Erica Joyner, Author at In The States

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So far Erica Joyner has created 570 blog entries.

California

Pursuant to the enacted 2025-26 State Budget, the Department of Health Care Services (DHCS) will be implementing Medi-Cal Rx policy updates, effective January 1, 2026. These changes are intended to reduce pharmacy spending, improve program integrity, and ensure continued, equitable access to quality pharmacy benefits and services. Also, effective November 1, 2025, the coordination of benefits (COB) claims submission process will be updated for Medicare. See Upcoming Changes to Medi-Cal Rx for background information.

Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please review the “90-day Countdown: Upcoming Changes to Medi-Cal Rx” alert. Note changes are effective January 1, 2026. Please see the alert for details.

Also in California, the Health & Human Services Agency (CalHHS) launched a new webinar series focused on recent federal policy changes in health and human services and how California is responding to ensure continued access to care. The first webinar in the series addressed vaccine access and guidance, a timely topic as the state enters respiratory virus season. A full recording of the webinar and presentation slides are available for those who were unable to attend. The webinar featured insights from CalHHS Secretary Kim Johnson, Department of Public Health (CDPH) Director and State Public Health Officer Dr. Erica Pan and Department of Managed Health Care Director Mary Watanabe. Topics covered included public health updates, health plan coverage requirements and Medi-Cal vaccine coverage.

Under updated California law, health plans and insurance companies regulated by the state, including Medi-Cal, are required to continue covering routine immunizations recommended by the CDPH. This includes vaccines for flu, COVID-19 and RSV. Californians are encouraged to review CDPH’s vaccine recommendations and check with their health plan or insurer if they have questions about coverage. To schedule a vaccine appointment, individuals can contact their health care provider, visit a local pharmacy, or go to MyTurn.ca.gov.

Finally in California, on September 26, Gov. Gavin Newsom (D) signed AB 260 (Chapter 136, Statutes of 2025), legislation related to sexual and reproductive health care. NACDS is sharing this as information for members as there are provisions in the newly enacted law related to “pharmacists”.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2025-10-02T14:32:51-04:00October 2, 2025|California|

District of Columbia

The Department of Health issued a statement declaring that pharmacists, interns and technicians with immunization authority should follow the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) guidelines to administer COVID-19 vaccines. The following bulletins were also published:

9-12-25 Transmittal 25-22- DC Healthcare Alliance Medical and Pharmacy Services Transition from Managed Care to Fee-for-Service that was effective October 1. (rx volume approximately 11,000 fills)
9-10-25 Transmittal 25-21 – Notice of Intent to Discontinue Coverage of OTC COVID-19 Testing Kits that was effective October 1.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2025-10-02T14:32:45-04:00October 2, 2025|District of Columbia|

Florida

Effective September 30, the state minimum wage increased to $14.00 per hour. Florida employers are permitted to take a tip credit of up to $3.02 per hour for tipped employees. Beginning September 30, the minimum hourly cash wage rate for eligible tipped employees is $10.98.

In accordance with the amendment, the minimum wage is set for annual increases on the path to a $15.00 minimum wage by September 30, 2026. The requirement applies to both public and private employers, regardless of size.

In addition to increasing pay, Florida employers also face posting obligations to reflect the new amounts. The new posters that comply with the posting requirement are available online.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2025-10-02T14:26:30-04:00October 2, 2025|Florida|

Illinois

In accordance with Public Act 104-0027, the Department of Healthcare and Family Services (HFS) is implementing a major update to the Critical Access Pharmacy (CAP) program. Effective January 1, 2026, the revised CAP program will consolidate the two existing initiatives into a single, streamlined model. See Provider Notice Issued 09/29/2025 for details. To minimize confusion during the transition, the Department has established a dedicated email address for all CAP-related inquiries.

Also in Illinois, the WIC [Special Supplemental Nutrition Program for Women, Infants and Children] program does not anticipate any disruption to its operations in the event of a federal government shutdown. The program continues to have funds available for food, and vendors should expect no issues with selling WIC products and receiving payment. As of October 1, 2025, businesses should proceed as usual for all Illinois WIC transactions.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Erica Joyner2025-10-02T14:26:00-04:00October 2, 2025|Illinois|

Iowa

The Iowa Insurance Division (IID) released Bulletin 25-06 RE: Prohibited Use of Deceptive and Unfair Practices and Implementation of SF 383.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2025-10-02T14:25:22-04:00October 2, 2025|Iowa|

Maryland

On September 19, the Department of Health issued Advisory 278 that includes a statewide COVID-19 vaccination standing order authorizing qualified healthcare professionals, including pharmacists, to administer COVID-19 vaccinations using the most current evidence-based guidelines developed by the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and American College of Obstetricians and Gynecologists (ACOG) as standards, and exercise reasonable medical judgment in vaccinating their patient. Please see these additional resources for more information:

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2025-10-02T14:24:53-04:00October 2, 2025|Maryland|

Michigan

Medicaid has issued bulletin MMP 25-44, removing the pharmacy copayment for drugs used to prevent Human Immunodeficiency Virus (HIV) (Pre-Exposure Prophylaxis [PrEP] & Post-Exposure Prophylaxis [PEP]).

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Erica Joyner2025-10-02T14:24:12-04:00October 2, 2025|Michigan|

Nebraska

The Department of Health and Human Services posted the Injectables fee schedule effective October 2025.

Also in Nebraska, the Department of Health and Human Services posted the October 28 agenda for Drug Utilization Review (DUR) Board.

Finally in Nebraska, the state’s Medicaid Drug Utilization Review (DUR) Board is currently seeking nominations for physicians and pharmacists to serve on the Medicaid Drug Utilization Review (DUR) Board. Board members are required to serve a three-year term with a three-year renewal opportunity. Meetings are held at least quarterly and no more than six times a year (every two months). All interested applicants are required to submit an application.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

Erica Joyner2025-10-02T14:20:50-04:00October 2, 2025|Nebraska|

New York

The NYRx, the Medicaid Pharmacy Program, posted the following updates effective October 1:

Also in New York, the NYRx Education & Outreach team posted NYRx Formulary Update: Xifaxan®. Effective October 1, Salix Pharmaceuticals, the manufacturer of Xifaxan®, discontinued participation in the Medicaid Drug Rebate Program. Xifaxan will no longer be covered by NYRx, the Medicaid Pharmacy Program. Prior authorization will not be available for this medication.

Also in New York, NYRx also provided an NYRx Notice to Prescribers and Pharmacies: tretinoin 0.08% micro gel pump, a non-preferred product. The maximum quantity that can be dispensed for tretinoin 0.08% micro gel pump is 50 grams per 30-day supply. The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at NYRxEO@primetherapeutics.com from 8:00 am to 5:00 pm ET, Monday through Friday, excluding holidays.

Also in New York, on September 24, the NY State Education Department (NYSED) proposed the changes for implementation of the Shared Pharmacy Services law passed in 2024 as recently published in the State Register (see pages 12-15). A 60-day public comment period will run until November 23.

Finally in New York, the Office of Health Insurance Programs of the New York State Department of Health has approved the release of the August 2025 Medicaid Update. Relevant topic includes New York State Medicaid Coverage for COVID-19 Vaccinations Administered by Providers.

For more information, please contact NACDS’ Mike Sargent at 207-272-6435.

Erica Joyner2025-10-02T14:20:17-04:00October 2, 2025|New York|