Kentucky
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.
Louisiana
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.
Michigan
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.
- Pradaxa® (dabigatran etexilate)
- Humalog Mix pen (insulin lispro protamine)
- Novolog cartridge (insulin aspart)
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Missouri
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.
Nebraska
The Department of Health and Human Services (DHHS) sent its fourth issuance of Summer Electronic Benefit Transfer (EBT) benefits to households with eligible school-age children. A one-time payment of $120 to purchase groceries will be issued for each eligible child, intended to cover the three summer months at $40 a month. Summer EBT benefits can be used to purchase food at grocery stores, online food retailers and farmer’s markets that accept SNAP EBT.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Nevada
Gov. Joe Lombardo (R) vetoed AB 411, legislation that would have allowed a prescriber to request that the prescription label for mifepristone, misoprostol or their generic alternatives would indicate the name of the prescribing health care practice instead of the name of the prescribing practitioner.
Also in Nevada, the Board of Pharmacy posted the agenda and meeting materials for the July 16 and 17 meeting in Las Vegas.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Jersey
At its June 25 public meeting, the Board of Pharmacy issued a temporary waiver of the 72-hour dispensing limit in N.J.A.C. 13:39-7.4(a) to allow for dispensing of up to a 10-day emergency supply of non-controlled substance medications for Rite Aid patients affected by the closure of their pharmacies. This waiver may be used by any state-registered pharmacy but applies only to prescriptions for former Rite Aid patients. The waiver will be in effect until October 1. To satisfy the requirement in N.J.A.C. 13:39-7.4(a)1, after obtaining suitable identification from the patient or caregiver, the pharmacist may rely upon information on a prescription bottle containing a Rite Aid label. Pharmacists are expected to comply with all documentation requirements in the Board’s existing rules.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New York
Effective July 15, NYRx, the Medicaid Pharmacy Program, will accept electronic prior authorization (ePA) requests via CoverMyMeds® in addition to the current phone and fax submission methods.
To learn more about CoverMyMeds® Electronic Prior Authorization for Medicaid Prescribers, please attend one of the webinars which occur on Tuesdays and Thursdays from 12:00 pm – 1:00 pm ET. View the calendar with upcoming dates and registration links.
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.
In addition, the following changes will be made to the Dispense Brand Name Drug When Less Expensive Than the Generic Program:
"NuvaRing® will be REMOVED from the program, as the new manufacturer of NuvaRing® does not participate in the Medicaid Drug Rebate Program (MDRP)." In conformance with State Education Law, a pharmacist shall dispense a less expensive, therapeutically equivalent drug containing the same active ingredients, dosage form and strength as the drug prescribed/ordered. This includes substituting the brand name drug when NYRx has determined it to be the less expensive alternative for the patient. Brand name drugs included in this program:
- Do not require "Dispense as Written" (DAW) or "Brand Medically Necessary" on the prescription.
- Have a generic copayment.
- Are paid at the Brand Name Drug reimbursement rate or usual and customary price, whichever is lower (SMAC/FUL are not applied).
- Do not require a new prescription if the drug is removed from this program.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
SB 479, the Supporting Community Retail Pharmacies and Improving Transparency (SCRIPT) Act, has been signed by Gov. Josh Stein (D). Effective upon signature, the bill extends the current Medicaid reimbursement paid to pharmacies from July 1, 2026, to June 30, 2031. Additionally, it makes sweeping reforms to pharmacy and prescription drug regulations by expanding patient choice; increasing transparency and oversight of PBMs and pharmacy services administrative organizations (PSAOs); strengthening fair reimbursement and network practices; mandating drug price disclosures; and enhancing consumer protections across the state.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
Sen. Mark Romanchuk (R) has introduced SB 230, legislation permitting pharmacists to test and treat patients for flu, strep, COVID-19, RSV and other respiratory conditions as specified in future rules adopted by the Board of Pharmacy. The Legislature has adjourned for the summer, so we do not expect any action on the bill before the fall.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The US Supreme Court has declined to review the PCMA v. Mulready case, marking a significant setback for efforts to protect patients and pharmacies from harmful practices by PBMs. This decision upholds the 10th Circuit’s ruling, which struck down key provisions of the state’s Patient’s Right to Pharmacy Choice Act on the grounds that they are preempted by ERISA and Medicare Part D. As a result, the state now faces limited options for safeguarding pharmacies and ensuring patient access to the medications they need.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Prescription Drug Affordability Board posted its draft agenda and meeting materials for the July 16 meeting. Register here in advance.
Also in Oregon, the Board of Pharmacy is proposing to adopt the following rules:
The July 22 Rulemaking Hearing will be held virtually via Teams and begins at 9:30 am. If you wish to provide virtual oral testimony during the hearing, please complete and submit the Rulemaking Hearing Testimony Sign Up Form on the board's website. You may also sign up by submitting your first and last name, email address and which rule(s) you would like to comment on to pharmacy.rulemaking@bop.oregon.gov no later than 9:00 am on July 22. You will receive a confirmation email and a calendar invitation to join the virtual hearing. Written comments must be received by 4:30 pm on July 22. Submit written comments to pharmacy.rulemaking@bop.oregon.gov. If you would like to listen to the rulemaking hearing, join the virtual Teams meeting or call: (503) 446-4951 Phone Conference ID: 429 564 160#. Email all rulemaking inquiries to pharmacy.rulemaking@bop.oregon.gov.
Also in Oregon, the Board of Pharmacy is proposing to adopt the following rule: Div 110 – Licensee & Registrant Fee Increase. The August 21 Rulemaking Hearing will be held virtually via Teams and begins at 9:30 am. If you wish to provide virtual oral testimony during the hearing, please complete and submit the Rulemaking Hearing Testimony Sign Up Form on the board's website. You may also sign up by submitting your first and last name, email address and which rule(s) you would like to comment on to pharmacy.rulemaking@bop.oregon.gov no later than 9:00 am on August 21. You will receive a confirmation email and a calendar invitation to join the virtual hearing. Written comments must be received by 4:30 pm on August 21. Submit written comments to pharmacy.rulemaking@bop.oregon.gov. If you would like to listen to the rulemaking hearing, join the virtual Teams meeting or call: (503) 446-4951 Phone Conference ID: 340 244 93 #. Email all rulemaking inquiries to pharmacy.rulemaking@bop.oregon.gov.
Finally in Oregon, the state's Special Supplemental Nutrition Program for Women, Infants and Children (WIC) updated its food package effective July 1 for participants to enhance nutrition and expand choice for families statewide. The state's WIC participants may shop for food on the updated list using their benefit card at any of the WIC-authorized grocery stores across the state. Enhancements to the WIC Food Package include more fruits and vegetables; a wider variety of protein and plant-based options; more cheese varieties; new yogurt brands with reduced added sugar; new plant-based milks; and new nut and seed butters.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Pennsylvania
Gov. Josh Shapiro (D) signed SB 95 into law on July 7. It was effective upon his signature. The law allows for pharmacist licensure by endorsement for 180 days to assist with the increased number of new prescriptions coming into stores due to pharmacy closures in the state. A provisional license application will be posted on the Board of Pharmacy's website soon. NACDS thanks the Pennsylvania Association of Chain Drug Stores (PACDS) for working with members to get this bill across the finish line remarkably quickly during a very challenging budget season.
Also in Pennsylvania, the long-awaited Pharmacy Technician Registration Regulations were finalized and effective on June 27.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Rhode Island
The 2025 legislative session has wrapped up. Notably, SB 114 was enacted which would prohibit discriminatory practices in the reimbursement of 340B covered entities and their contract pharmacies. Additionally, SB 314 was enacted to limit pharmacies to no more than one on-site audit per carrier within a twelve-month period, unless there is a reasonable suspicion of fraud or misrepresentation. The State Attorney General will have the authority to enforce compliance with this measure.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
Effective for dates of service on or after August 1, the Department of Health and Human Services (SCDHHS) will require prior authorization (PA) for the physician-administered drugs in the document linked below to ensure use is consistent with the medication’s indication(s) and appropriate clinical guidelines. This change only applies to medications administered to Healthy Connections Medicaid members enrolled in the fee-for-service (FFS) Medicaid program.
The list of physician-administered drugs for which a PA is required when administered to a FFS Medicaid member is available in the Procedure Codes section of the Physicians Services Provider Manual on the SCDHHS website. The list in the manual will be updated with the additional physician-administered drugs requiring a PA beginning August 1. The list of additional drugs is available online.
Requests for PA and questions should be submitted to Prime Therapeutics Management at https://gatewaypa.com or by calling 1-800-424-8219 between 8:00 am-5:00 pm Monday-Friday.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Dakota
The Board of Pharmacy published its July 2025 newsletter. Highlights including the following: South Dakota Board Welcomes Newly Licensed Pharmacists; In-State Pharmacies and Wholesalers; [Reminder] Pharmacist License Renewals; Updates to South Dakota Codified Laws (SDCL) 36-11 and SDCL 36-11A; Updates to Administrative Rules of South Dakota (ARSD) 20:51 and ARSD 20:67; PDMP Update; and Board of Pharmacy meeting dates, pharmacy contacts and staff.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
The Department of Insurance (DOI) Advisory Committee for the Standard Request Form for Prior Authorization of Prescription Drug Benefits will hold a public meeting on August 5 to discuss and take possible action on the standard prior authorization request form. As required by Insurance Code Section 1369.305(d), the advisory committee will:
- Review the adopted standard prior authorization request form.
- Examine the form's effectiveness and impact on patient safety.
- Determine whether changes are needed to the form.
Also in Texas, SB 1188, legislation ensuring electronic health records that contain patient information are maintained in the United States or a US territory, was signed into law by Gov. Greg Abbott (R).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
Effective July 1, the Health Care Authority (HCA) Apple Health (Medicaid) added a new section to the audio-only behavioral health procedure code list for HCPCS codes billable for Reentry Targeted Case Management (rTCM). The revised list is posted online under "Billing guides and fee schedules"; click on "Reentry services".
Also in Washington, Apple Health (Medicaid) announced changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program effective September 1. The full SMAC list can be found on the agency's Provider billing guides and fee schedules website under the Prescription Drug Program and applies to claims billed to FFS.
Also in Washington, the Health Care Authority (HCA) Prescription Drug Program's third quarter Preferred Drug List has been posted.
Also in Washington, the Health Care Authority (HCA) created a toolkit called Apple Health is Medicaid Communications Toolkit to assist providers, community leaders and advocates to help Washingtonians access care.
Finally in Washington, in an effort to effort to help prevent opioid misuse and overdose deaths, Fred Meyer's 60 pharmacies partnered with the Health Care Authority (HCA) to provide free locking bags to patients to more safely store their opioid prescriptions. The HCA's Lock Up Your Meds safe storage program is part of the statewide Starts with One campaign to prevent opioid overdoses by increasing the safe use, storage and disposal of opioid prescriptions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
The Secretary of State published a series of new proposed Board of Pharmacy rules that would implement legislation adopted in the 2025 session. Note that these include rules that allow pharmacist and technician licensing reciprocity and streamlining and that include a prohibition on dispensing abortion drugs and gender altering drugs for non-adults. Comments are due to the Board of Pharmacy by 5:00 pm on July 17.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
The Department of Health confirmed a case of measles in an unvaccinated child from Natrona County. This case is the first reported in the state since 2010.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alaska
The Board of Pharmacy is seeking input on a Just Culture Workplaces Survey. The results of this survey will be discussed by the board at the August 21 meeting.
Also in Alaska, the Prescription Drug Monitoring Program (PDMP) will require the following data elements starting July 30:
- AIR09 & AIR10: Full first and last name of the dispensing pharmacist (no initials).
- DSP15: Pharmacist's state license number.
- PAT20: Species Code (01: Human, 02: Animal) – required.
- PAT23: Animal name – required if PAT20 is "02".
Submissions with missing required fields will be rejected beginning on July 30. Please refer to the AK Data Submission Dispenser Guide v3.1 via the PMP Clearinghouse portal for detailed instructions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
NACDS sponsored the Arkansas Pharmacist Association's (APA) annual meeting. Gov. Sarah Huckaby Sanders (R) spoke about the importance of supporting our patients and their access to affordable healthcare. Chain and independent pharmacists thanked the Governor for her support of the profession and patients by protecting pharmacy access and ensuring patients across the state receive the care they deserve.
Also in Arkansas, the Insurance Department issued Bulletin No. 9-2025, Arkansas 2025 Legislation report, summarizing newly adopted insurance laws.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Service posted the following alerts on the Medi-Cal Rx Web Portal. As previously announced in the alert titled 60-Day Countdown: NCPDP Field 426-DQ Usual and Customary Charge Requirement, pharmacy providers submitting claims to Medi-Cal Rx with a date of service (DOS) on or after July 18 will be required to include their Usual and Customary (U&C) charge in NCPDP Field 426-DQ (Usual and Customary Charge). Claims submitted for the DOS on or after July 18 with a blank dollar amount or a value of $0.00 will be denied by Medi-Cal Rx with Reject Code DQ – M/I Usual and Customary Charge with the supplemental message "Resubmit claim with U&C charge in field 426-DQ."
- Reminder: Combined Medi-Cal Rx Provider Payment Releases to Occur on July 9, 2025, and July 15, 2025
Also in California, the Board of Pharmacy issued the following update regarding the California Medication Error Reporting (CAMER) system. An orientation webinar is being offered by the Institute for Safe Medication Practices (ISMP) at 1:00 pm Pacific on July 9. Also, medication errors that occur on or after September 1 must be reported to the CAMER system. For your convenience, here's a link to the CA Board of Pharmacy Medication Error Reporting System website hosted by ISMP.
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 statute requiring medication error reporting by community pharmacies can be viewed at BPC section 4113.1. The Board approved ISMP, an ECRI Company, as the entity to receive and review medication error reports under BPC section 4113.1.
Consistent with its commitment to keep licensees apprised of implementation activities related to the California Medication Error Reporting (CAMER) system, the Board is providing the following updates:
- ISMP will be holding an orientation webinar at 1:00 p.m. Pacific Time on July 9. Registration for the orientation webinar is available online. To view, go to FAQ and then "Will there be training or orientation sessions for how to use the reporting system and submit reports?".
- ISMP posted additional information related to reporting data elements. To view, go to FAQ and then "Which data elements will be built into the reporting system?".
Also in California, the Office of Administrative Law approved the Board of Pharmacy's updated compounding regulations. The regulations describe the Board's requirements for nonsterile compounding, sterile compounding, hazardous drug and radiopharmaceutical preparations.
The regulation is effective October 1. The Board will be releasing an updated policy statement regarding its expectations during the transition period. The Order of Adoption for the approved regulation regarding the compounding regulations has been posted.
Also in California, the Board of Pharmacy proposes taking rulemaking action related to "Medication-Assisted Treatment Protocol". The proposed text is available for review on the Board's website. Written comments must be received by the Board no later than August 4 or must be received by the Board at the hearing, if one is scheduled. Inquiries or comments may be addressed to:
- Lori Martinez Address: 2720 Gateway Oaks Drive, Ste. 100, Sacramento, CA 95833; Phone: (916) 518-3100; Fax.: (916) 574-8618; or e-Mail Address: PharmacyRulemaking@dca.ca.gov
- The backup contact person is: Debbie Damoth Address: 2720 Gateway Oaks Drive, Ste. 100, Sacramento, CA 95833; Phone: (916) 518-3100; Fax.: (916) 574-8618; or e-Mail Address: PharmacyRulemaking@dca.ca.gov
Finally in California, the Department of Health Care Services (DHCS) has been formally approved by the Centers for Medicare and Medicaid Services (CMS) to participate in the federal Cell and Gene Therapy (CGT) Access Model, with implementation effective July 1. This model is designed to improve access to high-cost, high-impact gene therapies for Medi-Cal members with complex conditions, starting with sickle cell disease (SCD). The initial therapies included in this model are Casgevy and Lyfgenia.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
The Family and Social Services Administration (FSSA) Health Coverage Programs (IHCP) issued a Bulletin documenting requirements clarified for claims billed to Medicaid for dually eligible members.
Also in Indiana, IHCP reminded providers about the benefits of submitting claims electronically and provided pharmacy updates approved by the Office of Medicaid Policy and Planning.
Also in Indiana, IHCP announced that effective July 1, they will expand provider enrollment to include licensed pharmacists. This new provider specialty will allow 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.
Finally in Indiana, the Office of Medicaid Policy and Planning is seeking applicants to serve on the Medicaid Advisory Committee which provides feedback on the program policies and proposed policies that ensure the program is responsive to concerns as well as providing transparency and accountability.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kansas
Gov. Laura Kelly (D) appointed two new pharmacists members to the Board of Pharmacy, Joanna Robinson, PharmD, MS, BCSCP, and Janine Ohler, PharmD, BCPS. They will each serve a four-year term and are replacing Jonathan Brunswig, PharmD, and William Walden, RPh, both of whom served eight years on the board.
Also in Kansas, SB 63 which became law earlier this year on February 20, requires in Section 4 that "if a healthcare provider violates the provisions of Section 3 of the law, the healthcare provider has engaged in unprofessional conduct and, notwithstanding any provision of law to the contrary, the license of such healthcare provider shall be revoked by the appropriate licensing entity or disciplinary review board with competent jurisdiction in this state".
For more information, contact NACDS’ Mary Staples at 817-442-1155.