Alaska
The first session of the regular legislative session adjourned on May 25. SB 147B and HB 195A, which were supported by pharmacies, aimed to expand access to care by granting pharmacists independent authority. This would establish a standard of care model, allowing pharmacists to fill urgent care gaps and provide patient care services. These bills will be carried over into the 2026 session.
Also in Alaska, Gov. Mike Dunleavy (R) signed SB 132, PBM reform legislation requiring insurers and PBMs to respond within 60 days to any inquiries by the Department of Health. The new law prohibits denial of claims submitted by the Department of Health from failure to obtain prior authorization.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Gov. Gavin Newsom (D) signed AB 116, the health omnibus trailer bill that contains the specific statutory language to implement the governor's PBM reform policies as outlined in the state's main budget bill. AB 116 requires PBMs to be licensed and regulated by the Department of Managed Health Care (DMHC), the same agency that also regulates health plans in the state. PBMs must obtain and maintain a license with DMHC on or after January 1, 2027, or the date on which DMHC has established the licensure process. DMHC is authorized to charge an annual fee on PBMs to support the department's actual and reasonably necessary expenses to implement PBM licensure and oversight. DMHC is also authorized to suspend or revoke a PBM license or assess administrative penalties if the director determines the licensee has committed acts or omissions constituting grounds for disciplinary action. The Pharmacy Benefit Manager Fund will be established to receive fees, fines, penalties and reimbursements to support regulation of PBMs. DMHC is authorized to conduct periodic routine and non-routine examinations of the fiscal and administrative affairs of any PBM. Furthermore, PBMs must inform its contracted pharmacists of the right to submit complaints to DMHC and must provide certain data to the Department of Health Care Access and Information (HCAI). A PBM also has a fiduciary duty to its payer client that includes a duty to be fair and truthful toward the payer, to act in the payer's best interests, and to perform its duties with care, skill, prudence and diligence.
Also in California, the Department of Health Care Services (DHCS) is establishing Medi-Cal provider enrollment requirements and procedures for pharmacy providers that hold a Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver. Effective August 1, 2025, pharmacy providers that hold a valid Clinical Laboratory Improvement Amendments (CLIA) Certificate of Waiver and current Certificate of California Clinical Laboratory Registration may bill for CLIA-waived tests provided within the pharmacist's scope of practice as defined by the Board of Pharmacy and authorized in Business and Professions Code Section 4052.4. Pharmacy providers must apply to enroll in the Medi-Cal program by submitting a Medi-Cal provider enrollment online application, along with all supporting documentation. Providers can access Medi-Cal provider enrollment information on the DHCS Provider Enrollment Division webpage.
Finally in California, the Department of Health Care Service posted the following alerts and monthly bulletin on the Medi-Cal Rx Web Portal.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Gov. Jared Polis (D) signed SB25-289, a law creating a new Drug Donation Program to facilitate the safe donation and dispensing of unused medicine to Coloradans in need. The program expands upon the drug donation provisions and the corresponding rules and regulations for the Board of Pharmacy; it establishes parameters for participation and sets directives for donation recipients on the requirements for record retention in the program; outlines how to distribute donated medicine; and identifies what types of medicine can be distributed through the donation program.
Also in Colorado, the Health Care Policy & Financing (HCPF) annual Pharmacy Stakeholder Webinar is on August 12 from 9:00 am-11:00 am MT. Discussion will focus on emerging federal threats to Medicaid, state budget challenges, Medicaid cost trend drivers and priorities for fiscal year 2025-2026. Participants are encouraged to register for the webinar in advance.
Finally in Colorado, SB25-308 creates a cash fund for state dollars designated to 1115 waiver programs such as health related social needs and re-entry services for those leaving prison or jail after incarceration.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
On July 8, 2025, Gov. Ned Lamont (D) signed HB 7192, An Act Implementing the Recommendations of the Bipartisan Drug Task Force. The law enhances the accountability and transparency of PBMs and health carriers and implements recommendations from the Bipartisan Drug Task Force which includes some of NACDS’ PBM policy priorities, including any willing provider. NACDS participated in the task force and submitted testimony when both bills had hearings.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Delaware
On July 1, the Board of Pharmacy held an emergency meeting and adopted emergency regulations regarding pharmacy closures in the state; see Department of State Division of Professional Regulation Emergency Order for details. Additionally, the Department of Insurance issued Domestic and Foreign Bulletin No. 153 RE: Department Expectations in Response to Emergency Order by the Board of Pharmacy and Pharmacy Closures; see the bulletin for details regarding emergency prescription coverage; prior authorizations and prescription transfer; pharmacy reimbursement and network adequacy; consumer protection and transparency; and compliance & enforcement. For questions, comments or requests for clarification, please email compliance@delaware.gov.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Hawaii
Gov. Josh Green (D) signed SB 1245 recognizing pharmacists as healthcare providers and ensuring health plan reimbursement for services they provide withing their scope of practice. Beginning July 1, 2026, private and public health plans in the state must reimburse licensed pharmacists for covered health services of contracted pharmacies when those services are delivered within the pharmacists’ scope of practice.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
The Department of Insurance (DOI) published its June 2025 newsletter. As a reminder pharmacy providers may submit inquiries and complaints on the DOI website. Complete a separate form for each PBM if there are multiple complaints. To date, the DOI has received 43 complaints from pharmacies regarding PBMs. Of these, 36 remain open or pending, while seven have been closed. Complaints may include multiple issues, with the most common being related to Maximum Allowable Cost (MAC) appeals and dispensing fees. The DOI Consumer Affairs team is also assisting the PBM Examiner with investigating reported concerns. For questions and information, please contact PBM@doi.idaho.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
Electric bills are expected to surge. What you need to know is that Midcontinent Independent System Operator (MISO) and PJM capacity auctions cleared at significantly higher prices for the 2025-2026 Planning Year: June 1, 2025, through May 31, 2026. MISO and PJM are the Regional Transmission Organizations (RTOs) that coordinate the movement of wholesale electricity in Ameren Illinois and ComEd electric territories, respectively. Ameren Illinois and ComEd electric customers will soon see the effects of these higher prices for the first time on invoices received in June/July. Ameren Illinois, ComEd, nor the suppliers have any control over these charges, nor do they have any power to change them. Due to a multitude of variables, Retail Energy Suppliers (RES) are handling this additional cost in many ways, according to supply contract terms and conditions as well as internal policy decisions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Health Coverage Programs (IHCP) expanded provider enrollment to include licensed pharmacists. This new provider specialty allows 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). Pharmacists may enroll as IHCP rendering providers using the IHCP Provider Healthcare Portal or via paper application. An active pharmacist license and successful completion of training as specified in IC 25-26-25 are required for IHCP pharmacist enrollment.
Also in Indiana, the Health Coverage Programs (IHCP) Drug Utilization Board (DUR) approved updates to the prior authorization (PA) criteria, Statewide Uniform Preferred Drug List (SUPDL) and Preferred Brand Drug List.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted to the attention of all Medicaid Medical Providers and Pharmacies INFORMATIONAL LETTER NO. 2693-MC-FFS RE: Implementation of House File 1049-Gender Transition Surgeries or Associated Procedures effective July 1, 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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.