Utah
The Division of Professional Licensing (DOPL) issued guidance clarifying the use of the 2025-2026 COVID-19 vaccine following the recommendations from the Advisory Committee on Immunization Practices (ACIP).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Board of Pharmacy amended the vaccine statewide protocol for adults. Pharmacists, or a pharmacy technician or pharmacy intern under the supervision of the pharmacist, may now administer the COVID-19 vaccine to persons 18 years of age or older in accordance with the directions for use in adults of a manufacturer’s product approved by the U.S. Food and Drug Administration (“FDA”) or the Immunization Schedule published by the Centers for Disease Control and Prevention (“CDC”). Visit the protocols page for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
Gov. Mark Gordon (R) along with Department of Health Director Stefan Johansson continue to seek citizen input regarding the state’s Rural Health Transformation Program through an online survey. The survey runs October 8 through October 15. Results will inform the state’s application and determine which directions the State should pursue in transforming rural health.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
A new episode has dropped on “Off Script”, The Alabama Pharmacy Podcast, with some CE available. All episodes and links to CE (in show notes) or wherever you like to listen. Watch Episode 44 – Board of Pharmacy Meeting Update: September 2025. Join Garrett Aikens and Allyson Gilliam as they recap the Board of Pharmacy meeting that took place on September 17.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Gov. Katie Hobbs (D) appointed Virginia “Ginny” Rountree as the new director of the state’s Health Care Cost Containment System (AHCCCS), the Medicaid agency, effective October 6. A health and human services expert based in Tucson, Ginny brings more than a decade of experience in public roles at AHCCCS and the Department of Economic Security (DES), as well as leadership positions in the private sector.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
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.
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.
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.
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.
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.
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.
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.
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.
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.
North Carolina
The Department of Health and Human Services announced Standing Orders issued by State Health Director Dr. Larry Greenblatt to allow pharmacists at retail locations to test and treat for influenza. Since October 1, pharmacists across the state are able to test for the influenza virus and then immediately treat with the appropriate medications to reduce severity of illness, when appropriate, as authorized under HB 67.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The North Dakota State University (NDSU) Center for Immunization Research and Education (CIRE) will be hosting a webinar, titled “Vaccine Communication in an Age of Polarization” on October 23 from 12:00 noon -1:00 pm CT. This activity has been approved for the following FREE credit:
- 1 AMA PRA Category 1 Credit™ through the Minnesota Medical Association (CME credit)
- 1 contact hour of continuing pharmacy education credit through CEimpact for pharmacists and pharmacy technicians
To access additional webinar resources from NDSU CIRE, visit Science to Practice: Protecting Children from Respiratory Viruses in 2025-2026.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Effective October 1, the quarterly supplemental dispensing fee that has been paid to retail pharmacies in Ohio since 2020 ended and became part of the claim-based dispensing fee structure. This resulted in a 9.6% dispensing fee increase for managed care pharmacy claims under the Single PBM. The increases range from $0.78 to $1.06 across the three dispensing fee tiers. Gainwell’s Frequently Asked Questions: Managed Care Pharmacy Dispensing Fees (October 2025 Update) provides further details. You can also utilize the dispensing fee lookup dashboard to check pharmacy tier designations and determine a location’s new dispensing fee.
Also in Ohio, Gainwell issued the following announcement: On October 1, 2022, Gainwell Technologies became the Single Pharmacy Benefit Manager (SPBM) for the Ohio Department of Medicaid (ODM). ODM only covers drugs that are part of the Medicaid Drug Rebate Program, with limited exceptions.
ODM was recently notified that drug manufacturer, Bausch Health, has decided to no longer participate in the Medicaid Drug Rebate Program. This means that medications made by this manufacturer will no longer be covered by Ohio Medicaid, effective November 1, 2025. The most common medications affected include: Aplenzin, Xifaxan, Relistor, Siliq, Jublia, and Trulance.
The manufacturer of these medications has extended coverage for selected drugs for Medicaid enrollees through their Patient Assistance Program. This program may provide the prescribed medication at no cost to your patient. More information about this option can be found at the following website: https://www.bauschhealthpap.com.
Prescribers also have the option to select an alternative covered medication from the Ohio Medicaid Unified Preferred Drug List (UPDL), found at: https:\\spbm.medicaid.ohio.gov. Select ‘Reference Material,’ then ‘Drug Coverage,’ and then ‘UPDL effective 10.01.2025’ and/or ‘OH SPBM Medical Necessity Policy.’
Affected Medicaid enrollees and prescribers have been notified of these changes. They may contact you, as their pharmacy provider, for additional guidance in navigating this change. We are providing this notification as a courtesy so that you are aware of the changes and recommended course of action to best help your patients. Thank you for your willingness to assist in this capacity.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda for the October 15 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Also in Oregon, the Oregon Health Authority Health Systems Division: Medical Assistance Programs issued a Notice of Proposed Rulemaking to amend rules to provide updates to Health Related Social Needs (HRSN) services covered in the Oregon Health Plan. Please note opportunities for food retailers related to Fruit and Vegetable Benefit Card, Fruit and Vegetable Box and Pantry Stocking Benefit. A hearing will be held on October 15 from 1:00 pm-1:45 pm. The last day and time to offer comments to the agency is October 21 at 5:00 pm.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Department of Health (DOH) issued new guidance expanding the list of organizations patients and providers should consult for vaccine recommendations to include the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP) and American College of Obstetricians and Gynecologists (ACOG).
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Vermont
The Board of Pharmacy held its regularly scheduled meeting on September 24. The agenda included a discussion of the September 17 meeting to approve a revision of the State Pharmacist Prescribing Protocol for COVID 19 and Influenza Vaccines Ages 5 and Up. The Prescribing Protocol includes:
- The purpose of updating this protocol is to remove requirements that COVID vaccines are only administered based on ACIP recommendation. Essentially removing the tie to ACIP.
- Technicians will still be able to administer vaccines
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alaska
The Department of Health ignored comments from NACDS and others submitted last March on adopted regulations lowering Medicaid payment rates for pharmacy dispensing fees based on the 2020 Myers and Stauffer cost of dispensing report.
Also in Alaska, NACDS completed the state survey on the Rural Health Transformation Program funds.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
The Board of Pharmacy posted the following on its website this week. Pursuant to Executive Order 2025-12, the Notice of Emergency Rulemaking for Section R4-23-411 is effective as of September 22. Please visit the “COVID-19 Vaccine Updates” to review the Executive Order, Notice of Emergency Rulemaking and approval, and the COVID-19 vaccine standing order and protocol as well as Department of Health Services COVID-19 Resources.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
On September 17, Gov. Gavin Newsom (D) along with Oregon Gov. Tina Kotek (D), Washington Gov. Bob Ferguson and Hawaii Gov. Josh Green of Hawaii announced coordinated winter virus vaccination recommendations through the West Coast Health Alliance (WCHA). These recommendations include the 2025–26 COVID-19, influenza and RSV vaccines.
Also on September 17, Gov. Newsom signed AB 144, authorizing the state to base future immunization guidance on credible, independent medical organizations rather than the CDC's increasingly politicized Advisory Committee on Immunization Practices.
Also in California, on September 17, the Department of Public Health (CDPH) announced California Issues Respiratory Virus Immunization Guidance. This guidance includes the CDPH Immunization Recommendations, Coverage and Availability and Changes to State Law. For more information on immunization requirements and resources, visit CDPH's Public Health for All webpage; bookmark this webpage to stay informed on vaccines, screenings and preventive care updates.
Also in California, on September 17, the Department of Health Care Services (DHCS) issued a letter to DHCS Stakeholders RE: Medi-Cal Coverage of Vaccines.
Also in California, on September 17, the article titled "Medi-Cal Coverage of Vaccines per Assembly Bill 144 Requirements" was posted to the Medi-Cal News area on the Medi-Cal Provider website.
Also in California, the Board of Pharmacy is releasing information to ensure licensees remain apprised of recent developments undertaken to uphold scientific integrity in public health.
- On September 3, 2025, Governor Newsom announced that California, along with Oregon and Washington, launched a new West Coast Health Alliance to provide evidence-based unified recommendations for residents regarding who should receive immunizations. Hawaii also joined the alliance. The California Department of Public Health announced official immunization recommendations in accordance with this Alliance.
- Recent enactment of Assembly Bill (AB) 144 (Budget Act of 2025) provides authority for pharmacists to independently initiate and administer an immunization that, on January 1, 2025, had in effect an ACIP recommendation and that are recommended by the California Department Public Health. AB 144 also contains provisions related to Medi-Cal coverage of vaccines and immunizations. Learn more about Medi-Cal coverage of vaccines here.
The Board also reminds pharmacists that Business and Professions Code section 4052(a)(11) currently provides a pharmacist with the authority to administer immunizations pursuant to a protocol with a prescriber.
The Board will continue to release information as it becomes available, including any further changes to pharmacist authority related to vaccine administration. Thank you for your commitment to California patients.
Also in California, the Department of Health Care Services posted the following:
- September 2025 Pharmacy Medi-Cal Update Bulletin
- September 2025 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
Finally in California, the Department of Health Care Service posted the following alerts on the Medi-Cal Rx Web Portal.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Hawaii
The Department of Health (DOH) issued immunization recommendations for the 2025–2026 respiratory virus season, as part of the West Coast Health Alliance (WCHA). Hawaii, along with California, Oregon and Washington, are members of WCHA. These recommendations provide evidence-based guidance for protecting against COVID-19, influenza and respiratory syncytial virus (RSV). Detailed recommendations are available on DOH’s Respiratory Virus, COVID-19 and Immunization Branch websites.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
The Division of Occupational and Professional Licenses published its September 2025 newsletter including the following items of interest: Congratulations! Nicole L. Chopski Elected NABP President-Elect, Fraudulent Activity and GLP-1 Drugs, 'Certification of No Dispensing of Controlled Substances' Form No Longer a Required Document for RDOs [Resident Drug Outlets], NDOs [Non-Resident Drug Outlets] and PDOs [Prescriber Drug Outlets], Celebrating the Career of Berkeley Fraser: A Legacy of Service to Idaho's Pharmacy Community, Struggling in Silence? You're Not Along – Health Is Here for Health Professionals, Pharmacy Professional Recovery Program Forum and Board of Pharmacy 2025 Meeting Schedule.
For more information, contact NACDS' Sandra Guckian at 703-774-4801.
Indiana: The Medicaid proposal to cut pharmacies' reimbursement remains unchanged, but the timeline for stakeholders to comment has been extended until October 27. A public hearing is scheduled on the same date to allow for public comments.
Also in Indiana, to address a $250 million Medicaid budget shortfall, the Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning (OMPP) is proposing to reduce the pharmacy dispensing fee from $10.48 to $9.63. This proposal is based on the 2024 survey conducted by Myers and Stauffer. If approved by the Centers for Medicare & Medicaid Services (CMS), the new reimbursement rate would take effect on March 1, 2026. NACDS is submitted a comment letter objecting to these proposed cuts.
Finally in Indiana, the Family and Social Services Administration (FFSA) Health Coverage Programs (IHCP) provided updates approved by Drug Utilization Review Board at the August 2025 meeting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.