California
The Department of Health Care Services (DHCS) posted the following on the Medi-Cal Rx Web Portal. Please note the following items: 1.) On January 1, 2027, the DHCS will transition approximately 2 million Medi-Cal members with Unsatisfactory Immigration Status (UIS) from the Medi-Cal managed care delivery system to Medi-Cal fee-for-service (FFS). Pharmacy providers and prescribers can also review the Policy Guide for Transition of the Unsatisfactory Immigration Status Population from Managed Care to Medi-Cal Fee-for-Service to understand the upcoming changes and prepare for the transition. See "Fee-for-Service Transition Town Hall" for details. 2.) Please review in its entirety the "Update: Include ICD-10-CM Diagnosis Codes on Pharmacy Claims".
- Fee-for-Service Transition Town Hall – September 30 at 10:00 am PT
- Ordering, Referring, and Prescribing Enrollment Requirements Town Hall – September 24 at 10:30 am PT
Also in California, the Board of Pharmacy posted the agenda and meeting materials for the Licensing Committee meeting being held on September 23. Of interest, the board will discuss changes in pharmacy law included in AB 1503 (Chapter 196, Statutes of 2025), including updates on implementation activities.
Finally 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.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Public Health and Environment (CDPHE) re-issued the state's COVID-19 vaccine standing order, allowing healthcare providers, including pharmacists, to administer updated COVID-19 vaccines without individual prescriptions.
Also in Colorado, the Board of Pharmacy will hold a permanent rulemaking webinar hearing on October 1 to decide on proposed revisions to multiple rules as follows:
- Rule 2.00.00. The purpose is to align the controlled substance transfer rule with new federal DEA requirements and clarifications.
- Rules 3. The purpose is to implement Colorado House Bill 26-1336.
- Rules 10.00.00 and 14.00.00. The proposed revisions implement Colorado House Bill 26-1220.
- Rule 11.00.00. The purpose is to align system automation and the transfer of controlled substance prescriptions with new DEA requirements and practice standards.
- Rules 3, 15 and 21. These amendments refine compounding rules to better align with recent FDA guidance and implement Colorado House Bill 26-1198.
- Repeal of Rule 28.00.00. The purpose of the repeal is to implement Colorado House Bill 26-1182.
- Rule 19.00.00 – The purpose is to implement Colorado Senate Bill 26-032.
- Rule 23. The purpose is to refine and define how long PDMP data is retained and/or archived to better align with other states and reduce risk where necessary.
- Correction to Appendix G. The purpose is to change the word provider to patient, as it was originally intended and adopted by the Board.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
The Agency previously announced effective October 1, the operation of the Children's Medical Services (CMS) Plan will move from Sunshine State Health Plan, Inc. (Sunshine) to Molina Healthcare of Florida, Inc. (Molina).
To ensure no disruption in current services and to support continuity of care, Molina will allow enrollees to continue receiving their Medicaid-covered authorized prescriptions through their current provider until the prescriptions expire or can be transferred to a provider in the plan's network.
Pharmacies should follow the process outlined below to receive reimbursement for services provided to a CMS Plan enrollee.
Effective October 1, pharmacies should bill Molina's Pharmacy Benefits Manager (PBM) for CMS Plan enrollees. If a pharmacy inadvertently bills Sunshine and receives a denial, the pharmacy should immediately bill Molina's PBM using the information below to process the claim(s). The pharmacy may ask the enrollee to provide their new membership card to obtain the health plan billing information.
Molina: CVS Caremark
- PBM Services Pharmacy Help Desk: 1-855-276-6580
- Group Number: RX51EN, RX51EP
- BIN Number: 004336
- PCN Number: MCAIDADV
For member questions regarding this transition, contact Molina Member Services at 1-800-262-0750. For provider questions regarding this transition, contact Molina Provider Services at 1-855-322-4076.
If enrollees encounter any issues, please refer them to the Medicaid Help Line at 1-877-254-1055 (TDD 1-866-467-4970).
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kansas
All pharmacy technician registrations expiring on October 31, must complete 20 hours of ACPE/Board-approved continuing education before renewal. Pharmacy Technicians can renew online.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
On September 14, the Department of Insurance filed an emergency regulation in accordance with SB 188 of 2024, a comprehensive commercial market PBM reform law that included a rate floor of NADAC + a professional dispensing fee as determined by a Department of Insurance cost of dispensing study. The Department’s study determined the cost of dispensing to be $16.31. The rule, effective upon filing, will require commercial insurers and the State Employee Health Plan to pay a professional dispensing fee of $16.31 per claim to all ambulatory pharmacies beginning January 1, 2027. The regulation will remain in effect until a subsequent ordinary regulation is finalized.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH) Medicaid Pharmacy Program announced that, effective September 15, it will reimburse enrolled pharmacies for influenza vaccines and administration of the vaccines for the 2026-2027 Influenza Season to Medicaid recipients who are nineteen years of age or older when the administering pharmacist is an enrolled Medicaid provider.
Also in Louisiana, LDH announced that Healthy Blue will exit at the conclusion of its Medicaid managed care contract, effective December 31, 2026.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Prescription Drug Affordability Board’s (PDAB) next meeting is on September 28 at 2:00 pm. Registration is required to attend remotely. The agenda, as well as information about providing public comments, can be found on the PDAB’s website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Minnesota
NACDS learned that pharmacies can expect to receive their first lump sum payment from the Medicaid Pharmacy Directed Payment Program (DPP) by October 15. The $4.50 per claim payment is based on claims from January 1 to May 31, 2026. The Department of Human Services shared this list of pharmacies that qualified for the payment as of August 18. Pharmacies with less than 14 locations or any located in federally designated rural areas that did not meet the initial affirmation deadline can still qualify for the second payment cycle. The third (and final) payment cycle payment will be processed at the end of 2026.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
MO HealthNet issued a provider bulletin on credentialing requirements for participation in Medicaid Managed Care.
Also in Missouri, CPESN MO pharmacies have two opportunities to contract with Medicaid Managed Care Organizations (MCOs) to provide monthly patient care services while also participating in value-based care payments tied to improving patient outcomes. These opportunities give pharmacy teams a pathway to expand clinical services, strengthen patient relationships, and generate additional revenue through monthly service payments and value-based care incentives.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Mexico
Effective September 1, 2026, pharmacists can use the new statewide order and the Department of Health (NMDOH) recommendations to provide 2026–2027 COVID-19 vaccines. The state preserved broad access, including vaccination of healthy individuals ages 2–64 years who request protection, and the pharmacist protocol recognizes NMDOH and several professional organizations as competent guideline authorities.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
Beginning November 1, 2026, controlled substances pharmacy claims billed under Medicaid Direct (Prime Therapeutics), will be denied at the pharmacy point of sale if the prescribing providers have not updated their NCTracks provider enrollment record with active DEA numbers. Additional details can be found in the 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 numbers. Pharmacies may begin seeing increased denials related to this update. North Carolina 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.
Texas
NACDS sponsored the Texas Public Policy Foundation's (TPPF) Healthcare Symposium, underscoring the association's continued engagement in advancing healthcare and pharmacy policy in Texas. NACDS Board of Directors member Kevin Host, Senior Vice President of Pharmacy at Walmart, participated on the "Texas Challenges" panel, bringing an important pharmacy perspective to the discussion. NACDS continues to advocate for policies that recognize and expand pharmacists' ability to provide essential healthcare services, helping patients access convenient, community-based care and leveraging pharmacies more fully to improve healthcare access, affordability and efficiency.
Also in Texas, Gov. Greg Abbott's (R) office confirmed that routine pharmacist-patient medication consultations conducted by telephone are not considered telehealth services under the intent of a new state telehealth law. As a result, these standard consultations will not be subject to recently adopted telehealth rule requirements, including patient informed consent documentation and related recordkeeping obligations, preserving existing pharmacy practice and avoiding additional compliance burdens. The governor's office directed the Texas State Board of Pharmacy to issue formal written guidance confirming this interpretation, which will also ensure no changes to inspection or enforcement practices related to audio-based medication counseling. Texas Federation of Drug Stores lobbyist Janis Carter, Nicole Kralj with Walgreens, and HEB pharmacists Doug Read and Roxi Afshar engaged with the Governor's Office and bill authors to help secure this favorable outcome for Texas pharmacy patients and providers.
Also in Texas, the Nutrition Advisory Committee (TNAC) published an annual report with nutritional guidelines created by Texans for Texans. SB 25, legislation passed in 2025, created TNAC with members appointed by Gov. Greg Abbott. In addition to establishing the committee, SB 25 expands physical education in elementary and middle school, enhances nutrition education at all levels and requires food manufacturers to label foods that contain certain ingredients.
Also in Texas, as required by SB 1 passed in 2025, the Health and Human Services Commission (HHSC) issued a report on Opioid Use Disorder expenditures.
Finally in Texas, the Health and Human Services Commission (HHSC) submitted its Legislative Appropriations Request (LAR) for fiscal years 2028-29 to the Office of the Governor's Budget and Policy Division and the Legislative Budget Board, detailing funding priorities, identifying exceptional item needs for state leadership and legislative consideration and reflecting the required 3% reduction to the base budget.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Health Care Authority (HCA) Apple Health is hosting another pharmacy Q&A discussion for pharmacy billers on November 4, 1:30 – 2:30 pm, phone conference ID: 873897520#, Phone conference ID: 873897520#, Telephone: +1 564 999 2000 US (Local – Olympia, WA) +1 833 322 1218 US (Toll-free).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wisconsin
The annual influenza, RSV and COVID-19 letters signed by Dr. Jasmine Zapata, Dr. Ryan Westergaard and Dr. Stephanie Schauer are now available. These letters provide guidance on administering influenza, RSV and COVID-19 vaccines for the 2026–2027 respiratory season. You can also find the letters on the Immunization Program home page under "annual respiratory vaccine updates."
The Wisconsin Department of Health Services (DHS) has issued statewide standing medical orders to ensure the 2026–2027 influenza and COVID-19 vaccines are available to all eligible Wisconsinites who want the vaccines, in alignment with recommendations from the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Family Physicians (AAFP).
For more information, contact NACDS’ Jermaine Smith at 703–837–4388.
Arizona
The Department of Health Services issued a “Standing Order for Administering 2026-2027 COVID–19 Vaccine”. This standing order was issued by Dr. Richard Carmona, MD, MPH, at the Department of Health Services and will expire on September 3, 2027.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
As part of the West Coast Health Alliance, the Department of Public Health released vaccine recommendations for the 2026–27 respiratory virus season.
Also in California, the Board of Pharmacy posted the agenda for the full Board Meeting on September 17. Please note item III. Discussion and Possible Action Related to Proposed Amendment of California Codes of Regulations, Title 16, Section 1707.4 Related to Central Fill Pharmacies, Including Discussion of Requirement for a Central Fill Pharmacy to be Located in California.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Hawaii
As part of the West Coast Health Alliance, the Department of Health released vaccine recommendations for the 2026–27 respiratory virus season.
Also in Hawaii, Gov. Josh Green (D) issued the Seventh Proclamation Relating to Pharmacist-Provided Vaccination Services allowing pharmacists to administer COVID-19 and influenza vaccines.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Oregon Health Authority (OHA) issued a standing order that lets vaccine providers across the state begin giving updated COVID-19 vaccines. The statewide order signed last week by Dean Sidelinger, MD, MSEd, OHA’s health officer and state epidemiologist, matches similar steps taken in the other three West Coast Health Alliance (WHCA) states—Washington, California and Hawaii.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Dakota
The Board of Pharmacy published the 2026 Book of Pharmacy Laws & Rules, providing a consolidated reference of current statutes and administrative rules governing pharmacy practice in the state.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Utah
The Department of Professional Licensing working with the Department of Health and Human Services issued guidance clarifying the use of the 2026-2027 influenza and COVID-19 vaccines.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
NOTICE IS HEREBY GIVEN that the Board of Pharmacy has proposed amendments to Title 16 CCR § 1749, related to Fee Schedules. Any person who wishes to comment on the proposed text may do so by submitting written comments beginning July 31 and ending on September 14 to the following:
Contact Person: Brianna Fujimoto
Agency Name: California State Board of Pharmacy
Address: 2720 Gateway Oaks Drive, Ste 100, Sacramento, CA 95833
Email: PharmacyRulemaking@dca.ca.gov
Fax: (916) 574-8618
Below are related links:
- Proposed Text (PDF)
Any responses to comments directly concerning the proposed addition of the text of the regulation will be considered and responded to in the Final Statement of Reasons.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
This notice provides updated information for providers regarding COVID At-Home Rapid Antigen Test Kits billed through Medicaid-participating pharmacies. This update applies to both the Fee-for-Service (FFS) program and Managed Care Organization (MCO) plans.
Effective September 1, 2026, COVID At-Home Rapid Test Kits will be limited to a quantity of eight (8) per Medicaid customer per rolling calendar year (a 365-day period measured from the date the first test kit is dispensed).
A list of covered COVID-19 At-Home Rapid Antigen Test Kits can be found in the Medicaid Preferred Drug List | HFS.
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 or the applicable MCO.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
In compliance with Revised Statute (R.S.) 37:1218.2, which authorizes pharmacists to provide services related to the initiation and dispensing of HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP) medications, the Department of Health (LDH) issued Informational Bulletin 26-11 for Pharmacist Billing for HIV PEP/PrEP Services.
Also in Louisiana, LDH announced that Healthy Blue (HBL) will end its participation as a Louisiana Medicaid managed care organization (MCO) at the conclusion of its Medicaid managed care contract, effective December 31, 2026.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Tennessee
TennCare is committed to ensuring that covered medications meet established standards for safety, efficacy, and regulatory approval. As part of this commitment, TennCare will reject claims for NDCs deemed non-FDA-approved. Effective September 1, 2026, pharmacy claims submitted for these products will be rejected at the point of sale with the following messaging: “Non-FDA-approved drug; Please try an alternative NDC.” Please visit the OptumRx-TennCare website regularly to stay up to date on changes to the pharmacy program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The House Select Committee on Health Care Affordability held a hearing this week with invited testimony only on ways to lower health care costs while maintaining access and quality. Discussions covered innovative delivery and financing models, flexible and affordable health plan design, and policies to help small and mid-sized employers offer more coverage. Lawmakers also explored ways to improve cost and quality transparency to help consumers make informed choices. The interim hearings guide future legislative recommendations to improve affordability, access, and sustainability in Texas healthcare.
For more information, contact NACDS’ Mary Staples at 817-442-1155.