Gov. Josh Green (D) signed SB 1245 recognizing pharmacists as healthcare providers and ensuring health plan reimbursement for services they provide withing their scope of practice. Beginning July 1, 2026, private and public health plans in the state must reimburse licensed pharmacists for covered health services of contracted pharmacies when those services are delivered within the pharmacists’ scope of practice.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Department of Insurance (DOI) published its June 2025 newsletter. As a reminder pharmacy providers may submit inquiries and complaints on the DOI website. Complete a separate form for each PBM if there are multiple complaints. To date, the DOI has received 43 complaints from pharmacies regarding PBMs. Of these, 36 remain open or pending, while seven have been closed. Complaints may include multiple issues, with the most common being related to Maximum Allowable Cost (MAC) appeals and dispensing fees. The DOI Consumer Affairs team is also assisting the PBM Examiner with investigating reported concerns. For questions and information, please contact PBM@doi.idaho.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Electric bills are expected to surge. What you need to know is that Midcontinent Independent System Operator (MISO) and PJM capacity auctions cleared at significantly higher prices for the 2025-2026 Planning Year: June 1, 2025, through May 31, 2026. MISO and PJM are the Regional Transmission Organizations (RTOs) that coordinate the movement of wholesale electricity in Ameren Illinois and ComEd electric territories, respectively. Ameren Illinois and ComEd electric customers will soon see the effects of these higher prices for the first time on invoices received in June/July. Ameren Illinois, ComEd, nor the suppliers have any control over these charges, nor do they have any power to change them. Due to a multitude of variables, Retail Energy Suppliers (RES) are handling this additional cost in many ways, according to supply contract terms and conditions as well as internal policy decisions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
The Health Coverage Programs (IHCP) expanded provider enrollment to include licensed pharmacists. This new provider specialty allows eligible pharmacists to enroll as rendering providers linked to a group provider. Group providers may be reimbursed for evaluation and management (E/M) services related to hormonal contraceptives provided by IHCP-enrolled pharmacists, as outlined in Indiana Code (IC 25-26-25). Pharmacists may enroll as IHCP rendering providers using the IHCP Provider Healthcare Portal or via paper application. An active pharmacist license and successful completion of training as specified in IC 25-26-25 are required for IHCP pharmacist enrollment.
Also in Indiana, the Health Coverage Programs (IHCP) Drug Utilization Board (DUR) approved updates to the prior authorization (PA) criteria, Statewide Uniform Preferred Drug List (SUPDL) and Preferred Brand Drug List.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
The Department of Health and Human Services, Iowa Medicaid posted to the attention of all Medicaid Medical Providers and Pharmacies INFORMATIONAL LETTER NO. 2693-MC-FFS RE: Implementation of House File 1049-Gender Transition Surgeries or Associated Procedures effective July 1, 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
The Department of Insurance (DOI) issued Bulletin 2025-03 to provide details regarding its enforcement of SB 188 of 2024, the comprehensive PBM commercial market reform law. As a reminder, the rate floor for chain pharmacies will not be effective until the DOI cost of dispensing study is completed.
Also in Kentucky, MedImpact issued a third reminder to pharmacies regarding recent changes to its covered diabetic supplies list.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
The Board of Pharmacy reminded pharmacies that effective April 1, the Surgeon General Dr. Ralph Abraham issued statewide standing orders implementing Act 657 from the 2024 legislative session authorizing the dispensing of three emergency medications: albuterol, epinephrine and naloxone. These medications are intended to support time-sensitive emergency medical situations, including acute allergic reactions (anaphylaxis), known or suspected opioid overdoses and acute respiratory distress caused by asthma or allergic reactions. The Department of Health (LDH) launched an informational webpage with key resources, including standing orders, medical protocols and dispensing request forms for each medication.
Also in Louisiana, Walmart pharmacist Jack Hall from Columbia has been named the 2025 Chain Pharmacist of the Year by his colleagues. He received this honor from the National Association of Chain Drug Stores (NACDS) during an awards ceremony held at the Louisiana Pharmacy Association's annual convention in Natchez on July 12.
Also in Louisiana, Gov. Jeff Landry (R) signed SB 19, a law allowing pharmacists to dispense ivermectin to individuals 18 years of age and older under a standing order from the Department of Health (LDH). The law also permits pharmacies to charge an administrative fee for additional services and grants civil immunity to pharmacists dispensing ivermectin per LDH rules.
Also in Louisiana, Gov. Jeff Landry (R) signed SB 182, a law that requires the Department of Health (LDH) Medicaid Managed Care Organizations (MCOs) to suspend prior authorization restrictions during a state of emergency declared by the governor. Additionally, the law mandates that Medicaid reimburse providers for medically necessary drugs, services, equipment, supplies and therapies provided to Medicaid recipients. This includes reimbursement for out-of-state providers who offer essential care to patients who have evacuated the state.
Finally in Louisiana, the Department of Health (LDH) published an Emergency Rule on Medicaid Reimbursement methodology. Effective July 1, LDH's Bureau of Health Services Financing adopted a new methodology with higher reimbursement rates for Medicaid Managed Care Organization's reimbursement and fee-for-service reimbursement rates. The Emergency Rule was adopted to better align Medicaid rates to Medicare rates.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Medicaid has announced that, effective October 1, pharmacy providers must enroll in electronic funds transfer (EFT) to receive fee-for-service pharmacy payments. After this date, paper checks will no longer be issued for pharmacy payments. This change is intended to address issues such as lost checks, payment delays and mailing time, as well as to modify payment security protocols. Providers that still need to enroll in EFT will need to first register with the Prime User Administration Console (UAC). See the UAC Quick Start Guide for step-by-step instructions on the registration process. Once registered, you will have access to the Provider Job Aid/Prime Therapeutics Financial Portal Guide which will provide step-by-step instructions on completing the EFT enrollment process. After submitting your enrollment request, you will receive a phone call within three business days to verify the information you provided. Please make every effort to complete this verification as soon as possible once contacted to avoid any delays in finalizing your enrollment. Questions should be directed to the Prime Therapeutics Provider Support Line at 1-888-277-5510, OPTION 1.
Also in Michigan, Medicaid announced via email that effective August 1, the following brand products will no longer be preferred and will be replaced by their generic alternatives on the preferred drug list (PDL). An updated Brand over Generic List will be posted soon.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
MO HealthNet announced that due to the increase in the state’s Pharmacy Reimbursement Allowance (Pharmacy Provider Tax), the adjustment to account for the Medicaid-reimbursed prescriptions increased effective July 1. In-state pharmacy providers will continue to receive a professional dispensing fee of $12.22, plus an adjustment to account for the cost of the Pharmacy Reimbursement Allowance attributable to Medicaid-reimbursed prescriptions. The professional dispensing fee plus the current adjusted amount will total $14.33. Out-of-state pharmacy providers will continue to receive a professional dispensing fee of $8.85.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
