Colorado
The Prescription Drug Affordability Board (PDAB) is seeking comments on its proposal to cap payment for the drug Enbrel at the Medicare price. Enbrel is one of the first Medicare Part D 10 drugs to be included in the Medicare Drug Price Negotiation Program (MDPNP) beginning January 1, 2026. Rulemaking for Enbrel began in May, and the rulemaking hearings continued on upper payment limit (UPL) for Enbrel in July and August. The fourth and possibly final rulemaking hearing on UPL for Enbrel will be on October 3.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Delaware
On August 25, Gov. Matt Meyer (D) signed SJR 7, an act authorizing the State Employees Benefits Committee (SEBC) to utilize specific strategies and policies when interacting and contracting with PBMs in order to achieve lower cost pharmaceutical drug benefit plans for the state. NACDS supported this legislation during the 2025 session and will continue to support PBM legislation and enforcement in Delaware.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Indiana
Earlier this year, pharmacies successfully passed SB 140, legislation that included a provision tying the commercial dispensing fee rates to Medicaid’s fee-for-service (FFS) rates as a minimum floor. Unfortunately, the Family and Social Services Administration (FSSA) announced last week that, based on the results of a recent cost of dispensing survey, Medicaid plans to reduce the dispensing fee by 8%, lowering it from $10.48 to $9.63, effective March 1, 2026. NACDS will submit comments by September 19 deadline and encourages members to do so as well.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
On August 26, the Department of Professional and Financial Regulation, Bureau of Insurance, held a hearing on proposed rule change to define and prohibit spread pricing. NACDS attended the hearing and submitted testimony in support of the proposed changes. Additional written comments are due by September 9 at 4:00 p.m. and should be addressed to: Karma Lombard, Maine Bureau of Insurance, 34 State House Station, Augusta, Maine 04333 or Karma.Y.Lombard@maine.gov.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Maryland
The Prescription Drug Affordability Board published a notice that they will be holding two Zoom informational hearings on September 3 to receive input, information and opinions from the public and stakeholders to assist the Board in developing policy to address the affordability challenges created by the use of Farxiga and Jardiance. Details are available in the notice.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Also in Maryland, on August 27, the Insurance Administration (MIA) and Medicaid hosted the inaugural meeting of a workgroup to study PBM practices in both Medicaid and the commercial market. NACDS is serving on the panel, which already has four meetings scheduled for this fall. The department leads presented slides outlining the workgroup composition, schedule, expectations, goals and timeline.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
In this month’s Pharmacy Facts, published by MassHealth, they provided an update to the vaccine administration fee.
In accordance with 101 CMR 317.03(5): Allowable Fee for Certain Eligible Providers, payment for services provided by pharmacies that utilize pharmacists, or other health care professionals certified in accordance with 105 CMR 700.00: Implementation of M.G.L. c. 94C, is 85% of the allowable fee set forth in 101 CMR 317.04: Maximum Allowable Fees – Medical Services.
Following the pricing methodology cited above, for pharmacies that utilize pharmacists, or other health care professionals certified in accordance with 105 CMR 700.00: Implementation of M.G.L. c. 94C, the administration fee for vaccines other than COVID-19 is $17.38. The administration fee for COVID-19 vaccines is $38.21. Starting August 22, these rates were reflected on all such claims.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
New York
On August 21, NYRx, the New York State Medicaid Prescription Drug Program, announced an update to its Preferred Drug Program (PDP).
Also in New York, the State Department of Health Office of Health Insurance Programs released a Medicaid update. This update includes a reminder of 90-day prescriptions for most maintenance medications and OTC drugs. The update also includes a notice that NYRx now accepts electronic prior authorizations through CoverMyMeds.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Alaska
The Board of Pharmacy’s next quarterly meeting will be held virtually only on August 21. The Zoom log-in information, tentative agenda and public meeting packet are available on the board’s webpage. The public will need to register in advance using the link provided on the agenda. If you plan to testify on a subject, you must select “yes” in the questions when registering.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Service posted the following alert on the Medi-Cal Rx Web Portal: Now Active: Changes to Remittance Advice.
Also in California, continuing collaborative efforts, the Board of Pharmacy and the Veterinary Medical Board are working to schedule a forum for stakeholder engagement to discuss crosscutting issues. To ensure interested stakeholders are kept apprised of these efforts, the Board is establishing an interested parties list. Please email rxwebmaster@dca.ca.gov to be added to the email distribution list specific to this forum.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
House Speaker Danny Perez (R) has invited lawmakers to join a committee to examine potential mid-decade redistricting. Perez said the House lacks the time and resources to hold a special session but wants the committee to convene in October during the scheduled interim committee meeting period.
Also in Florida, Attorney General James Uthmeier (R) has issued an emergency rule prohibiting 7-OH, a concentrated byproduct of kratom. Physicians caution that the substance is as addictive as opioids. Joining Uthmeier for the announcement, FDA Commissioner Mark Makary warned that kratom could signal the fourth wave of the opioid epidemic.
Finally, the Department of Revenue has released Tax Information Publication (TIP), titled "Sales Tax on Commercial Rentals Repealed Effective October 1, 2025." Effective October 1, the state sales tax imposed on rent or license fees for the use of real property (commercial rentals) under section 212.031, Florida Statutes (F.S.), is repealed. This means no state sales tax or discretionary sales surtax applies to rent or license fees for rental or occupancy periods beginning on or after October 1, 2025. Examples of commercial rentals subject to the repeal include rentals of commercial office or retail space, warehouses and self-storage units. This publication provides important guidance regarding the upcoming repeal of sales tax on commercial rentals. We encourage you to review the TIP for details on how this change may affect your business or operations.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Health Coverage Programs (IHCP) posted several important provider bulletins of interest to pharmacies:
- BT2025117 – Pharmacy updates approved by the Office of Medicaid Policy and Planning August 2025 on Ordering, Prescribing or Referring; Pharmacy/Prescribing, Physician/Practitioner
- BT2025112 – Pharmacy updates approved by Drug Utilization Review Board July 2025
- BT2025107 – Final Notice: Gainwell mail forwarding expired on August 1, 2025
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
The Cabinet for Heath and Family Services released an extremely positive, in-depth report on parity in pharmacy payment for services. The report is a result of SJR 46, legislation adopted in 2025 that NACDS supported. The report found that paying pharmacies for clinical services would have minimal costs and positively impact access to care. As a result, NACDS intends to work with in-state partners to pass legislation mandating Medicaid payment for services in 2026.
Also in Kentucky, MedImpact issued an updated list of covered influenza vaccines, effective August 16. As a reminder, MedImpact does not require pharmacies to enroll in the Vaccines for Children program to be eligible for reimbursement.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The Department of Health (LDH) published several bulletins of interest for pharmacies:
Also in Louisiana, LDH shared the slide deck from the July Medicaid PBM transition virtual meeting.
Also in Louisiana, in 2024, Act 711 of 2024 (R.S. 37:1218.2) became law, enabling pharmacists to independently dispense and/or administer HIV PrEP and PEP medications and order/interpret related rapid or laboratory testing. LDH posted the information about the statewide protocol, standing order, guidelines and training resources.
Finally in Louisiana, the Board of Pharmacy posted the August 20 meeting agenda.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Medicaid Pharmacy and Therapeutics Committee is seeking a pharmacist to join the committee beginning in May 2026. The committee meets twice a year (May and November), and members receive a $600 annual stipend. If you are interested in serving, you must apply online.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maine
On August 13, the Board of Pharmacy held its regular monthly meeting. The next monthly meeting is scheduled for September 4.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts:
On August 7, the Board of Pharmacy shared the following updates:
Contains new terms found in the newly promulgated 247 CMR 9.00 and terms that have been moved from 247 CMR 15.00.
Controlled Substance Prescriptions
Updates guidance for pharmacies to consider when evaluating the legitimacy of controlled substance prescriptions.
Failed HEPA Filters in ISO-Classified Environments
Updates guidance for compounding during remediation of failed HEPA filters, including updated BUD assignments.
Updates guidance for compounding during excursions of temperature, humidity, and differential pressures, including updated BUD assignments.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Michigan
The Department of Health and Human Services has proposed policy change 2534-Pharmacy, removing copays for PrEP & PEP, effective November 2, 2025, contingent upon CMS approval. Comments are due by September 15 to GoethalsV@michigan.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
The Board of Pharmacy license renewals for pharmacies, drug distributors, drug outsourcers, drug distributor registrants and third-party logistics providers will be emailed on August 15 to the business e-mail address on file with the Board, along with instructions for renewing online via the MOPRO online licensing portal.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
The State Department of Health shared the following reminder:
NYRx, the Medicaid Pharmacy Program would like to remind stakeholders, including prescribers, pharmacists, members and other caregivers, that 90-day supplies of most maintenance medications and over the counter (OTC) drugs are covered by NYRx. This benefit applies, but is not limited to, NYRx covered OTC medications such as aspirin, acetaminophen, ibuprofen, antihistamines and covered vitamins and minerals, such as prenatal vitamins, vitamin B, vitamin D, calcium, fluoride and iron preparations. For a complete list of medications covered by NYRx, see the Medicaid pharmacy list of reimbursable drugs. 90-day supplies offer numerous benefits:
- For patients, cost savings with less copays, convenience of less trips to the pharmacy, improved medication adherence and reduced risk of missing refills.
- For prescribers, increased patient adherence equals easier monitoring, reduced administrative burden, increased patient satisfaction and a more streamlined process for chronic disease management.
- For pharmacies, increased patient adherence, improved operational efficiency leading to more time for additional services such as immunizations and medication therapy management (MTM) and enhanced customer satisfaction resulting in a stronger patient-pharmacy relationship.
Prescribers should consider writing for a 90-day supply and pharmacists should work with prescribers to switch to a 90-day supply, once it is determined the patient is on a stable dose of a maintenance medication or OTC drug.
Furthermore, pharmacists may also submit for package size quantities that closely represent the prescriber's fiscal order. For instance, if a prescriber writes for a quantity of 90 tablets and the closest package size is 100 tablets, that can be utilized.
For questions on this policy, contact NYRx@health.ny.gov or 518-486-3209.
Also in New York, NYRx Education and Outreach team shared an NYRx Brand Less Than Generic Program Update, effective August 21.
- Complera® will be ADDED to the program.
- Pradaxa®, Sandostatin LAR®, and Sprycel® will be REMOVED from the program.
For more information related to the Brand Less Than Generic (BLTG) Program, please review the BLTG YouTube webinar, NYRx, the Brand Less Than Generic (BLTG) Program – YouTube.
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.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
General Dynamics Information Technology (GDIT) is now accepting applications for non-voting, volunteer peer review members of the Department of Health and Human Services (NCDHHS) Credentialing Committee. For background and details on the Credentialing Committee, please see the announcement from NCTracks entitled Coming Soon: NCDHHS Credentialing Committee.
Providers interested in being considered for peer review roles should submit their resume to: ncmedicaidcredcomm-candidate@gdit.com.
For more information about the Credentialing Committee and related resources, including Fact Sheets and links to the stakeholder webinar series, visit the NCDHHS Credentialing Committee webpage.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
The Board of Pharmacy posted the quarterly newsletter.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
On August 13, the Board of Pharmacy adopted Temporary Rule OAR 855-115-0345 updating the Standard Vaccination Protocols to include the CDC's Advisory Committee on Immunization Practices (ACIP) recommendations for the 2025-2026 influenza season.
The ACIP guidance, adopted on July 22, reaffirmed recommendations for the routine annual influenza vaccination of all persons aged ≥6 months who do not have contraindications for the 2025-2026 season.
ACIP recommends only single-dose formulations of annual influenza vaccines that are free of thimerosal as a preservative for three populations:
- Children 18 years or younger
- Pregnant women
- All adults
Please remember licensees are required to follow the age restrictions set forth by state law in ORS 689.645.
Also in Oregon, the Board of Pharmacy permanently adopted the following rules at the August 2025 board meeting:
- Div 102 – Board Delegated Limited Authority for Vaccine Protocol rules *Effective August 8
- Divs 104/115 – Standard Vaccination Protocols *Effective August 8
- Standard Vaccination Protocol for Managing Adverse Reactions & Assessment and Treatment Care Pathway
- Divs 115/135 – Standards Adopted by Reference *Effective August 8
Review the Secretary of State filing notices on the rulemaking page.
Review the Standard Vaccination Protocols located on the Public Health & Pharmacy Formulary Advisory Committee / Protocols page.
Email all rulemaking related inquiries to pharmacy.rulemaking@bop.oregon.gov.
Also in Oregon, the Oregon Health Authority issued a Notice of Proposed Rulemaking amending pharmacy dispensing, prescription requirements and regulatory cleanup of program rules as follows. A hearing will be held on September 18 from 1:30 pm – 2:15 pm and comments are due to the agency by 5:00 pm on September 21; see notice for details.
- 410-121-0000 (Foreword and Definition of Terms): Amending definition of "mental health drug" to align with other rules and remove references to previous repealed rule definition.
- 410-121-0111 (Pharmacy and Therapeutics Committee): Removing outdated language referencing 2011 bill and previous governing body.
- 410-121-0145 (Prescription Requirements): Removing outdated language for age restrictions and contraceptive prescribing.
- 410-121-0146 (Dispensing Limitations): Amending language to allow large days supply for select MH [mental health] carve out medications.
- 410-121-0147 (Exclusions and Limitations): Amending language to clean up repealed rule references.
- 410-121-0155 (Reimbursement): Amending language to exempt IHS [Indian Health Service] and Tribal pharmacies from AAAC survey process.
Finally in Oregon, the Prescription Drug Affordability Board posted its draft agenda and meeting materials for the August 20 meeting. Register in advance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
In the wake of Rite Aid closures, the Department of Insurance (PID) issued Notice 2025-07 urging to insurers and PBMs to take immediate steps to protect patients' access to prescription medication as many Pennsylvanians look for a new pharmacy. Specifically, PID asked them to:
- Help patients quickly find a new pharmacy if their local Rite Aid has closed;
- Allow a patient to use out-of-network pharmacies when in-network pharmacies are not available and, make sure patients do not pay more than in-network prices in such cases;
- Transfer any existing approvals or prior authorizations to the new pharmacy automatically;
- Set up hotlines, websites or other support tools to make prescription transfers easy;
- Fast-track urgent requests, like specialty medications and controlled substances; and
- Pause or reschedule pharmacy audits.
Additionally, the notice encouraged consumers experiencing issues accessing their prescriptions to file a complaint or call 1-866-PA-COMPLAINT.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
The Tennessee Pharmacists Association (TPA), National Community Pharmacists Association (NCPA) and American Pharmacists Association (APhA) jointly filed an amicus brief in federal court supporting Tennessee’s 2021 law regulating PBMs. The law, aimed at protecting patient choice and pharmacy access, bans PBMs from practices like patient steering and excluding pharmacies from preferred networks. The case stems from a challenge by McKee Foods arguing that the law is preempted by the federal ERISA statute.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The 30-day special legislative session is set to officially conclude on August 19. However, many Democratic lawmakers are currently out of the state, which means the House cannot conduct business without a quorum. As a result, House Speaker Dustin Burrows (R) announced that if a quorum is not present, the House will adjourn sine die on August 15. If this occurs, Gov. Greg Abbott (R) has pledged to immediately call for another special session.
Also in Texas, at the August 8 meeting, the Board of Pharmacy adopted rules on prescription delivery, allowing certain prescription drugs to be delivered by drones and contract carriers. The rules take effect on the date that they are published in the Texas Register.
Also in Texas, the Board of Pharmacy members elected HEB pharmacist Donna Montemayor to serve at Vice President of the Board and Donnie Lewis, RPh to serve as Treasurer.
Also in Texas, on September 1, the Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) will begin identifying some drugs with temporary non-preferred (TNP) status. TNP drugs are new-to-market drugs available on the Medicaid formulary but that have not yet been reviewed by the state's Drug Utilization Review Board for a preferred drug list status, either preferred or non-preferred.
Also in Texas, HHSC is encouraging pharmacies to enroll in Healthy Texas Women (HTW), offering women's health and family planning services at no cost to eligible Texans. More information on the program can be found on the HTW website. Pharmacies can enroll as participating HTW providers when completing the enrollment process through the Texas Medicaid & Healthcare Partnership's (TMHP's) Provider Enrollment and Management System (PEMS). Pharmacies are automatically enrolled in HTW when completing the Medicaid enrollment unless the pharmacy unchecks the HTW participation box. The HTW Provider Certification and Attestation form does not apply to pharmacies. See the TMHP PEMS website for enrollment information.
Also in Texas, HHSC removed the non-preferred status from the generic methylphenidate patch products on the preferred drug list effective August 11, as a result of manufacturer-reported backorders due to supply shortages.
Finally in Texas, HHSC published an update to the Clinical Prior Authorization Assistance Chart (PDF). HHSC requires managed care organizations (MCOs) to implement specific clinical prior authorizations for clients enrolled in managed care. Usage of other clinical prior authorizations will vary between MCOs at the discretion of each MCO. Refer to the Pharmacy Provider Procedure Manual for more information about required clinical prior authorizations in managed care.
For more information, contact NACDS’ Mary Staples at 817-442-1155.