registration is required to attend.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
The Board of Pharmacy’s October newsletter includes important information related to technician supervision and duties.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
On October 9, MO HealthNet (Medicaid) completed its required annual review of all drug coverage criteria for the Preferred Drug List Prior Authorization Process.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
Reminder of Test and Treat Flu Authority. As pharmacists know, in 2025, the General Assembly authorized pharmacists to implement test and treat programs for influenza. Initially implemented by protocols issued by State Health Director Larry Greenblatt, the Pharmacy and Medical Boards have since adopted these protocols (both a test-and-initiate-treatment protocol and an influenza-prophylaxis protocol) by rule effective August 1, 2026.
Pharmacists are also reminded of the Board's July 31, 2026, statement concerning pharmacist administration of fall 2026 vaccines. The statement is available on the Board of Pharmacy's website.
Also in North Carolina, beginning November 1, controlled substances pharmacy claims billed under Medicaid Direct (Prime Therapeutics), will be denied at the pharmacy point of sale if the prescribing provider has not updated their NCTracks provider enrollment record with an active DEA number. Additional details can be found in this NC Medicaid Bulletin. This policy change follows identification of providers who are prescribing controlled substances but have not indicated this in their NCTracks enrollment record and have not provided their DEA number. Pharmacies may begin seeing increased denials related to this update. Medicaid is continuing outreach to impacted providers to encourage them to update their enrollment records ahead of the November 1 deadline.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its agenda and meeting materials for the October 21 meeting. Check the PDAB website for updates prior to the meeting.
Also in Oregon, the Board of Pharmacy is proposing to adopt the following Oregon Administrative Rules:
- Standard Vaccination Protocol for Managing Adverse Reactions & Assessment and Treatment Care Pathway v. 09/2026
- Coronavirus 19 v. 09/2026
- Influenza v. 09/2026
- Respiratory Syncytial Virus v. 09/2026
Please review and submit written comment(s) on the proposed rule language including the Fiscal Impact statement and Racial Equity statement. You can find the filing notices and proposed rule text on the Board's website.
The November 24 Rulemaking Hearing will be held virtually via Teams and begins at 9:30 am.
If you wish to provide virtual oral testimony in real time during the hearing, please complete and submit the Rulemaking Hearing Testimony Sign-up Form on the Board's website. You may also sign up by submitting your first and last name, email address and which rules/protocols you would like to comment on to pharmacy.rulemaking@bop.oregon.gov no later than 8:30 am on November 24. You will receive a confirmation email and a calendar invitation to join the virtual hearing.
Written comments must be received by 4:30 pm on November 24. Submit written comments to pharmacy.rulemaking@bop.oregon.gov.
If you would like to listen to the rulemaking hearing, join the virtual Teams meeting or call:
(503) 446-4951 Phone Conference ID: 538 650 615 #
Email all rulemaking inquiries to pharmacy.rulemaking@bop.oregon.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Board of Pharmacy is scheduled to meet for private executive session at 9:00 am followed by public session at 10:30 am on October 20. The agenda and instructions to join the meeting remotely are on the Board’s website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) held a Pharmacy Stakeholder meeting and shared the following updates.
- Pharmacy Payment Information: VDP emphasized that pharmacies must maintain accurate physical addresses, email addresses, phone numbers and primary contacts in the Texas Medicaid & Healthcare Partnership (TMHP) Provider Enrollment and Management System. Direct deposit changes must be submitted using Form CPA 74-176. Keeping this information current matters because the Comptroller may purge a Texas identification number when no payment or voucher history exists for a full fiscal year.
- Continuous Glucose Monitors (CGMs): VDP's planned addition of CGMs to the outpatient drug benefit remains delayed because CMS required pharmacies to enroll as DME suppliers. VDP is seeking removal of the DME requirement and is planning to submit a new state plan amendment (SPA) in November.
- Temporary Non-Preferred Drug Rule: VDP implemented the rule required by HB 3286 (2023) that requires new drugs that are available on the formulary but have not yet been reviewed by the Drug Utilization Review (DUR) Board to receive temporary non-preferred status. The related Texas Administrative Code amendment was published in the Texas Register as of October 2 and became effective October 7. Pharmacy organizations should ensure that formulary-management and patient-support teams understand how this temporary status applies while new products await DUR Board review.
- Usual and Customary: VDP is developing a Texas Administrative Code amendment to implement House Bill 2402 (2025), a law that excludes fees, charges or rates offered through monthly fee-based membership discount programs from the usual-and-customary fee calculation. VDP stated that the rule must remain limited to the statutory language and cannot extend to third-party discount cards; the exclusion applies only to qualifying membership discount programs.
Also in Texas, VDP published an update to the VDP Pharmacy Provider Procedure Manual.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
Effective October 1, the Health Care Authority (HCA) published quarterly updates to many of the Apple Health billing guides.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The Wisconsin Immunization Registry (WIR) Unit will host its next WIR User Webinar on October 21 from 11:00 am to 12:00 noon to help users prepare for the new WIR system. Topics will include historical immunizations, updating client records, upcoming system changes and data exchange updates. Register for the WIR User Webinar.
For more information, contact NACDS’ Jermaine Smith at 703–837–4388.
Arkansas
On September 22, the Arkansas Attorney General’s Senior Assistant Solicitor General Joseph Nelson presented Arkansas’s arguments before the U.S. Eighth Circuit Court of Appeals to protect Act 624, the state’s law addressing PBM ownership and vertical integration. The case, Express Scripts et al. v. Rodney Richmond et al., involves an appeal of the preliminary injunction issued by the district court in July 2025. NACDS will continue to follow this case and the potential impact of Act 624 on Arkansas pharmacies, pharmacists and patients.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Services posted the following:
- September 2026 Pharmacy Medi-Cal Update Bulletin
- September 2026 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
- August 2026 Pharmacy Medi-Cal Update Bulletin
- August 2026 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
- July 2026 Pharmacy Medi-Cal Update Bulletin
- July 2026 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
Also in California, the Department of Health Care Services (DHCS) posted the following on the Medi-Cal Rx Web Portal: New Federal Reimbursement Limitations on Gender Affirming Care for Youth, Effective October 13, 2026.
Also in California, Medi-Cal is offering a new course titled Medication Therapy Management (MTM) Live Webinar (IO105LW). The course will provide information to registered outpatient pharmacies about certain clinical services, such as reviews of a Medi-Cal member’s medications, member education (for example, about how to correctly use medication) and follow-ups with members to ensure treatment efficacy.
Webinars for the MTM training will be held on the following dates:
- October 7 at 10:00 am
- October 27 at 10:00 am
Providers must register for the webinar through the Medi-Cal Learning Portal (MLP) and select the session they plan to complete to ensure enrollment.
Note: To register for the course, providers must have internet access and a user profile in the MLP. Google Chrome is the recommended web browser for accessing the MLP. Detailed instructions about the registration process and accessing webinar classes are available on the Outreach & Education page of the Medi-Cal Providers website.
For additional assistance, contact the Telephone Service Center (TSC) at 1-800-541-5555.
Finally in California, the NACDS/California Retailers Association and Medi-Cal Rx Standing Meeting will be held on October 12 at 1:00 pm Pacific. Please use the information below to join the call.
Microsoft Teams Need help?
Meeting ID: 245 923 124 206 12
Passcode: pr3q2Tj6
Dial in by phone
+1 612-772-9010,,548080788# United States, Minneapolis
(844) 730-9010,,548080788# United States (Toll-free)
Phone conference ID: 548 080 788#
As a reminder, please direct inquiries to the PBD inbox: Medi-Cal.PharmacyBenefits@dhcs.ca.gov. This inbox replaces the former DHCS RX Carve Out inbox.
Need more information or assistance?
- Medi-Cal Rx Customer Service Center (CSC), available 24 hours a day, 7 days a week, 365 days a year at 1-800-977-2273 for help with claim denials, prior authorization status, account password and unlock assistance, beneficiary support, and other inquiries about Medi-Cal Rx
- Medi-Cal Rx Web Portal
- Medi-Cal Rx List of Resources
- Medi-Cal Rx Subscription Service (MCRxSS) sign-up
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Health Care Policy and Financing (HCPF) invites stakeholders to register for a webinar on October 26, from 10:00 am to 12:00 noon, to learn about updates on federal changes to Medicaid coverage due to H.R. 1, also known as the 2025 “One Big Beautiful Bill Act.”
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Georgia
Gov. Brian P. Kemp declared a state of emergency due to global market volatility and suspended the state’s motor fuel excise tax for a period of 30 days. The suspension will take effect at 12:01 am on September 29 and run through October 29. The governor’s executive order declaring state of emergency also suspends state weight limits on commercial vehicles.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
The Board of Pharmacy posted the minutes from its June 4 meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
The Attorney General Kris Kobach (R) recently issued an opinion on the validity of certain prescriptions issued by mid-level prescribers, specifically physician assistants (PAs) and nurse practitioners (APRNs). The opinion concludes that the Kansas Pharmacy Act requires PAs and APRNs to hold a Kansas license from the Kansas Board of Healing Arts and the Kansas Board of Nursing, respectively, to prescribe medication in Kansas. This differs from the Board of Pharmacy’s previous understanding and enforcement. Without the appropriate Kansas licensure, mid-level practitioners are not authorized to prescribe medication in the state. Pharmacists should review the opinion, consult legal counsel, if necessary, and ensure dispensing practices under the Kansas Pharmacy Act align with these requirements.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Michigan
The Board of Pharmacy has posted the agenda for the October 14 full board meeting.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
NACDS participated in the Missouri PBM Reform Summit, which brought together pharmacy stakeholders to identify crucial provisions for PBM reform legislation in 2027. NACDS voiced support for a commercial rate floor and increased enforcement, as well as prohibiting clawbacks, retroactive fees and transaction fees.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
The Retail Association of Nevada (RAN) publicly endorsed Attorney General Aaron Ford (D) for Governor, over incumbent Gov. Joe Lombardo (R).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Department of Consumer and Business Services (DCBS) Division of Financial Regulation announced the Prescription Drug Price Transparency (DPT) Program published PBM data results and analysis from its third year of collecting this data. This year, it received data for calendar year 2025. The payments PBMs received from manufacturers and reported to DPT for Oregon covered lives were more than $217 million. Most of these manufacturer payments – almost $210 million – were passed to insurers. The remainder of the payments were retained by the PBM or its affiliate ($6.4 million) or passed to enrollees ($875,000). Additionally, PBMs retained administrative fees of $25.8 million, four-fifths of the total ($20.1 million) from insurers and one-fifth ($5.7 million) from manufacturers. Refer to the published PBM data for additional details. For more information, contact the department at rx.prices@dcbs.oregon.gov.
Also in Oregon, the Board of Pharmacy adopted the following Temporary Rule and Vaccine Protocols during the September 18 special board meeting. While the Oregon Health Authority State of Oregon Statewide Standing Order is still valid, pharmacists should transition to using the Board’s Coronavirus 19 Protocol v. 09/2026 as their primary source of authority for prescribing/dispensing/administering COVID-19 vaccines.
September 22: Temporary Rule & Vaccine Protocols Noticed
- Div 115 – Services: Prescribing – Pursuant to Protocol *Effective 9/22/2026
- Standard Vaccination Protocol for Adults 18 Years of Age and Older & Assessment and Treatment Care Pathway v. 09/2026
- Standard Vaccination Protocol for Person 7 through 17 Years of Age & Assessment and Treatment Care Pathway v. 09/2026
- Standard Vaccination Protocol for Managing Adverse Reactions & Assessment and Treatment Care Pathway v. 09/2026
- Coronavirus 19 v. 09/2026
- Influenza v. 09/2026
- Respiratory Syncytial Virus v. 09/2026
Email all rulemaking related inquiries to pharmacy.rulemaking@bop.oregon.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
NACDS and the Texas Federation of Drug Stores (TFDS) are launching a series of three Advocacy Training sessions in Dallas/Fort Worth, Houston and Austin. These events are designed to empower Texas pharmacists, technicians and interns to become influential voices at the Capitol ahead of the pivotal 2027 legislative session. With both in-person and virtual participation options, attendees will gain insider knowledge and actionable strategies on the most pressing pharmacy issues—building critical advocacy skills and a powerful professional network.
Also in Texas, the Chairman of the House Committee on Public Health, Rep. Gary Van Deaver (R), who wasn’t seeking a 7th term, suddenly resigned from the Texas House of Representatives this week to take a position as the new Executive Director of the Texas Association of School Boards.
For more information, contact NACDS’ Mary Staples at 817-442-1155.