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North Carolina

The latest Medicaid Pharmacy Newsletter, dated December 2025, is now available on the Medicaid website. In addition to the January 2026 checkwrite schedule, this edition of the newsletter includes the following articles:

  • Reminder: Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies
  • NC Medicaid’s Participation in Centers for Medicare & Medicaid Services Cell and Gene Therapy Access Model for Sickle Cell Disease
  • Discontinuation of Coverage: Xifaxan (Rifaximin)
  • North Carolina to Launch First-of-its-Kind NC Medicaid Managed Care Plan for Children and Families on Dec. 1, 2025
  • Billing Reminder of a Third-Party Prescription to Medicaid
  • NC Medicaid Reinstitutes Coverage for GLP-1s in Weight Management

Also in North Carolina, following the recent announcement of the Rural Health Transformation Program (RHTP) award by CMS, the state reaffirmed its commitment to continue collaboration with a broad coalition of state agencies, rural providers, community partners, academic institutions and the private sector. To advance this collaboration, the Department of Health and Human Services will host a virtual town hall on January 16 to outline program goals, discuss next steps and highlight the anticipated statewide impact. Additional details and registration information will be shared soon. For updates and more information, visit the NC Rural Health Transformation Program webpage.

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

2026-01-08T16:39:32-05:00January 8, 2026|North Carolina|

North Dakota

The North Dakota State University (NDSU) Center for Collaboration & Advancement in Pharmacy (CAP Center) is hosting a Community Health Worker (CHW) Q&A. Pharmacies have a new opportunity in North Dakota to get reimbursed for services. This opportunity is for a pharmacy technician to become certified as a Community Health Worker. To learn more about this opportunity, NDSU invites pharmacists and pharmacy technicians to an informal Q&A session focused on Community Health Workers (CHWs) and how to get started.

What is a community health worker? Community Health Workers connect individuals to appropriate services and resources to help them improve their health. Many pharmacy technicians already provide these types of services. Becoming a CHW presents an opportunity for pharmacy technicians to bill for these services and help the people they serve; see Medicaid Billing and Policy Manual for more information.

This will be an open conversation—not a presentation—where you can:

  • Ask questions about CHW certification, implementation, and best practices
  • Share ideas and learn from others
  • Simply listen if you prefer

Format:

  • 60 Min Interactive Q&A (no formal presentation)
  • Preferably, questions are submitted in advance to help guide the discussion (submit here or below)
  • Live questions are welcome during the session

Date & Time:

Please submit your questions by January 22: Submit Your CHW Questions Here!

Also in North Dakota, the Department of Health and Human Service issued a Health Advisory regarding the use of antivirals for the treatment of influenza.

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

2026-01-08T16:38:44-05:00January 8, 2026|North Dakota|

Ohio

The state released its first Rural Health Transformation Project (RTHP) Request for Proposals (RFP) seeking a project manager for the Rural Health Workforce Recruitment, Retention and Upskilling Pipeline Program. As outlined in the RFP, the program envisions pharmacies playing a key role in both the workforce initiative, and in the “upskilling” portion of the program. The RFP specifically calls for the development of training programs for pharmacists to practice at the top of their license to support point-of-care test and treat services. We urge members to review the RFP for awareness and preparation. Members may review the RFP and supporting materials on OhioBuys website.

Also in Ohio, the Board of Pharmacy released a draft Electronic Verification Rule (4729:5-3-25) that would authorize and regulate electronic product verification. The rule would allow a pharmacist to use technology to complete final product verification from a remote site. The rule is not specific to any practice site but specifies that it does not apply to remote dispensing pharmacies or automated dispensing systems. Please send any feedback you may have to Jill McCormack as soon as possible, as the comment deadline is January 15.

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

2026-03-10T15:07:55-04:00January 8, 2026|Ohio|

Oklahoma

The Legislature will convene on February 2 and is scheduled to adjourn on May 29.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2026-01-08T16:36:37-05:00January 8, 2026|Oklahoma|

Oregon

The state received $197.3 million in 2026 to improve rural healthcare and could receive more in the following four years. The Oregon Health Authority (OHA) will invest the federal funding in community-driven projects that improve healthcare access, boost chronic disease management and prevention, grow and sustain the healthcare workforce and expand the use of health technology and data in the state’s rural and frontier communities. OHA will move as fast as possible to distribute funding and plans to make two sets of awards in quick succession during 2026. Oregon initially requested $200 million annually, or a total of $1 billion over five years, from the federal program. OHA will scale down its original proposal to fit its given budget.

Also in Oregon, the Prescription Drug Affordability Board is seeking applicants to fill a vacancy, especially individuals with knowledge and experience in health care and prescription drug payment systems. The board consists of eight members appointed by the governor and confirmed by the State Senate. Members serve four years and can seek reappointment. The time commitment is about 15 hours per month, including virtual board meetings held on the third Wednesday each month. The new member will begin serving in mid-2026. Applicants should apply through Workday by January 30.

Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted its draft agenda for the January 21 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.

Finally in Oregon, the Oregon Health Authority issued the following statement: West Coast Health Alliance continues to endorse AAP [American Academy of Pediatrics]-recommended child, adolescent immunization schedules.

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

2026-03-10T15:08:59-04:00January 8, 2026|Oregon|

Pennsylvania

The Board of Pharmacy’s proposed Licensure by Endorsement Rule was published in the Pennsylvania Bulletin on December 20, 2025. The rule will permanently implement the expedited licensure process required by Act 34 of 2025. NACDS and the Pennsylvania Association of Chain Drug Stores (PACDS) helped advance the law to allow pharmacies to more easily manage increased prescription volume following Rite Aid’s closure.

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

2026-01-08T16:32:39-05:00January 8, 2026|Pennsylvania|

Tennessee

TennCare is continuing the process of reviewing all covered drug classes. Changes to the Preferred Drug List (PDL) occur as new classes are reviewed, and previously reviewed classes are revisited. As a result of these changes, some medications your patients are taking may be considered non-preferred agents in the future. Please inform your patients who are on these medications that switching to preferred products will decrease delays in receiving their medications. We encourage you to share this information with other TennCare providers. The individual changes to the PDL are listed below. The new PDL will be posted on January 1, 2026. For details on clinical criteria, please visit OptumRx/TennCare and click on “Criteria PDL” under “Useful Links”.

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

2026-01-08T16:31:59-05:00January 8, 2026|Tennessee|

Texas

Insurance Commissioner Cassie Brown announced that she will be retiring on February 2, after more than four years of leading the Texas Department of Insurance (TDI).

Also in Texas, the Texas Pharmaceutical Initiative (TPI) Board announced that they are sending a Request for Information (RFI) to companies that believe they can operate a single PBM for the 1.4 million state beneficiaries covered by public higher education insurance, the Employees Retirement System of Texas, the Teacher Retirement System of Texas, the Texas Criminal and Juvenile Justice systems and other individuals served by the Health and Human Services Commission. TPI’s plan is due on Gov. Greg Abbott’s (R) desk by June 1, 2026.

Finally in Texas, the legislature is not in session in 2026.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

2026-01-08T16:31:14-05:00January 8, 2026|Texas|

Utah

The Department of Health and Human Services (DHHS) announced the state’s first-year award for the Rural Health Transformation Program from CMS totaling $195,743,566.

Work is underway to support implementation, and DHHS will share the next steps as they are finalized. As the state legislature appropriates funding, the state will begin the process of making awards for the initiatives that will serve rural communities. For questions or to join the contact list for updates, email ruralht@utah.gov.

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

2026-03-10T15:11:06-04:00January 8, 2026|Utah|
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