Delaware
The Board of Pharmacy held its monthly meeting on May 21. The agenda included:
- President's report from Dr. Coffield
- Executive Director's Report
- Committee Reports
- Legislative Committee Report
- Professional Liaison Reports
- Vincent Madaline, PharmD
- Controlled Substance Liaison Report
- Inspection Report from Pharmacist Compliance Officer- Matthew Moritz, PharmD
- PMP Report from Pharmacist Administrator- Jason Slavoski, PharmD
- Pharmacist/Pharmacy Ratification Listing
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Florida
The Senate Budget Chairs have continued productive discussions with the House regarding joint budget allocations. However, the budget conference will not begin next week. Senators have been informed that they will not need to return to Tallahassee before Memorial Day.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
Gov. Brian Kemp (R) has signed HB 196 into law. This legislation reforms how the State Health Benefit Plan and University System Benefit Plan reimburse pharmacies for self-administered drugs. Effective January 1, 2026, the law will require a transparent pricing model and set fair dispensing fees. The legislation also closes loopholes by prohibiting insurers from skirting these requirements through discount programs and arms the Insurance Commissioner with the authority needed to enforce these vital protections.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Louisiana
The new Secretary of the Department of Health (LDH), Bruce Greenstein, announced that LDH will transition away from the single PBM that the previous administration adopted in October 2023. Citing the closures of independent and chain pharmacies that threaten patient access, the Secretary is launching a new approach to the pharmacy Medicaid program to reduce the middleman's impact. LDH pledged to work closely with pharmacists and managed care organizations (MCOs) to ensure the best approach to managing pharmacy benefits and operate a pharmacy program that ensures access, controls expenses and safeguards the financial stability of the state's Medicaid system.
Also in Louisiana, the Council on Medicaid Reimbursement, on which NACDS has a designated seat, held the Council's monthly meeting on May 22. In addition to the regular agenda, LDH staff fielded questions on why they transitioned away from the single PBM.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
The State Senate debated the state budget legislation, which did not include the Governor’s proposed $2.00 per prescription tax. The budget is now moving to conference committee, having passed the House last month. The legislature will likely finish its work next month. Since neither chamber considered the tax, it cannot be included in the final budget bill.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Missouri
The General Assembly adjourned on May 16.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services (DHHS) sent out its second 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 during 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.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
A678/S3236, legislation that allows pharmacy technicians to practice in any pharmacy under the supervision of a pharmacist, has been passed by both chambers. The bill now moves to the Governor for signing. NACDS and the Community Pharmacy Association of New York have advocated for this bill all session, having directly lobbied both chambers and the administration.
Also in New York, the State Department of Health held its monthly pharmacy call to discuss NYRx, the New York state Medicaid pharmacy benefit program. The agenda included two items: a change in covered diabetic supplies (see below) and a reminder that electronic prior authorizations will start this summer through CoverMyMeds.
- As a reminder, NYS Medicaid is the payor of last resort and providers are required to bill all applicable third-party payors before Medicaid. For additional information about the coordination of benefits, refer to NYRx Third Party Liability and Coordination of Benefits.
- If a member cannot switch from a LifeScan product to a Preferred Diabetic Supply, the pharmacy can request a review of the claim for payment by NYRx by following the steps outlined below. Consideration will be made if there are formulary limitations with the primary payor and it is not possible to switch the member to a preferred product.
- The pharmacy provider may fill out this form and submit it to eMedNY Claims Processing for review. Responses will be faxed back to the pharmacy within three business days. Providers may also call the eMedNY Call Center at 1-800-343-9000 to request a review of the claim.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
North Carolina
NACDS and representatives from member companies met with Senate and House leadership in North Carolina to advocate for key priorities related to PBM reform, with a focus on SB 479 and HB 163. In addition, we participated in the NC Retail Merchants Association Spring Legislative Reception.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oklahoma
Gov. Kevin Stitt (R) signed into law two bills of importance to pharmacies:
- SB 806, the Food is Medicine bill, will improve access to essential nutrition services for Medicaid beneficiaries utilizing an 1115 waiver.
- SB 906, legislation enhancing pharmacies' capacity to deliver essential pharmacy care services by increasing the current restrictive pharmacy technician to pharmacist ratio in retail pharmacies from 2:1 up to 4:1.
Also in Oklahoma, Gov. Stitt (R) vetoed SB 773, legislation pharmacies supported that would give the Attorney General (AG) greater enforcement authority. In his veto message, the Governor accused the Attorney General of trying to grow his office and expand his authority, and that "he has shown again and again that he will abuse it".
Also in Oklahoma, Gov. Stitt (R) selected, and the Senate officially confirmed the appointment of Walmart pharmacist, Shannon Griggs, to serve a five-year term on the Board of Pharmacy, succeeding Mark St. Cyr.
Finally in Oklahoma, SB 789 that was amended in the House removing the rate floor language that triggered the $28M fiscal note, passed the Senate on May 21. The bill provides network transparency and reimbursement appeal protections. It was sent to the Governor's office.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
A record 9.7% of kindergartners claimed nonmedical exemptions from the state's school vaccination requirements for the 2024-2025 school year, the highest rate ever recorded, Oregon Health Authority announced. The increase continues an upward trend from 8.8% in 2024, when Oregon had the fourth-highest nonmedical exemption rate in the United States, behind Idaho, Alaska and Utah, according to the Centers for Disease Control and Prevention (CDC). National data for the current school year are not yet available.
Also in Oregon, effective May 21, the Oregon Health Authority amended prior authorization (PA) criteria implementing recommendations from Drug Utilization Review (DUR) / Pharmacy & Therapeutics (P&T) Action. The Authority needed to implement changes to the Preferred Drug List and Prior Authorization Criteria to ensure the safe and appropriate use of cost-effective prescription drugs for the Oregon Health Plan's fee-for-service recipients, based on the P&T Committee recommendations.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
South Carolina
The Senate Subcommittee Hearing originally scheduled for May 7 has been rescheduled to May 28 at 10:00 am in the Gressette Building, Room 308. NACDS has submitted a support letter for this pivotal legislation for meaningful PBM reform.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
SB 1236, PBM reform legislation that provides fair and transparent contract protections for pharmacies, requires that a group number identifying the plan be on the enrollee's identification card, audit protections and ensures compliance with existing laws, passed unanimously approved by both houses and sent to Gov. Greg Abbott (R) to sign into law.
Also in Texas, the House passed HB 3540 (SB 254), a bill that 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. The bill is supported by the Texas Medical Association, the Texas Pediatric Society and all pharmacy groups. It was referred to the Senate Health and Human Services Committee awaiting a hearing.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
The Pharmacy Quality Assurance Commission met on May 22. The meeting materials are available online. There was a discussion on the Commission waiving certain staffing rules allowing out-of-state pharmacists and technicians to remotely aid in the transfer of Rite Aid and Bartell’s prescriptions. The next meeting is scheduled for June 26.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alaska
Legislation that would expand access to care by giving pharmacists independent authority establishing a standard of care model allowing pharmacists to fill urgent care gaps by providing patient care services is pending in both the House and Senate. SB 147 was approved by the Senate Labor and Commerce Committee last week, and it was referred to the Finance Committee. HB 195A is awaiting a hearing in the House Labor and Commerce Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Service posted the following weekly notices on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap up for May 2-8.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Prior to the General Assembly adjourning on May 7, lawmakers passed several bills of interest to pharmacies, including:
- HB25-1094, governing PBM practices – Allowing a PBM to earn income derived from a flat-dollar service fee assessment and prohibits a PBM from earning income based on the cost of a prescription drug; prohibiting a PBM from designing a formulary to favor a certain branded pharmaceutical or biologic; requiring a PBM to credit income from a source other than a flat-dollar service fee to a health insurance carrier or a self-funded health benefit plan beneficiary; setting the amount that a PBM shall reimburse an unaffiliated pharmacy or a PBM-affiliated retail, mail order or specialty pharmacy for a prescription drug; and requiring a PBM to make certain documents and data available to a carrier, a self-funded plan or the insurance commissioner upon request and authorizing the health benefit plan to execute an audit to validate compliance with the contract.
- HB25-1222, the bill's rate floor and telepharmacy provisions only apply to independent pharmacies, passed out of both houses on May 1. For the purposes of this bill, "rural independent pharmacies" are defined as a drug outlet that is privately owned by at least one licensed pharmacist with no ownership interest by or affiliation with a chain pharmacy or a publicly traded prescription drug outlet. The bill will reimburse independents not less than NADAC, plus pay a dispensing fee. It also includes audit protection provisions, and it exempts independent pharmacies from the direct supervision rule if the initial interpretation and final evaluation of the prescription are done by a pharmacist in person or remotely.
Finally in Colorado, SB25-045, legislation that requires school of public health to analyze model legislation for implementing a single-payer, nonprofit, publicly financed, and privately delivered universal health-care payment system for Colorado that directly compensates a provider. A report detailing its findings must be submitted to the General Assembly by December 31, 2026. The bill creates the Statewide Health Care Analysis Collaborative under the Department of Health Care Policy and Financing (HCPF) to assist the university in its report.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Connecticut
On May 12 and 13, the General Assembly procedurally moved SB 11 and HB 7192 through their respective committees. This legislation came out of the bi-cameral, bi-partisan Prescription Drug Taskforce that began last fall. Amongst the provisions, HB 7192 would provide that PBMs owe a fiduciary duty to health carriers; prohibit a PBM to charge a health plan a contracted price that differs from what the PBM pays the pharmacy for the services; expand the contents of the insurance commissioner’s annual report on health carrier rebates to include certain information on how rebates affected cost sharing; and require the insurance commissioner to require carriers to annually report on pricing offered to, and profit generated between, the carrier and any PBM or mail-order pharmacy. NACDS participated in the taskforce and supported both bills during the committee process. NACDS, with the Connecticut Association of Chain Pharmacies, participates with the Connecticut Patients Not PBMs coalition, made up of pharmaceutical companies, patient advocacy groups and pharmacy industry peers. The Connecticut legislative session ends firmly on June 4.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Delaware
On May 21, the Board of Pharmacy will hold its next regular meeting. The agenda includes:
- President’s report from Dr. Coffield
- Executive Director’s Report
- Application Review
- Pharmacist Application Review
- Committee Reports
- Legislative Committee Report 2.
- Professional Liaison Reports
- Controlled Substance Liaison Report
- Inspection Report from Pharmacist Compliance Officer- Dr. Matthew Moritz, PharmD
- PMP Report from Pharmacist Administrator- Dr. Jason Slavoski, PharmD
- Pharmacist/Pharmacy Ratification Listing
- Pharmacist In Charge/Consultant Pharmacist Interviews
- Pharmacist & Pharmacy Discussion /Action Items
- DHSS/DPH Discussion Items
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Idaho
Myers and Stauffer is the vendor contracted to conduct the annual prescription volume survey of pharmacy providers on behalf of the Department of Health & Welfare. In accordance with the Idaho Administrative Code 16.03.09.665.01j, the prescription volume data collected from pharmacies will be used to determine their dispensing fee tier for the following calendar year. Each year, surveys are distributed starting May 1 and will be due by May 31. Providers who fail to participate in the survey will be placed in the lowest dispensing fee tier of $11.51. Below are the current dispensing fee tiers based on Total Annual Prescription Volume:
- Fewer than 40,000 claims: $15.11 dispensing fee
- Between 40,000 and 69,999 claims: $12.35 dispensing fee
- 70,000 or greater claims: $11.51 dispensing fee
Please note that the requested information applies to total pharmacy volume and is not limited to prescription/sales information related to Department of Health & Welfare recipients unless otherwise indicated.
2025 Idaho Prescription Volume Survey
Providers should fill out the survey form for all pharmacy NPIs within their organization that are enrolled with Idaho Medicaid. For providers with 5 or more pharmacy NPIs, please upload via the “multiple store” submission option at the survey link above. For questions or help completing the survey, please contact Myers and Stauffer at pharmacy@mslc.com or toll free at 800-591-1183.
Also in Idaho, Myers and Stauffer is working with the Department of Insurance to conduct a survey of costs incurred by pharmacies to dispense prescription medications to Idaho residents. All pharmacies that dispense prescriptions to Idaho residents are requested to complete the pharmacy dispensing fee survey.
Myers and Stauffer mailed a packet with survey information to pharmacies on April 17. Providers can also access the survey documents and download an electronic version of the survey tool located on the Dispensing Fee Survey webpage.
It is very important that all pharmacies cooperate fully by filing an accurate cost survey. Pharmacies are encouraged to return the requested information as soon as possible, but forms must be returned no later than May 29.
If you have any questions, please call toll free at 1-800-374-6858 or send an email to disp_survey@mslc.com.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
The Department of Healthcare and Family Services released an updated Preferred Drug List.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
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’ Mike Sargent at 207-272-6435.
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.