Washington
The Health Care Cost Transparency Board analyzed healthcare spending from 2017 to 2023, using data from both public and commercial insurers in the All-Payer Claims Database. The analysis revealed that spending on retail pharmacies increased by 71 percent during this period, which is a significantly faster rate of growth compared to any other category of services. Rising prices were the primary driver of growth in spending on prescription drugs, with the number of prescriptions increasing by only three percent, compared to a 66 percent price increase. This study aligns with other studies that show that list prices set by manufacturers are the primary reason why costs are escalating.
Also in Washington, the Health Care Authority's (HCA) 2025-27 Operating Budget was reduced for Apple Health (Medicaid) managed care organization (MCO) rates by one percent, or approximately $90 million, for calendar year 2026. HCA provided guidance and FAQ on the managed care rate reductions effective January 1, 2026.
Also in Washington, the Health Care Authority (HCA) updated the substance use disorder (SUD) provider guide, clarifying state and federal laws that limit the use and disclosure of SUD information.
Finally in Washington, starting August 1, submitting eligibility policy questions and data requests for Eligibility Policy Innovation and Community Support (EPICS) is transitioning from the email inboxes to the ServiceNow platform, renamed to Apple Health Policy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Medi-Cal Rx shared the following information for pharmacy providers. The US Food and Drug Administration has asked the four companies that have teriparatide products (FOREO by Lilly and generics by Prasco, Teva, and Apotex) to change the package size on the label of the products. Changing package size will affect claims billing while labels with both package sizes are in distribution. Note, the product NDCs were not changed to account for the change in package size. However, the reimbursement rate was updated to account for the reduction in package size from 2.4 ml to 2.24 ml.
The Department of Health Care Services would also like to request pharmacy providers update their POS systems to allow these claims to be submitted for 2.24 ml as this change took effect on March 29. Medi-Cal Rx also asks pharmacy providers to submit claims for 2.24 ml regardless of the package size displayed on the package. This will prevent overpayment. If the pharmacy POS system does not allow the claim to be submitted for 2.24 ml, please resubmit the claim and call Medi-Cal Rx Customer Service Center for assistance.
Also in California, the Department of Health Care Service posted the following alerts on the Medi-Cal Rx Web Portal:
Finally in California, the Board of Pharmacy issued the following: NOTICE OF DECISION NOT TO PROCEED - Pursuant to Government Code section 11347
Re: Notice of Proposed Rulemaking concerning Quality Assurance Programs
Pursuant to Government Code Section 11347, the California Board of Pharmacy (Board) hereby gives notice that it has decided not to proceed with the rulemaking action published in the California Regulatory Notice Register on August 9, 2024, Register 2024, No. 32-Z. The proposed rulemaking concerned Quality Assurance Programs (OAL Notice Z2024-0725-02).
Any interested person with questions concerning this rulemaking should contact Lori Martinez at 916-244-6648 or by e-mail at: PharmacyRulemaking@dca.ca.gov.
The Board will also post this Notice of Decision Not to Proceed on its website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Health Care Policy and Financing (HCPF) is soliciting stakeholder input before August 30, regarding the draft Supervision Policy for Medicaid Billable Behavioral Health Services. Feedback can be provided either by attending a stakeholder meeting or providing written feedback using this Google Form.
Also in Colorado, the Department of Regulatory Agencies (DORA) Board of Pharmacy is hosting a pharmacy stakeholder meeting on proposed rules on July 31 at 9:00 am MDT. Oral comments will be taken from webinar participants. Written comments need to be submitted as soon as possible so that they can be included in this stakeholder meeting.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services (HHS) confirmed a case of measles in an adult resident of Western Iowa and has notified the public of potential exposure locations. The individual is fully vaccinated and has no known link to the previous measles cases in Iowa, nor any recent travel outside the state. Iowa has a total of eight confirmed measles cases in 2025. For the latest information on measles in Iowa, visit the Iowa HHS Center for Acute Disease Epidemiology disease information page. This page is updated weekly, on Thursdays, with current case counts and public health guidance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact distributed an updated statewide naloxone protocol. Please note that the protocol requires pharmacies to notify the Department for Public Health when initiating participation under the statewide protocol by emailing or faxing (502-564-9377) the signed protocol within seven days of dispensing naloxone.
Also in Kentucky, MedImpact issued a bulletin detailing NADAC pricing and the process for reversing and refilling claims when drug prices increase.
Also in 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.
Finally 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
Gov. Jeff Landry (R) signed several bills into law that impact pharmacies, including:
HB 15/Act 121, effective August 1, updates the state's controlled substance schedules to align with recent federal scheduling actions taken since the last legislative session. Three substances were added to Schedule I, including two opiates and one stimulant.
HB 210 /Act 159, effective August 1, establishes provisions for the retention, archiving and destruction of certain information within the state's Prescription Monitoring Program.
SB 19 /Act 464, effective June 20, 2025, authorizes pharmacists to dispense ivermectin to individuals aged 18 years and older under a standing order issued by a Department of Health (LDH) healthcare professional with prescriptive authority. LDH must first adopt rules outlining the procedures for dispensing ivermectin.
SB 154 /Act 41, effective August 1, defines "Kratom" and classifies 7- hydroxymitragynine and mitragynine as Schedule I controlled substances in the state. The Act also adds Mitragyna speciosa to the state's list of prohibited plants.
HB 690 /Act 396, effective June 20, 2025, directs the State Surgeon General to develop rules for the administration of medical activities under Emergency Use Authorization (EUA) or all members of the healthcare community in the state. These rules will not override federal regulations but will provide state specific guidance to promote uniformity and safety in administration.
HB 264 /Act 474, effective June 20, 2025, introduces several key reforms regulating PBMs in the state.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Medicaid Office of Pharmacy Services (OPS) issued an advisory this week reminding Medicaid-enrolled pharmacies about the regulatory requirements for returning an unclaimed prescription to stock. According to COMAR 10.09.03.03 (M), pharmacies are required to reverse invoice charges for any prescription not picked up by the participant or their designee within 14 days of dispensing the opioid antagonist. The 14-day period begins at the date of service (dispensing). The advisory cautioned that they are actively monitoring claim reversals and that signs of non-compliance may trigger audits and further review.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The August 6-8 Board of Pharmacy meeting agenda and meeting materials are available. Please note on August 6, the board will meet in Executive Session for most of the day and anticipates resuming Open Session around 4:30 pm. Also note on August 7, the board anticipates meeting in Executive Session after roll call and resuming Open Session at 1:00 pm.
Finally, the board anticipates meeting in Open Session on August 8 and will break for lunch between 12 noon to 1:00 pm. Please see the meeting agenda for additional information. Additional meeting materials may be added to the agenda prior to the board meeting. Visit the board website for current meeting materials.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Board of Pharmacy has posted the application for pharmacists seeking temporary provisional licenses. The process was required by Act 34 of 2025, the recently enacted bill intended to provide relief to pharmacies experiencing increased workloads due to pharmacy closures.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Texas
The Board of Pharmacy (TSBP) issued guidance for the emergency dispensing of prescription medications as a result of flooding in the Hill Country.
Also in Texas, the Drug Utilization Review Board posted the agenda for the July 25 meeting.
Also in Texas, the Health and Human Services Commission (HHSC) Vendor Drug Program (VDP) Medicaid issued guidance for pharmacy claims for a 90-day supply of prescription drugs for children in the Fee-For-Service program impacted by the Hill Country flooding.
Also in Texas, NACDS sponsored the Texas Pharmacy Association's (TPA) 2025 Conference and Expo in Austin. The three-day event featured lots of CE sessions, including an update from the Executive Director of the Board of Pharmacy, pharmacist Danny Carroll. There was also a recap of the successful 89th legislative session and a Passing of the Gavel ceremony, during which pharmacist Jason Davis from HEB was sworn in as the president of TPA.
Also in Texas, Gov. Greg Abbott (R) convened a 30-day special session on July 21. The Governor's proclamation identified 18 issues lawmakers will debate including increased funding for statewide emergency communication warning systems, regulation of hemp-derived products, tightening laws against medication abortion and congressional redistricting aimed at adding five more GOP seats. House Democrats are coming under increased pressure from national leaders in their party to prevent Republican leadership from redrawing congressional districts. Special sessions last 30 calendar days, but there is no limit on how many the governor can call. Acting Comptroller Kelly Hancock (R) announced that the Biennial Revenue Estimate (BRE) for fiscal years 2026–27 remains unchanged, with $3.1 billion available for general-purpose spending through August 31, 2027.
The National Association of Chain Drug Stores (NACDS) sponsored the Texas Pharmacy Association's (TPA) 2025 Conference and Expo in Austin, where pharmacists, students, and technicians joined with their pharmacy peers. The three-day event featured lots of CE sessions, including the opening general session featuring a look at the new era at TPA under the leadership of CEO RoxAnn Dominguez, and an update from the Executive Director of the Board of Pharmacy, pharmacist Danny Carroll. There was also a recap of the successful 89th legislative session and a Passing of the Gavel ceremony, during which pharmacist Jason Davis from HEB was sworn in as the president of TPA.
Finally in Texas, Acting Comptroller Kelly Hancock (R) announced that the Biennial Revenue Estimate (BRE) for fiscal years 2026–27 remains unchanged, with $3.1 billion available for general-purpose spending through Aug. 31, 2027.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Pharmacy Quality Assurance Commission collaborated with the Washington Medical Commission, the Washington State Board of Nursing, the Board of Osteopathic Medicine and Surgery and the Board of Naturopathy to create brief tip sheets for the ongoing Rite Aid closures. Download the Rite Aid Closures Tip Sheet for Clinicians and the Rite Aid Closures Tip Sheet for Patients.
Also in Washington, the Department of Health Office of the Assistant Secretary announced policy, procedures and guidelines exercising enforcement discretion to permit pharmacists and pharmacy technicians to practice in the state without an active Washington state credential or certification under chapters 18.130, 18.64, or 18.64A RCW only for the purpose of assisting with prescription transfers due to the closures of Rite Aid and Bartell Drugs pharmacies in Washington.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Department of Health (WDH) confirmed a third case of measles in an unvaccinated adult from Carbon County.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
The Alabama Pharmacy Association is now accepting nominations for two Alabama Board of Pharmacy Seats.
Nominations for the Pharmacy Technician position are being accepted through July 31. All candidates must be a resident of the state and must be nationally certified and registered in the state for a minimum of five years. They must also be actively engaged in the practice of pharmacy. Nominators should include CPhT documentation along with nomination.
Nominations for the Specialty Pharmacist position are being accepted through July 31. All candidates must be a resident of the state. They must be licensed pharmacists who have been licensed in the state for a minimum of five years and who are actively engaged in the practice of pharmacy, or pharmacy administration, or both. 34-23-90 defines "Specialty" as "such as nuclear, home infusion, compounding only or consultant pharmacist".
Nominations should be submitted in writing to LJones@aparx.org and should include the nominee's name and contact information along with the name and contact information of the individual submitting the nomination.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Board of Pharmacy is sponsoring a training program, "Inspection Expectations, Diversion Trends, Loss Prevention, Legal Updates and CURES," on August 8 via WebEx. Pharmacists who participate will receive six hours of continuing education (CE) credit.
The event is free, but space is limited and preregistration is required. The board has transitioned its registration and CE certification to PharmEd, its new learning management system. To register for the event, you will need to create an account in PharmEd if you do not already have one. To create an account please go to https://pharmed.thinkific.com/. Training attendees who do not use PharmEd will not be given CE credit.
For information on how to register for the event, visit the Board's website at www.pharmacy.ca.gov, scroll down to "Important Information for Licensees," and click on "Free CE Training Registration".
For questions about the event, email the Board at pharmacy.ce@dca.ca.gov.
Also in California, the Department of Health Care Services posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact will host the 2nd Quarter Pharmacy Provider Forum on July 30 from 2:00 pm – 3:00 pm EST. For information on how to join the webinar and other items of interest, please see the most recent pharmacy newsletter.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maryland
The Health Care Commission and Chesapeake Regional Information System for our Patients (CRISP) are hosting the Blueprint for Dispenser Reporting of Non-CDS Dispenses webinar on July 23 at 1:00 pm EST via Zoom. Registration is required by July 21. During the webinar, presenters will discuss new requirements for dispensers to report noncontrolled (non-CDS) prescription drugs to the prescription drug monitoring program (PDMP) starting September 1, outlined in Noncontrolled Prescription Drugs Dispenser Data Submission Manual. Attendees are encouraged to share questions ahead of the webinar. Please email your questions to mhcc.noncds@maryland.gov. Please note, CRISP will also host a technical webinar on July 29 at 1:00 pm EST via Zoom to walk through the process for submitting non-CDS dispensing information. Please register in advance for the Non-CDS Data Submission Webinar.
Also in Maryland, NACDS reminds members that Medicaid pays for certain pharmacy healthcare services including MTM, administration of medications, tobacco cessation and vaccinations. They will also pay for any services provided under a collaborative practice agreement (CPA). For more details and enrollment instructions, please refer to this Advisory Bulletin.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services posted the following fee schedules effective July 2025:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On July 16, the State Department of Health hosted its monthly pharmacy community meeting for NYRx, the state Medicaid pharmacy benefit program. NYRx also offers a monthly newsletter that contains helpful updates and links. The call focused on two topics. First, an update on diabetic testing supplies – advising pharmacies to become familiar with the preferred supply list. Second, a reminder to update the ETIN (Electronic Transmitter Identification Number), if needed, and how to do so.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Due to issues at the Department of Motor Vehicles (DMV), the state legislature passed SB 391, extending the expiration of drivers’ licenses by two years. These expired licenses remain valid for driving, but other uses, like alcohol, tobacco and certain pharmacy sales, are affected. The Board of Pharmacy allows pharmacies to accept expired licenses for dispensing controlled substances. However, pseudoephedrine sales are more complicated, as license scans feed into a national database. NACDS’ in-state partner, North Carolina Retail Merchants Association (NCRMA), is working with legislators to clarify rules for businesses over the next two years.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The Board of Pharmacy posted the following rules. NACDS does not intend to comment on these. Members can find more information on submitting comments in the links.
- CSI – BIA – Responsible Person Requirements (Comments Due 8.11.2025).pdf – requires minimum work hours for the Pharmacist-in-Charge (PIC)
- For Stakeholder Comment – Manner of Issuance (Comments Due 8.1.2025).pdf – requires a child's weight on certain pediatric prescriptions
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Pennsylvania
Members can now bring out-of-state pharmacists into their Pennsylvania stores to help with the high demand for new prescriptions due to pharmacy closures. On July 7, Gov. Josh Shapiro (D) signed Act No. 34 of 2025, which allows the Board of Pharmacy to issue a temporary provisional endorsement license to pharmacists licensed and in good standing in another state. An applicant seeking licensure under the act will not be required to demonstrate substantial equivalency or work experience. The act will expire 180 days from July 7. Further details and the provisional license application have been posted on the board’s website.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
Last week, Gov. Bill Lee (R) announced that Ralph Alvarado has stepped down as state’s Commissioner of Health (TDH), effective July 11. The current state epidemiologist, John Dunn, will serve as interim commissioner.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Board of Pharmacy issued guidance for the emergency dispensing of prescription medications as a result of flooding in the Texas Hill Country.
Also in Texas, the Drug Utilization Review Board posted the agenda for the July 25 meeting.
Finally in Texas, Gov. Greg Abbott (R) will convene a 30-day special legislative session on July 21.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Pharmacy Quality Assurance Commission collaborated with the Medical Commission, the Board of Nursing, the Board of Osteopathic Medicine and Surgery and the Board of Naturopathy to create brief tip sheets for the ongoing Rite Aid closures. Download the Rite Aid Closures Tip Sheet for Clinicians and the Rite Aid Closures Tip Sheet for Patients.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Wyoming
The Department of Health confirmed a second, unrelated case of measles in an unvaccinated child from Natrona County.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.