Indiana
Gov. Mike Braun (R) signed into law SB 140, PBM reform legislation establishing commercial reimbursement floors. The bill, effective January 1, 2026, requires reimbursement not less than the greater of the reimbursement level paid to PBM-owned or affiliated pharmacies, one of the following reimbursement methodologies depending on whether pharmacies hold permits to sell liquor. For pharmacies not holding permits to sell liquor, the reimbursement floor is NADAC, plus the professional dispensing fee from the Medicaid fee-for-service program. For pharmacies holding permits to sell liquor, the rate floor will be the actual acquisition cost (AAC) plus a “fair and reasonable” dispensing fee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kansas
The Department of Health and Environment issued two bulletins for paying pharmacists for services. The Stand-Alone Vaccine Counseling and Pharmacists bulletin authorizes pharmacists to provide and bill for vaccine counseling services for patients under the age of 21 years, retroactive to April 1, 2025. The Pharmacist as Provider, Emergency Opioid Antagonists and Medication Therapy Management adds payment for the extra counseling required when pharmacists dispense emergency opioid agonists (EOA) using the statewide protocol, commonly referred to as the naloxone protocol. This should be billed with the date of service dispensed and counseled, retroactive to January 1, 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maine
The Joint Committee on Appropriations and Financial Affairs met daily the week of May 12 for budget work sessions. The Chairs have yet to bring up the pharmacy tax. The bill remains pending before the joint committee. NACDS, working with the Maine Pharmacists Association and Retail Association of Maine, helped advocate against a potential "compromise" that would have exempted the independent pharmacies from the tax. While being fundamentally unfair, that compromise would have negated the federal match, eliminating the tax's utility. NACDS will continue to lobby the Governor's office and the legislature throughout the budget process. The bill must be moved by the Joint Appropriations Committee and approved by both chambers of the legislature. The fiscal year ends June 30.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Minnesota
As the General Assembly enters its last week of the session, both the House and Senate have passed our priority PBM reform language in their respective health omnibus bills, HF 2435 and SF 2669. The bills are now on their way to conference committee to hammer out differences. (HF 2435/SF 2669). The provisions would reform the Medicaid pharmacy program under a single state-directed pharmacy benefit administrator. The bills require a rate floor of AAC + $11.55 and include prohibitions on questionable PBM business practices. Also included is a provision changing the cost of dispensing study frequency from every three years to biannually.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New Hampshire
On May 21, the Board of Pharmacy will hold its regular monthly meeting. The agenda includes the following:
- NABP Update
- Administrative Rules and Legislative Topics
- Hearings
- Office of Professional Licensure and Certification (OPLC) Updates
- Memo from Executive Director Deanna Jurius
- 50 State Drug Compounding Meeting June 4-5
- Public Comments
- Board of Pharmacy Research Organization Registration
- NH Program Flyer
- PH 300 Public Comment
- Non Public Session
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New Jersey
On May 15, the New Jersey Assembly Committee on Financial Institutions and Insurance held a hearing. During this hearing, the committee received testimony from invited guests concerning pharmacy benefit managers, their place within the broader health insurance system and their impact on prescription drug prices. The invited speakers included Dr. Pragya Kakani, Assistant Professor of Population Health Sciences, Well Cornell Medical College, and Anna Kaltenboeck, President, Verdant Research. They spoke about the PBM relationships with affiliated and unaffiliated pharmacies and the FTC reports. NACDS attended the hearing and will continue to support PBM reform efforts in New Jersey.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
The legislative session has reached the crossover deadline, the point by which bills must pass their chamber of origin to remain viable this session. Bills that did not meet this deadline are ineligible for carryover to 2026. However, the crossover rule does not apply to budget and appropriations bills, study bills, local bills or constitutional amendments.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
NACDS sent Gov. Kevin Stitt (R) a letter asking him to sign SB 806, the Food is Medicine bill that would improve access to essential nutrition services for Medicaid beneficiaries and incentivize improvements in their health, utilizing an 1115 waiver.
Also in Oklahoma, SB 789 was amended in the House removing the rate floor language that triggered the fiscal note, and returned to the Senate for concurrence.
Finally in Oklahoma, SB 906, legislation that empowers pharmacists to optimize the pharmacy technician workforce and delegate more administrative and technical activities that do not require a pharmacist's by expanding the pharmacist-to-pharmacy technician ratio to 4:1, passed both houses and was sent to Gov. Kevin Stitt (R). NACDS sent a support letter asking Gov. Stitt (R) to sign the bill into law.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Immunization Policy Advisory Team (IPAT) meets June 5 from 12:00 noon -2:00 pm Pacific via Zoom and requires registering in advance using this link. The final agenda will be available at the meeting or via email request three days before the meeting date by contacting imm.info@odhsoha.oregon.gov. The Immunization Program works to reduce the incidence of vaccine-preventable disease in the state. Staff members identify and promote evidence-informed public health best practices to both the public and healthcare professionals throughout the state. For more information, visit the program's website.
Also in Oregon, the Oregon Healthcare Authority (OHA) seeks help to make healthcare more affordable. Oregonians are invited to submit applications to serve on two new committees focused on healthcare affordability. May 16 is the extended deadline to apply for both committees. Applications and more information are available on the Committee on Health Care Affordability and Industry Advisory Committee webpages. Once their members are chosen, the committees plan to meet beginning this summer.
The Committee on Health Care Affordability, also simply called the Affordability Committee, is seeking diverse voices. Its members may include people who receive health care, employers that purchase insurance, health economists and health policy experts.
The Affordability Committee will be supported by the Industry Advisory Committee, which also aims to include a variety of perspectives, ranging from health insurers to providers, hospitals and health industry leaders. Health care professionals in small or independent practices, and those who specialize in primary care, behavioral health, oral health or pediatrics are particularly encouraged to apply to the industry committee.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The General Assembly has adjourned, with plans to reconvene in June to address appropriations bills, gubernatorial vetoes and legislation advancing from conference committees. All bills left on the calendar will carry over to the 2026 legislative session, including NACDS reimbursement reform and scope expansion.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Several bills of interest to pharmacy are advancing in the final three weeks of the biennial session:
- SB 1236 (HB 3317), PBM reform legislation that provides contract protections for pharmacies. The bill provides fairness and transparency, requires that a group number identifying the plan be on the enrollee's identification card, provides audit protections and ensures compliance with existing laws. The bill passed both houses and is on its way to Gov. Greg Abbott (R).
- HB 3540 (SB 254) permanently authorizes pharmacists to order and administer all childhood vaccines to individuals five years of age and older (three years of age and older for flu & COVID) and allows pharmacists to delegate vaccine administration to a certified technician. Physicians, pediatricians and pharmacies reached a compromise. The bill is supported by the Texas Medical Association, the Texas Pediatric Society and all pharmacy groups. The bill is on the House calendar this week. More than a dozen pharmacists from Albertsons, Brookshire Brothers, Kroger and Walgreens spent all-day Tuesday advocating for the immunizations bill and distributing the joint HB 3540 one-pager on the agreed-to bill. The chain pharmacists helped field questions and count votes.
- HB 1027, legislation aimed at increasing access to pharmacies in underserved areas, would remove the current mileage restrictions on telepharmacies and also repeals provisions that prohibit a telepharmacy system located at a remote dispensing site from dispensing a Schedule II controlled substance. The bill passed the House and was referred to be considered next by the Senate Health and Human Services Committee.
Also in Texas, Albertsons pharmacist Rob Gagliardi, who also serves as the Bedford Mayor Pro Tem, connected with his friend Rep. Tony Tinderholt (R), the influential Floor Leader for the House Republican Caucus.
Also in Texas, the Health and Human Services Commission (HHSC) is interested in quality improvement and value-based payment initiatives for Medicaid and other publicly funded health services. HHSC is seeking a pharmacist to serve on the Value-Based Payment and Quality Improvement Advisory Committee. The Texas Health and Human Services Commission executive commissioner will appoint members to the committee to serve a term expiring December 31, 2028. Applications are due by 11:59 pm, May 23. More information is available on the website.
Finally in Texas, the Board of Pharmacy (TSBP) approved rules exempting central fill pharmacies from the 6:1 pharmacy technician-to-pharmacist ratio at the May 6 board meeting. The rules take effect immediately after publication in the Texas Register.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
NACDS sent Gov. Bob Ferguson (D) a letter asking him to veto a surcharge on prescription medications in Section 201 of HB 2081 due to its detrimental impact on pharmacy operations and patient care. This new proposed tax does not apply to retail sales of prescription drugs exempted in current law.
Also in Washington, the State Department of Health held a Sunrise Review public hearing on May 14 on pharmacist prescriptive authority. The Senate Health and Long-Term Care Committee had requested a review of a proposal to increase the pharmacist scope of practice to assess whether it meets the sunrise criteria in RCW 18.120.010. The request would grant the Pharmacy Quality Assurance Commission the authority to regulate licensed pharmacist prescribing outside of a collaborative agreement. NACDS and many other groups submitted written comments for the record in advance of the hearing.
Finally in Washington, the Washington Health Care Privacy Toolkit has been updated with new information, including 2024 updates to reproductive health privacy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
It is time again for the Payment Error Rate Measurement (PERM) Cycle for Medicaid Pharmacy providers. CMS collaborates with a vendor to conduct PERM retrospective reviews (i.e., audits) on Medicaid claims, and they are beginning their reviews on our program. Of note:
- The Payment Error Rate Measurement (PERM) program, authorized by CMS, has begun its reviews for Review Year (RY) 2026.
- The Payment Error Rate Measurement (PERM) program measures improper payments in the Medicaid and the State Children's Health Insurance Program (SCHIP) and produces state and national-level error rates for each program.
- PERM RY2026 will review claims from July 1, 2024, to June 30, 2025.
- Empower AI, Inc. is the Review Contractor (RC) for PERM RY2026, and providers will be contacted by representatives from Empower AI, Inc. Providers must respond to all Medicaid Record Requests (MRRs) from the RC. MRRs have begun as of May 5, 2025.
- All PERM questions from Medicaid's providers should be referred to the PERM Program Manager, Faith Pedro at (334) 242-5346 or Faith.Pedro@medicaid.alabama.gov.
The Department respectfully asks that pharmacy providers respond to ALL PERM REQUESTS in a timely manner, as this is a mandatory review; Medicaid is 'graded' on our providers' response rates.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The May 2025 issue of the Board of Pharmacy's newsletter, The Script, is now published online. The newsletter includes information on the following:
- New PIC training online seminar
- Ensuring consumers receive medication (BPC 733)
- Online portal for drug thefts and loss
- SB 339: emergency to permanent regulation
- How to support future licensees through donating to a scholarship fund
- Wholesaler Thresholds
- Becoming an inspector
- CURES fee increase
- Tribal health professionals' exemptions
Previous newsletters can also be viewed and downloaded. Go to the "Quick Hits" column at www.pharmacy.ca.gov and click on The Script-Archive to find electronic issues of The Script published since October 1998.
Also in California, the Board of Pharmacy published an update on medication error reporting. 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 can be viewed here: BPC section 4113.1. In September 2024, the Board approved the Institute for Safe Medication Practices (ISMP), an ECRI Company, as the entity to receive and review medication error reports under BPC section 4113.1.
Pursuant to BPC section 4113.1, "community pharmacy" includes any pharmacy that dispenses medication to an outpatient, including both resident (PHY and PHE) and nonresident (NRP) pharmacies, but does not include facilities of the Department of Corrections and Rehabilitation. Additionally, outpatient hospital pharmacies are not required to report a medication error under BPC section 4113.1 if the error meets the requirements of an adverse event that has been reported to the State Department of Public Health pursuant to section 1279.1 of the Health and Safety Code.
A community pharmacy shall submit the report no later than 14 days after the date of the error's discovery. The community pharmacy shall maintain records demonstrating compliance with this requirement for three years and shall make these records immediately available at the request of a Board of Pharmacy inspector.
ISMP, as the Board-approved entity, sent a postcard to community pharmacy licensees the week of April 21 with information about how to register with ISMP's California medication error reporting program. Registration can be completed using this website: https://mederrors.ismp.org/. If you experience any technical issues when signing up for California's medication error reporting program through ISMP, please email clientservices@ecri.org. Licensees are encouraged to register by May 24. The online reporting system will be available to submit reports in early June 2025. You will receive a follow-up email from ISMP in early June 2025 with a link to the user registration page of the online reporting system.
FAQs regarding medication error reporting are available online.
Finally in California, the Department of Health Care Service posted the following weekly notices, alerts, and monthly bulletin on the Medi-Cal Rx Web Portal.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
NACDS submitted comments to the Board of Pharmacy in support of proposed rules eliminating the current maximum pharmacy technician-to-pharmacist ratios across various pharmacy settings. Instead, the proposed rules would allow supervising pharmacists to determine the number of technicians under their oversight, thereby enabling pharmacies to optimize the use of pharmacy technicians to perform technical and administrative tasks and allowing pharmacists to dedicate more time to direct patient care.
Also in Florida, the State Legislature has passed a concurrent resolution to extend the Legislative Session until 11:59 pm on June 6, in accordance with Section 3(d), Article III of the State Constitution. All other measures in both houses were indefinitely postponed and withdrawn from consideration of the respective House as of 12:00 am on May 3. The Legislature will only be considering bills related to the budget during the extension. Senate President Ben Albritton (R) issued a statement on the 60th day of the 2025 legislative session, announcing that the Senate has developed "a framework for a budget plan and a tentative schedule to move forward" in agreement with the House. As part of this agreement, the Senate and House are proposing a historic $2.8 billion in tax relief. The Legislature is expected to return to Tallahassee the week of May 12 to hash out differing ideas about the spending plan for the coming fiscal year.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
The Pharmacy Practice Act allows pharmacists in the state to provide PrEP (pre-exposure prophylaxis) under a standing order issued by either an Illinois-licensed physician or the Illinois Department of Public Health (IDPH). IDPH has now issued said standing order, along with a corresponding press release. In accordance with the law and the standing order’s protocols, pharmacists are required to complete specific training. Additionally, IDPH will monitor and collect data on the program’s utilization. For patients, IDPH has established this website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services, Iowa Medicaid posted INFORMATIONAL LETTER NO. 2685-MC-FFS-D – June 2025 Iowa Medicaid Pharmacy Program Changes effective June 1.
Also in Iowa, Gov. Kim Reynolds (R) announced the US Department of Agriculture Food and Nutrition Service approved a demonstration project for the state's own summer food pilot program. Healthy Kids Iowa is an alternative to the summer EBT program that serves Iowa children healthier foods at a lower cost by leveraging Iowa's already-existing, successful network of summer feeding programs and community providers. With the state's summer feeding demonstration project, each family will be able to select $40 worth of fresh and nutritious food for each eligible child per month. Families will be able to choose their monthly items, respecting their preferences and cultural and dietary needs. The Healthy Kids Iowa pilot program will run in June, July and August 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maine
On May 1, the Joint Committee on Appropriations and Financial Affairs held another budget work session, that was called on short notice. The Chairs never brought up the pharmacy tax, nor moved the budget. The bill remains pending before the joint committee. NACDS, working with the Maine Pharmacists Association and Retail Association of Maine, helped advocate against a potential “compromise” that would have exempted the independent pharmacies from the tax. While being fundamentally unfair, that compromise would have negated the federal match, eliminating the tax’s utility. NACDS will continue to lobby the Governor’s office and the legislature throughout the budget process. The next legislative work session for the Joint Committee on Appropriations and Financial Affairs was May 8. The bill must be moved by the Joint Appropriations Committee and approved by both chambers of the legislature. The fiscal year ends June 30.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Massachusetts
On April 29, the Joint Committee on Financial Services heard both H1091 and S800, Acts Relative to Pharmacists as Health Care Providers. These bills would authorize the Department of Public Health to allow pharmacists to order, test, screen and treat patients. H1091 and S800 would also require pharmacies to be reimbursed for services. NACDS submitted testimony and will continue to support the bill throughout the legislative session which ends July 31, 2026.
Also in Massachusetts, the Board of Pharmacy released three updates:
Policy 2025-01: Rapid Microbial Methods (Rapid Sterility Testing)
Outlines general considerations and requirements for compounding pharmacies contemplating the use of an alternative sterility testing method.
Addresses non-resident Designated PIC absences and departures.
Pharmacies can order take-back envelopes and access other information on this website.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Nebraska
The Department of Health and Human Services (DHHS), Division of Medicaid and Long-Term Care (MLTC) is seeking individuals to serve on the Medicaid Advisory Committee (MAC). The MAC has a broad focus and includes a diverse range of stakeholders, including healthcare providers, community organizations, advocates and policy experts. The MAC advises the Medicaid agency on overall policy development and program improvements. For the MAC, the MLTC is seeking healthcare providers, community-based organizations, tribal representatives, public health professionals, social service providers, advocates and others with insight into the Medicaid system. To learn more or apply, explore the following online resources:
- Learn more: https://dhhs.ne.gov/Pages/MAC.aspx
- Apply now: https://dhhs.ne.gov/Documents/MLTC-39.pdf
Also in Nebraska, the Department of Health and Human Services (DHHS) recently sent out its first issuance of Summer Electronic Benefit Transfer (EBT) benefits. Throughout the 2025 Summer EBT period, households with eligible school-age children can receive assistance in buying groceries with the program's second year of operation. A one-time payment of $120 will be issued for each eligible child, intended to cover the three summer months at $40 a month. Eligible families will have 122 days, or four months, to use Summer EBT benefits. Summer EBT benefits can be used to purchase food at grocery stores, online food retailers, and farmer's markets that accept SNAP EBT.
Finally in Nebraska, Gov. Jim Pillen (R) signed LB 168, the 340B Contract Pharmacy Protection Act, legislation prohibiting any manufacturer from either directly or indirectly, denying, restricting, or prohibiting the acquisition of any 340B drug by or delivery of any 340B drug to any authorized 340B location.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
North Dakota
Gov. Kelly Armstrong (R) signed several bills of interest into law including HB 1087, legislation replacing “certificate of authority” requirement for PBMs with a “licensure” requirement; HB 1584, legislation outlining requirements for licensure of PBMs; creating a PBM enforcement fund, strengthening enforcement of PBM laws and regulations and establishing penalties for PBMs found in violation of laws and regulations; and HB 1473, legislation prohibiting any manufacturer from either directly or indirectly, denying, restricting or prohibiting the acquisition of a drug by a contract pharmacy and from interfering with the ability of a covered entity or contract pharmacy to dispense a drug to an eligible patient of the covered entity.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
On May 5, NYRx issued a notice NYRx Helpful Hints for Pharmacies: Diabetic Testing Supplies.
Diabetic Test Strips and Lancets: NYRx coverage of preferred blood glucose test strips and lancets for members with diabetes aligns with Medicare Coverage of Diabetes Supplies.
Pharmacies must submit claims based on units per days' supply as follows:
- Members who use insulin: Maximum 300 test strips and lancets per 90-day supply
- Members who do not use insulin: Maximum 100 test strips and lancets per 90-day supply
Continuous Glucose Monitors and Disposable Insulin Pumps: Continuous Glucose Monitors and Disposable Insulin Pumps should be billed at the pharmacy point-of-sale for the proper quantity and days' supply as outlined on the product label.
What Pharmacies Need to Do: The pharmacy should become familiar with the NYRx Preferred Diabetic Supply Program. When submitting claims for preferred diabetic supplies do not request a PA (prior authorization) from the prescriber if the claim rejection states one of the following:
- Maximum Quantity Exceeded
- Early Fill Overuse
- Recipient Ineligible on Service Date
- Refill Number Exceeds Maximum
- Therapeutic Duplication
- Client Has Medicare Part D or Client Has Other Insurance
- Coordination of Benefits Claim Processing
- NYRx is always the payor of last resort and federal regulations require that all other available resources be used before NYRx considers payment.
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.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Oregon
The Board of Pharmacy announced the agency’s new director, Dr. Gary Runyon, PharmD, a graduate of the University of Tennessee College of Pharmacy. Gary brings over 22 years of diverse pharmacy experience to Oregon, where he relocated in late 2020. Gary joined the Board of Pharmacy as a Compliance Officer, then transitioned to the Pharmacist Consultant position before becoming Executive Director effective April 14.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
NACDS submitted comments to the Senate Banking and Insurance Committee ahead of its hearing on SB 342, which includes several NACDS priorities related to reimbursement reform. As this marks the first session of a two-year legislative term, NACDS expects to continue advocating for this and related legislation throughout the summer and fall in preparation for the 2026 session.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Virginia
Virginia Pharmacies had a remarkable win in Virginia, when Gov. Governor Glenn Youngkin (R) signed our Medicaid PBM reform bill, HB 2610, after initially vetoing it and replacing it with a study. NACDS and VACDS were present on the ground in Richmond throughout the process, working with members and partners to pull every lever to secure a final victory. T NACDS issued a press release to praise Gov. Youngkin’s signature, and the legislature’s willpower, that led to the enactment of Virginia’s “single PBM” bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.