Maryland
The Department of Health’s Office of Pharmacy Services announced upcoming changes to the Medicaid Preferred Drug List regarding brand vs. generic product coverage. Updates include new requirements for Sabril, Concerta and Ritalin LA claims when submitted with DAW 6 codes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The public is invited to attend the Medicaid Health Plan Common Formulary stakeholder meeting from 9:30 am to 12:00 noon on October 20. It will be held virtually via Zoom using the password SLVU14. Participants may also access the meeting by phone by dialing 408-961-3928 and entering access code 351013. Attendees are asked to RSVP by emailing KrepsD@michigan.gov by October 15.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New York
On October 7, the State Board of Regents voted to amend paragraph (8) of subdivision (a) of section 63.6 of the Regulations of the Commissioner of Education. This amendment, adopted as an emergency rule and effective immediately, requires pharmacists transferring prescriptions to transfer the entire prescription, including all remaining refills, to the new pharmacy chosen by the patient. As an emergency adoption, the amended regulation is now in effect. A Notice of Emergency Adoption and Proposed Rulemaking will be published in the State Register on October 22 for a 60-day public comment period as required under the State Administrative Procedure Act (SAPA). It is anticipated that the regulation will be presented to the Board of Regents for permanent adoption at its February 2026 meeting. Once adopted, the regulation would become permanently effective on February 25, 2026.
The state has also provided the following:
- An advisory notice highlighting key elements of the amendment: https://www.op.nysed.gov/advisory-notice-pharmacists-transferring-prescriptions
- Updated FAQs on prescription transfers, developed with input from the Board's committee https://www.op.nysed.gov/professions/pharmacist/frequently-asked-questions/prescription-refills and https://www.op.nysed.gov/professions/pharmacist/frequently-asked-questions/transfer-of-prescriptions
Also in New York, Gov. Kathy Hochul (D) extended the declaration of a disaster in the state of New York due to federal actions related to vaccine access by issuing Executive Order 52. 1 to continue access to COVID-19 vaccine through November 2.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
Dr. Larry Greenblatt, North Carolina Health Director, will rescind the statewide standing order effective October 13. Beginning on that date, pharmacies and pharmacists must revert to the protocols previously used to administer COVID-19 vaccines in the state. Please refer to the North Carolina Board of Pharmacy's guidance regarding CDC/ACIP recommendations and state law governing pharmacy-based COVID-19 vaccine administration.
Also in North Carolina, the Department of Health and Human Services (NCDHHS) remain committed to transparency, collaboration and fiscal responsibility in administration of the state's Medicaid program. Fee schedules impacted by rate reductions were released October 1, but are subject to change if additional appropriations are made available.
NC Medicaid provider reimbursement rate reductions are being implemented by the Division of Health Benefits (DHB) to maintain the NC Medicaid program within the current funding allocated to the Medicaid program by the North Carolina General Assembly (NCGA).
For more information, please see:
- Medicaid Provider Bulletin article NC Medicaid Rate Reductions – Effective October 1, 2025
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The House Insurance Committee held a proponent hearing on HB 192 as amended. You can watch the hearing here. NACDS’ submitted written testimony in support of the bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Division of Financial Regulation (DFR) recently hired Sarah Young as the executive director of the Prescription Drug Affordability Board and the Drug Price Transparency Program.
Also in Oregon, the Prescription Drug Affordability Board published its October 2025 quarterly newsletter.
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted its draft agenda and meeting materials for the October 15 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Finally in Oregon, the Board of Pharmacy posted The Public Health & Pharmacy Formulary Advisory Committee (PHPFAC) October 22 meeting agenda. Please note that the Committee will meet in Executive Session after approving the agenda and anticipates resuming Open Session between 9:45 am-10:00 am. Please see the agenda for additional information including the link to join the virtual Teams meeting. For more information, contact pharmacy.formulary@bop.oregon.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
In response to the Board of Pharmacy’s (TSBP) request for input on the strategic plan, NACDS made several recommendations to pursue policy changes that will benefit public health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Division of Professional Licensing (DOPL) issued guidance clarifying the use of the 2025-2026 COVID-19 vaccine following the recommendations from the Advisory Committee on Immunization Practices (ACIP).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Board of Pharmacy amended the vaccine statewide protocol for adults. Pharmacists, or a pharmacy technician or pharmacy intern under the supervision of the pharmacist, may now administer the COVID-19 vaccine to persons 18 years of age or older in accordance with the directions for use in adults of a manufacturer’s product approved by the U.S. Food and Drug Administration (“FDA”) or the Immunization Schedule published by the Centers for Disease Control and Prevention (“CDC”). Visit the protocols page for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
Gov. Mark Gordon (R) along with Department of Health Director Stefan Johansson continue to seek citizen input regarding the state’s Rural Health Transformation Program through an online survey. The survey runs October 8 through October 15. Results will inform the state’s application and determine which directions the State should pursue in transforming rural health.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
A new episode has dropped on “Off Script”, The Alabama Pharmacy Podcast, with some CE available. All episodes and links to CE (in show notes) or wherever you like to listen. Watch Episode 44 – Board of Pharmacy Meeting Update: September 2025. Join Garrett Aikens and Allyson Gilliam as they recap the Board of Pharmacy meeting that took place on September 17.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Gov. Katie Hobbs (D) appointed Virginia “Ginny” Rountree as the new director of the state’s Health Care Cost Containment System (AHCCCS), the Medicaid agency, effective October 6. A health and human services expert based in Tucson, Ginny brings more than a decade of experience in public roles at AHCCCS and the Department of Economic Security (DES), as well as leadership positions in the private sector.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Pursuant to the enacted 2025-26 State Budget, the Department of Health Care Services (DHCS) will be implementing Medi-Cal Rx policy updates, effective January 1, 2026. These changes are intended to reduce pharmacy spending, improve program integrity, and ensure continued, equitable access to quality pharmacy benefits and services. Also, effective November 1, 2025, the coordination of benefits (COB) claims submission process will be updated for Medicare. See Upcoming Changes to Medi-Cal Rx for background information.
Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please review the “90-day Countdown: Upcoming Changes to Medi-Cal Rx” alert. Note changes are effective January 1, 2026. Please see the alert for details.
Also in California, the Health & Human Services Agency (CalHHS) launched a new webinar series focused on recent federal policy changes in health and human services and how California is responding to ensure continued access to care. The first webinar in the series addressed vaccine access and guidance, a timely topic as the state enters respiratory virus season. A full recording of the webinar and presentation slides are available for those who were unable to attend. The webinar featured insights from CalHHS Secretary Kim Johnson, Department of Public Health (CDPH) Director and State Public Health Officer Dr. Erica Pan and Department of Managed Health Care Director Mary Watanabe. Topics covered included public health updates, health plan coverage requirements and Medi-Cal vaccine coverage.
Under updated California law, health plans and insurance companies regulated by the state, including Medi-Cal, are required to continue covering routine immunizations recommended by the CDPH. This includes vaccines for flu, COVID-19 and RSV. Californians are encouraged to review CDPH’s vaccine recommendations and check with their health plan or insurer if they have questions about coverage. To schedule a vaccine appointment, individuals can contact their health care provider, visit a local pharmacy, or go to MyTurn.ca.gov.
Finally in California, on September 26, Gov. Gavin Newsom (D) signed AB 260 (Chapter 136, Statutes of 2025), legislation related to sexual and reproductive health care. NACDS is sharing this as information for members as there are provisions in the newly enacted law related to “pharmacists”.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
The Department of Health issued a statement declaring that pharmacists, interns and technicians with immunization authority should follow the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) guidelines to administer COVID-19 vaccines. The following bulletins were also published:
- 9-12-25 Transmittal 25-22- DC Healthcare Alliance Medical and Pharmacy Services Transition from Managed Care to Fee-for-Service that was effective October 1. (rx volume approximately 11,000 fills)
- 9-10-25 Transmittal 25-21 – Notice of Intent to Discontinue Coverage of OTC COVID-19 Testing Kits that was effective October 1.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Effective September 30, the state minimum wage increased to $14.00 per hour. Florida employers are permitted to take a tip credit of up to $3.02 per hour for tipped employees. Beginning September 30, the minimum hourly cash wage rate for eligible tipped employees is $10.98.
In accordance with the amendment, the minimum wage is set for annual increases on the path to a $15.00 minimum wage by September 30, 2026. The requirement applies to both public and private employers, regardless of size.
In addition to increasing pay, Florida employers also face posting obligations to reflect the new amounts. The new posters that comply with the posting requirement are available online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
In accordance with Public Act 104-0027, the Department of Healthcare and Family Services (HFS) is implementing a major update to the Critical Access Pharmacy (CAP) program. Effective January 1, 2026, the revised CAP program will consolidate the two existing initiatives into a single, streamlined model. See Provider Notice Issued 09/29/2025 for details. To minimize confusion during the transition, the Department has established a dedicated email address for all CAP-related inquiries.
Also in Illinois, the WIC [Special Supplemental Nutrition Program for Women, Infants and Children] program does not anticipate any disruption to its operations in the event of a federal government shutdown. The program continues to have funds available for food, and vendors should expect no issues with selling WIC products and receiving payment. As of October 1, 2025, businesses should proceed as usual for all Illinois WIC transactions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Iowa Insurance Division (IID) released Bulletin 25-06 RE: Prohibited Use of Deceptive and Unfair Practices and Implementation of SF 383.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
On September 19, the Department of Health issued Advisory 278 that includes a statewide COVID-19 vaccination standing order authorizing qualified healthcare professionals, including pharmacists, to administer COVID-19 vaccinations using the most current evidence-based guidelines developed by the American Academy of Pediatrics (AAP), American Academy of Family Physicians (AAFP), and American College of Obstetricians and Gynecologists (ACOG) as standards, and exercise reasonable medical judgment in vaccinating their patient. Please see these additional resources for more information:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
Medicaid has issued bulletin MMP 25-44, removing the pharmacy copayment for drugs used to prevent Human Immunodeficiency Virus (HIV) (Pre-Exposure Prophylaxis [PrEP] & Post-Exposure Prophylaxis [PEP]).
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services posted the Injectables fee schedule effective October 2025.
Also in Nebraska, the Department of Health and Human Services posted the October 28 agenda for Drug Utilization Review (DUR) Board.
Finally in Nebraska, the state’s Medicaid Drug Utilization Review (DUR) Board is currently seeking nominations for physicians and pharmacists to serve on the Medicaid Drug Utilization Review (DUR) Board. Board members are required to serve a three-year term with a three-year renewal opportunity. Meetings are held at least quarterly and no more than six times a year (every two months). All interested applicants are required to submit an application.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The NYRx, the Medicaid Pharmacy Program, posted the following updates effective October 1:
Also in New York, the NYRx Education & Outreach team posted NYRx Formulary Update: Xifaxan®. Effective October 1, Salix Pharmaceuticals, the manufacturer of Xifaxan®, discontinued participation in the Medicaid Drug Rebate Program. Xifaxan will no longer be covered by NYRx, the Medicaid Pharmacy Program. Prior authorization will not be available for this medication.
Also in New York, NYRx also provided an NYRx Notice to Prescribers and Pharmacies: tretinoin 0.08% micro gel pump, a non-preferred product. The maximum quantity that can be dispensed for tretinoin 0.08% micro gel pump is 50 grams per 30-day supply. 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.
Also in New York, on September 24, the NY State Education Department (NYSED) proposed the changes for implementation of the Shared Pharmacy Services law passed in 2024 as recently published in the State Register (see pages 12-15). A 60-day public comment period will run until November 23.
Finally in New York, the Office of Health Insurance Programs of the New York State Department of Health has approved the release of the August 2025 Medicaid Update. Relevant topic includes New York State Medicaid Coverage for COVID-19 Vaccinations Administered by Providers.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
The Department of Health and Human Services announced Standing Orders issued by State Health Director Dr. Larry Greenblatt to allow pharmacists at retail locations to test and treat for influenza. Since October 1, pharmacists across the state are able to test for the influenza virus and then immediately treat with the appropriate medications to reduce severity of illness, when appropriate, as authorized under HB 67.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The North Dakota State University (NDSU) Center for Immunization Research and Education (CIRE) will be hosting a webinar, titled “Vaccine Communication in an Age of Polarization” on October 23 from 12:00 noon -1:00 pm CT. This activity has been approved for the following FREE credit:
- 1 AMA PRA Category 1 Credit™ through the Minnesota Medical Association (CME credit)
- 1 contact hour of continuing pharmacy education credit through CEimpact for pharmacists and pharmacy technicians
To access additional webinar resources from NDSU CIRE, visit Science to Practice: Protecting Children from Respiratory Viruses in 2025-2026.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Effective October 1, the quarterly supplemental dispensing fee that has been paid to retail pharmacies in Ohio since 2020 ended and became part of the claim-based dispensing fee structure. This resulted in a 9.6% dispensing fee increase for managed care pharmacy claims under the Single PBM. The increases range from $0.78 to $1.06 across the three dispensing fee tiers. Gainwell’s Frequently Asked Questions: Managed Care Pharmacy Dispensing Fees (October 2025 Update) provides further details. You can also utilize the dispensing fee lookup dashboard to check pharmacy tier designations and determine a location’s new dispensing fee.
Also in Ohio, Gainwell issued the following announcement: On October 1, 2022, Gainwell Technologies became the Single Pharmacy Benefit Manager (SPBM) for the Ohio Department of Medicaid (ODM). ODM only covers drugs that are part of the Medicaid Drug Rebate Program, with limited exceptions.
ODM was recently notified that drug manufacturer, Bausch Health, has decided to no longer participate in the Medicaid Drug Rebate Program. This means that medications made by this manufacturer will no longer be covered by Ohio Medicaid, effective November 1, 2025. The most common medications affected include: Aplenzin, Xifaxan, Relistor, Siliq, Jublia, and Trulance.
The manufacturer of these medications has extended coverage for selected drugs for Medicaid enrollees through their Patient Assistance Program. This program may provide the prescribed medication at no cost to your patient. More information about this option can be found at the following website: https://www.bauschhealthpap.com.
Prescribers also have the option to select an alternative covered medication from the Ohio Medicaid Unified Preferred Drug List (UPDL), found at: https:\\spbm.medicaid.ohio.gov. Select ‘Reference Material,’ then ‘Drug Coverage,’ and then ‘UPDL effective 10.01.2025’ and/or ‘OH SPBM Medical Necessity Policy.’
Affected Medicaid enrollees and prescribers have been notified of these changes. They may contact you, as their pharmacy provider, for additional guidance in navigating this change. We are providing this notification as a courtesy so that you are aware of the changes and recommended course of action to best help your patients. Thank you for your willingness to assist in this capacity.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda for the October 15 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Also in Oregon, the Oregon Health Authority Health Systems Division: Medical Assistance Programs issued a Notice of Proposed Rulemaking to amend rules to provide updates to Health Related Social Needs (HRSN) services covered in the Oregon Health Plan. Please note opportunities for food retailers related to Fruit and Vegetable Benefit Card, Fruit and Vegetable Box and Pantry Stocking Benefit. A hearing will be held on October 15 from 1:00 pm-1:45 pm. The last day and time to offer comments to the agency is October 21 at 5:00 pm.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.