Washington

The Health Care Authority (HCA) Apple Health (Medicaid) released a new provider fact sheet with information about language access. 

Also in Washington, the 2025-27 Operating Budget directed the Health Care Authority (HCA) to reduce Apple Health (Medicaid) managed care organization (MCO) rates by 1 percent, or approximately $90 million, for calendar year 2026. HCA is implementing several specific reductions that combined will result in $90 million in reduced expenditures. HCA summarized the changes which take effect January 1, 2026. 

Also in Washington, HCA posted information about language access and interpreter services: 

Also in Washington, the Washington Health Care Privacy Toolkit was updated. 

Also in Washington, the Health Care Authority (HCA) launched a Naloxone Pilot Program for a one-time distribution of naloxone to behavioral health agencies (BHAs) in the state. This pilot is the result of efforts to expand access to opioid reversal medication and listening to feedback from community partners, which showed that BHAs have a high need for upfront funding to purchase the initial stock of naloxone before they can begin a "stock and replenish" model.  

Finally in Washington, the Pharmacy Quality Assurance Commission (PQAC) published its August newsletter. 

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

August 15, 2025|Washington|

California

The Department of Health Care Service posted the following alerts and monthly bulletin on the Medi-Cal Rx Web Portal. Please review the “Reminder: Medi-Cal Rx Pharmacy Claim Reimbursement” as it relates to “Now Active: NCPDP Field 426-DQ Usual and Customary Charge Requirement”.  Also note the mass adjustments for commercial COVID-19 vaccines; see alert below for details.

Also in California, the Board of Pharmacy provided this August 1 update regarding the

California Medication Error Reporting (CAMER) Pursuant to Business and Professions Code section 4113.1.

Business and Professions Code (BPC) section 4113.1 establishes requirements for a community pharmacy to report medication errors to an entity approved by the Board. The Board refers to this as the California Medication Error Reporting (CAMER) system. The statute requiring reporting to CAMER can be viewed at BPC section 4113.1.

In September 2024, the Board approved the Institute for Safe Medication Practices (ISMP), an ECRI Company, as the entity to receive and review medication error reports under BPC section 4113.1. Please note while ECRI and ISMP operate a Patient Safety Organization (PSO), event reports submitted pursuant to BPC section 4113.1 are not submitted to the ECRI and ISMP PSO.

Following the Board’s decision in June 2025 to withdraw the Quality Assurance (QA) rulemaking, questions have arisen regarding its impact on reporting to CAMER. It is important to note that QA and CAMER are two distinct requirements under pharmacy law. The withdrawal of the QA rulemaking does not affect the statutory requirement for community pharmacies to report to CAMER. For more information, please refer to the Board’s CAMER website.

As a reminder, community pharmacies may register for CAMER online. Additionally, the Board advises licensees that medication errors that occur on or after September 1 must be reported to the CAMER system consistent with legal requirements established.

Finally in California, the Board of Pharmacy posted its News Roundup – August 2025 and includes the following: Upcoming Meetings, Rite Aid Closures, California Medication Error Reporting (CAMER), Self-Assessment Forms: July 1, 2025 Deadline, Report a Drug Theft/Drug Loss Online Portal and NEW PIC Training Webinar.

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

August 7, 2025|California|

Colorado

Gov. Jared Polis (D) issued an executive order announcing a special legislative session on August 21 to address a $1.2 billion budget shortfall caused by the passage of H.R. 1, the federal “One Big Beautiful Bill Act”. In addition to addressing fiscal issues, the Governor wants legislators to address health care, food insecurity and artificial intelligence issues.

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

August 7, 2025|Colorado|

Illinois

The Women, Infants and Children (WIC) Vendor Relations Unit will host its next Quarterly Vendor Information Conference Call on August 12 from 10:00 am to 11:00 am CST. Please use the following information to access the call: Dial-in Number: 844-291-5490 Access Code: 2902421

This call provides an opportunity for the Department of Human Services to share important program updates, address recent issues and hear general questions or concerns from vendors.

When joining the call, please be prepared to provide your name, company name and WIC Vendor ID (if you represent a specific vendor location).

Key discussion topics have been outlined in the agenda. If you would like to address a specific issue during the call, in addition to the topics on the agenda, please complete the Help IL WIC Improve vendor questionnaire before the call.

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

August 7, 2025|Illinois|

Iowa

The Department of Health and Human Services announced that Lee Grossman has been appointed as the new Director of Iowa Medicaid. Grossman, an Iowa native, brings more than 14 years of experience from the Wyoming Department of Health, where he most recently served as Medicaid Director since February 2023. Lee will begin this new role in early September.

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

August 7, 2025|Iowa|

Kentucky

With dozens of overdose deaths in the state involving bromazolam, Attorney General Russell Coleman (R) is calling on the Cabinet for Health and Family Services (CHFS) to take emergency action to ban the drug. Additionally, he has contacted the US Drug Enforcement Administration asking them to quickly schedule the drug as a controlled substance. The drug has already been scheduled in some states, including Nevada, New Mexico, North Dakota, Virginia and West Virginia.

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

August 7, 2025|Kentucky|

Louisiana

The Board of Pharmacy will meet on August 19 and 20 at the Board’s office in Baton Rouge. The agenda has not yet been posted, but the meeting schedule is provided below:

  • Reinstatement Committee – 10:30 am on August 19
  • Impairment Committee – 1:00 pm on August 19
  • Finance Committee – 2:30 pm on August 19
  • Executive Committee – 3:30 pm on August 19
  • Board Meeting – 9:00 am on August 20
  • Administrative Hearing – 12:30 pm on August 20

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

August 7, 2025|Louisiana|

Maryland

The Maryland Health Care Commission (MHCC) announced the appointment of Douglas Jacobs, MD, MPH, as its new Executive Director, effective August 18. Dr. Jacobs, a primary care physician, brings extensive experience in public health leadership, policy innovation and clinical care. Most recently, he served as Chief Transformation Officer at the Centers for Medicare and Medicaid Services (CMS) and previously held senior roles in Pennsylvania’s Department of Human Services, where he helped lead the state’s COVID-19 response. He is also a practicing primary care doctor with first-hand experience of how policies affect patient care.

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

August 7, 2025|Maryland|

Massachusetts

MassHealth shared this month’s Pharmacy Facts. The ordering, referring and prescribing (ORP) referring provider national provider identifier (NPI) is not required for claims for durable medical equipment (DME) and home infusion services billed by pharmacies through the Medicaid Management Information System (MMIS). To avoid denials for claims with dates of service on and after August 1, 2025, pharmacy providers should not enter the ORP referring provider’s NPI on the claims for DME and home infusion services billed through MMIS.

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

August 7, 2025|Massachusetts|

Mississippi

Please note survey open for public input on development of Rural Health Transformation Plan. On July 3, Congress passed via the FY 2025 budget reconciliation process H.R. 1, the “One Big Beautiful Bill Act” (OBBBA). Section 71401 of the Bill modifies Section 2105 of the Social Security Act and establishes a $50 billion grant program ($10 billion per fiscal year for FY 2026 – 2030) for the Department of Health and Human Services (HHS) to distribute payments to the 50 states through the Rural Health Transformation Program. Applications to participate in the grant program must be approved by the HHS Secretary no later than December 31, 2025.

The Office of the Governor, in coordination with the Division of Medicaid (DOM) and the State Department of Health (MSDH), intends to solicit public input through a public survey and a stakeholder forum by the Office of the Governor, develop a Rural Health Transformation Plan (Plan) and submit a timely application for the grant funding. The Office of the Governor will make the final selection for initiatives included in the Plan.

Please complete the survey by 5:00 pm on August 14: Rural Health Transformation Program Stakeholder Survey

See the full Survey: https://medicaid.ms.gov/wp-content/uploads/2025/07/Attachment-E-Rural-Health-Transformation-Program-Stakeholder-Survey.pdf

To learn more visit: https://medicaid.ms.gov/rural-health-transformation-program/

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

August 7, 2025|Mississippi, RH|

Nebraska

The Department of Health and Human Services posted the agenda for the September 9 meeting of the Drug Utilization Review (DUR) Board.

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

August 7, 2025|Nebraska|

New York

The Office of Health Insurance Programs of the State Department of Health has approved the release of the June 2025 Medicaid Update. The current issue’s table of contents includes the following:

All Providers

Policy and Billing

Pharmacy

Also in New York, the July Department of Health (DOH) Pharmacy Association meeting shared the updated form for NYRx, the New York State Medicaid Pharmacy Program Coordination of Benefits: Non-Preferred Diabetic Supplies, as discussed in the July Department of Health (DOH), Office of Health Insurance Programs (OHIP) and Pharmacy Associations meeting. The update is also located on the DOH website in the Medical Supplies section under Preferred Diabetic Supply Program (PDSP).

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

August 7, 2025|New York|

North Carolina

With no full budget agreement in sight, state lawmakers reached a deal on a 31-page mini-budget, HB 125: Continuing Budget Operations, which now heads to Gov. Josh Stein (D). The bill allocates over $1 billion in funding, including step increases for public school teachers, support for K-12 growth and Medicaid rebase funding, critical dollars needed annually to cover changing Medicaid costs.

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

August 7, 2025|North Carolina|

Oregon

The Division of Financial Regulation recently announced the following permanent rulemaking that took effect on August 1:

ID 6-2025: Updates to Pharmacy Benefit Manager Rules and DPT Insurer Reporting Rule

Rules: 836-053-1630, 836-200-0401, 836-200-0406, 836-200-0411, 836-200-0416, 836-200-0418, 836-200-0421, 836-200-0436, 836-200-0440

This rulemaking replaces references to registration throughout the current rules, encoded at OAR 836- 200-0401 et seq with references to licensure. It also adds new data elements to the reporting rule and new market conduct requirements. It also adds language clarifying the bar on retaliation against pharmacies, noting that a pharmacy claims audit may be considered retaliation under certain circumstances. Finally, the rulemaking includes substantial revisions to the language related to pharmacy reimbursement in order to clarify expectations for PBMs when a pharmacy is reimbursed below acquisition cost under a maximum allowable cost schedule.

Also in Oregon, the Prescription Drug Affordability Board posted its draft agenda for the August 20 meeting. Register in advance.

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

August 7, 2025|Oregon|

Rhode Island

See the August 2025 provider update, which includes information on upcoming Pharmacy & Therapeutics (P&T) Committee and Drug Utilization Review (DUR) Board meetings scheduled for September 9 at the Executive Office of Health and Human Services (EOHHS) office in Cranston as well as upcoming payment and processing schedules. Additional provider updates can also be found on the EOHHS website.

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

August 7, 2025|Rhode Island|

South Carolina

US Rep. Nancy Mace (R) announced her candidacy for governor this week at The Citadel, where she made history as the first female graduate. She enters a crowded Republican primary field that already includes US Rep. Ralph Norman, Lt. Gov. Pamela Evette, Attorney General Alan Wilson and state Sen. Josh Kimbrell.

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

August 7, 2025|South Carolina|

Tennessee

During the July Board of Pharmacy meeting, the Office of the General Counsel announced that the new pharmacy technician rules are expected to take effect around October 21. Additionally, a rulemaking hearing on compounding regulations is anticipated to be scheduled later this year or early next year. The Board’s October meeting has been rescheduled to October 20 and 21.

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

August 7, 2025|Tennessee|

Texas

The 30-day special legislative session entered its third week with high drama, as Democrat lawmakers fled the state to prevent Republicans from holding a vote in the House on a new congressional map that was approved by the House Select Committee on Congressional Redistricting. The Democrats face a $500 fine for every day they break quorum. The Texas House voted 85-6 on August 4 to track down and arrest more than 50 Democrat lawmakers. House Speaker Dustin Burrows (R) signed civil warrants, empowering the House sergeant-at-arms and state troopers to arrest and bring them to the Capitol.

Also in Texas, Diabetes News You Can Use is a free news bulletin from the Department of State Health Services (DSHS). It is compiled by the Diabetes Prevention and Control Program and highlights information and news related to diabetes.

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

August 7, 2025|Texas|

Utah

The Board of Pharmacy published its August 2025 newsletter including the following items of interest: New Online Toolkit Supports Utah Pharmacists in Managing CS [Controlled Substances] and 2025 Utah Pharmacy Law Update: Therapeutic Interchange and Expanded Pharmacist Authority.

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

August 7, 2025|Utah|

Washington

The Pharmacy Quality Assurance Commission (PQAC) will hold a regular business meeting beginning on August 14. They posted the agenda and meeting materials.

Also in Washington, PQAC released a draft rule for utilization of pharmacy ancillary personnel. The rules workshop will be held at the August 14 meeting. The draft rule language considers amending WAC 246-945-001, -315, and -317 and adding two new sections in chapter 246-945 WAC to provide clarification on the utilization of ancillary personnel and technology within the pharmacy.

Finally in Washington, the Prescription Drug Affordability Board (PDAB) Advisory Group will meet on August 12 to discuss these agenda items.

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

August 7, 2025|Washington|

West Virginia

NACDS reminds members that SB 526, the “Pharmacists Prescribing Authority Act” was effective July 11, 2025, and allows pharmacists to test and treat patients for flu, RSV and COVID under their own authority. The law does not require rules. Further details on this law, as well as other new laws and rules, are available in the West Virginia Pharmacists Association July newsletter.

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

August 7, 2025|West Virginia|

Alabama

The Medicaid Agency (Medicaid) is required to conduct administrative desk reviews to ensure providers are following state policies and practices that comply with federal regulations. Medicaid coordinates with SafeGuard Services, LLC (SGS), a Unified Program Integrity Contractor (UPIC) working with the Centers for Medicare & Medicaid Services (CMS). SGS performs fraud, waste and abuse detection, deterrence and prevention activities for Medicaid claims through administrative desk reviews. See Medicaid’s ALERTs for details.

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

July 31, 2025|Alabama|

Arizona

The Board of Pharmacy published its July 2025 newsletter including the following articles and items of interest: Update Your Profile, Be on Alert – Scam Letters and/or Phone Calls, Thank You for Serving – Cedar Lahann and Kevin Dang, Welcome to the Board – Christopher Hogan and Stephanie Spark, Understanding ARS §20-1742: Malpractice Reporting Requirements in Arizona, 2025 Legislative Update and Bills Signed Into Law and Disciplinary Actions and Update – Health Boards.

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

July 31, 2025|Arizona|

Arkansas

On July 28,a federal judge for the US District Court for the Eastern District of Arkansas Central Division granted a preliminary injunction to stop the implementation of HB 1150/Act 624, a state law prohibiting out-of-state PBMs from operating pharmacies inside the state, due to take effect on January 1, 2026. The reason given in the court order was because it likely violates the Commerce Clause, and it is likely preempted by TRICARE.  

Also in Arkansas, the Centers for Medicare & Medicaid Services (CMS) approved a new section 1115 demonstration titled "Arkansas Opportunities to Test Transition-Related Strategies to Support Community Reentry from Incarceration and Institutions for Mental Disease." It allows the state to receive federal financial participation (FFP) for Medicaid state plan services provided to adult beneficiaries who are in institutions for mental disease (IMD) for substance use disorder (SUD) or serious mental illness (SMI) treatment.  

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

July 31, 2025|Arkansas|
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