Minnesota

The Department of Health (MDH) published the March 2025 list of drugs of substantial public interest with a focus on insulin products. It is the second list published as part of the statutory reporting requirement. You can also find it on MDH’s Public Interest Drug Lists webpage along with the Public Interest List Methodology & Summary—March 2025. Reporting entities, including pharmacies, have approximately 90 days to report (notifications will be sent 30 or more days after the list release date; reports are due 60 days after notifications are sent). Data and analysis from this and other Lists of Drugs of Substantial Public Interest will be made available on the Prescription Drug Price Transparency website. For direct updates, subscribe to the Prescription Drug Price Transparency email list. For more information, visit the Prescription Drug Price Transparency website.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

March 20, 2025|Minnesota|

Nebraska

Gov. Jim Pillen (R) signed LB 118, legislation increasing the pharmacist-to-pharmacy technician ratio to permit a pharmacist to supervise any combination of pharmacy technicians and pharmacist interns up to four people. For any pharmacist supervising four pharmacy technicians or pharmacist interns, at least one person must be a certified pharmacy technician.

Also in Nebraska, starting on June 1, Medicaid will no longer accept paper applications for Medicaid provider enrollment. All enrollments can be completed electronically at Maximus’ Nebraska Provider Data Management System  (PDMS) website. For more information about Maximus’ PDMS, call 844-374-5022 or email at nebraskamedicaidPSE@maximus.com. For questions about how to enroll as a Nebraska Medicaid provider, call 402-471-9018.

Also in Nebraska, on March 19, the Department of Health and Human Services updated provider Bulletin 24-22: Coverage of Interpretation Services.

Finally in Nebraska, the Department of Insurance (NDOI) released a PBM-specific complaint form for reporting concerns. The form is reflective of what is in the Pharmacy Benefit Manager Licensure and Regulation Act that was passed in 2022. There is also a free text space for complaints that do not fall into those statutes. It is important to fill out this form completely and then send it to the NDOI via email or mail as follows:

Email: doi.insurancecomplaints@nebraska.gov

Mail: Nebraska Department of Insurance

P.O. Box 95087

Lincoln, NE 68509-5087

Any materials, medical records or documents that are provided at any time in connection with a complaint will be shared with the insurance companies or PBM against whom the complaint is filed, and their counsel. These documents may also be distributed to other parties engaged in a contested case or other matters pending before the Insurance Commissioner.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

March 20, 2025|Nebraska|

Nevada

SB 316, a PBM reform bill that NACDS supports that would require insurers to issue a report to the Insurance Commissioner that includes information regarding prescription cost data to help promote transparency and assess any impact on premiums. The bill also prohibits patient steering to affiliated pharmacies and unfair below cost reimbursements to nonaffiliated pharmacies; ensures any willing pharmacy terms; includes anti-discrimination provisions to protect pharmacy contracting; and subjects PBMs to civil monetary penalties for any violations. The bill is scheduled for a hearing in the Business and Commerce Committee on March 24.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 20, 2025|Nevada|

New York

On March 17, Gov. Kathy Hochul (D) announced the launch of DFS Connect, a new digital program launched by the Department of Financial Services (DFS) that will centralize the Department’s interactions with both regulated entities and consumers and ensure better service to businesses and consumers. Building on the state’s actions to protect New Yorkers from rising drug costs, the initial functions launched today on DFS Connect provide a streamlined and transparent way to file complaints for prescription drug prices that increase more than 50 percent over the course of a year and PBMs. Additionally, individuals can file complaints via mail or by calling the DFS Hotline.

Also in New York, the Office of Health Insurance Programs of the State Department of Health has approved the release of the January 2025 Medicaid Update. Relevant sections are below:

Pharmacy

 All Providers

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

March 20, 2025|New York|

Pennsylvania

It is our understanding that the Governor’s office is close to completing its review of the Pharmacy Technician Registration Final Regulation #16A-5433. We anticipate that if the Governor’s office sends the regulations back to IRRC (Independent Regulatory Review Commission) by April 14, IRRC can finalize them at its May 15 meeting. Following that, it would be published in the Pennsylvania Bulletin as final.

Also in Pennsylvania, the PACE Program issued a update regarding manufacturers who, effective April 14, will no longer have their products reimbursed by PACE (Pharmaceutical Assistance Contract for the Elderly).

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

March 20, 2025|Pennsylvania|

South Dakota

Gov. Larry Rhoden (R) signed SB 154, legislation prohibiting pharmaceutical manufacturers from interfering in contracts between 340B entities and pharmacies and providing a 340B entity or a pharmacy may file a civil action against a pharmaceutical manufacturer for a violation and may request injunctive relief, actual and consequential damages and reasonable attorneys’ fees and costs.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

March 20, 2025|South Dakota|

Tennessee

The Emergency Prescription Assistance Program (EPAP) expires April 1. The Tennessee Pharmacists Association (TPA) recently learned that the Administration for Strategic Preparedness and Response (ASPR) does not plan to renew this program beyond the April 1 deadline. Pharmacies are encouraged to use the Healthcare Ready fact sheets to learn how they can best assist their eligible patients while EPAP funding is still available.

Also in Tennessee, TennCare has enhanced reimbursement rates for its Diaper Benefit Program, creating new revenue opportunities for participating pharmacies. Effective February 15, maximum allowable cost (MAC) rates increased for diaper brands on the covered product list, and since February 28, pharmacies have been able to submit claims for private-label and “unlisted” diapers using a Generic Diaper UPC. Diaper program updates provide higher reimbursements, greater inventory flexibility and increased foot traffic for pharmacies statewide.

Finally in Tennessee, the Department of Health is urging clinicians to identify, isolate and inform people regarding suspected measles cases. Immediately report cases by phone at 615-741-7247. According to the CDC (Centers for Disease Control and Prevention), there have been 222 cases of measles across 12 states during 2025 alone, including three identified outbreaks and one pediatric death.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

March 20, 2025|Tennessee|

Texas

The highly contagious measles virus continues to spread in the unvaccinated populations in eleven counties. The Department of State Health Services (DSHS) reported that there are currently 279 confirmed measles cases and two deaths since late January.

Also in Texas, March 14 was the bill filing deadline. In total, 5,646 bills have been filed in the House of Representatives and 3,028 in the Senate.

Also in Texas, HB 4051, legislation allowing test-and-treat for certain minor ailments, was filed by Rep. James Frank (R).

Finally in Texas, HB 4533, critical pharmacy legislation that would require a transparent reimbursement methodology for prescription drugs dispensed in Medicaid and state-funded programs, was introduced by Rep. Tom Oliverson, MD, (R).

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 20, 2025|Texas|

Virginia

SB 875 and HB 2610 are now on Gov. Glenn Youngkin’s (R) desk. The bills require the Department of Medical Assistance Services (DMAS) to contract a single PBM to manage the pharmacy benefit under Medicaid Managed Care. Additionally, they would streamline the program and require pass-through pricing and reasonable pharmacy reimbursement. NACDS is currently engaged in both grassroots and grasstops campaigns with members and partners to urge the Governor to sign the bills. The Governor’s deadline to act is midnight on March 24.

Also in Virginia, the Department of Health released a clinician letter outlining requirements for reporting COVID test results.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

March 20, 2025|Virginia|

Washington

The Pharmacy Quality Assurance Commission is meeting on March 27. The agenda, meeting materials and Zoom information was posted on their website. The rules workshop will review the draft Proposed Utilization of Pharmacy Ancillary Personnel Rule Language, which amends WAC 246-945-001, 246-945-315, 246-945-317, 246-945-320, to clarify the utilization of pharmacy ancillary personnel and technology within the pharmacy.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 20, 2025|Washington|

Wisconsin

On March 19, NACDS sponsored and participated in the Pharmacists Society of Wisconsin’s lobby day. Legislative leaders spoke to the group collectively in the morning, and pharmacists met with all legislators in their offices in the afternoon. The primary objective was to ask for support for a new bill, Cole’s Act, aimed at reforming PBMs, a critical step toward ensuring fair drug pricing, increasing transparency for healthcare purchasers and alleviating workforce challenges in the healthcare sector.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

March 20, 2025|Wisconsin|

Alabama

The Alabama Medicaid Agency (Medicaid) provides full Medicaid benefits for eligible pregnant individuals during pregnancy and 12 months postpartum. Medicaid does not require positive confirmatory pregnancy testing for maternity Medicaid coverage.

Pregnant individuals may apply for Medicaid programs using the single streamlined Medicaid application.

  • Online application (fast service),
  • Paper application (mailed to Medicaid),
  • Phone application by calling the Recipient Call Center at 1-800-362-1504 (toll-free), Monday through Friday, 8:00 am until 4:30 pm or
  • In-person application at a local county health department, a federally qualified health care center (FQHC), the regional Alabama Coordinated Health Network (ACHN) or some local hospitals.

For questions related to maternity Medicaid eligibility, providers may contact Gainwell Technologies at 1-800-688-7989.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

March 13, 2025|Alabama|

Arkansas

Gov. Sarah Huckabee Sanders (R) announced the Grocery Tax Relief Act, SB 377, sponsored by Senate President Bart Hester (R) and Rep. Kendon Underwood (R), would eliminate the state’s grocery tax by January 1, 2026. Referred to as the Good Neighbor Act, the bill seeks to expand legal protections for food bank donors, including churches, restaurants, farmers, grocery stores and wholesalers. It is estimated that it will return nearly $10.9 million to taxpayers annually.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 13, 2025|Arkansas|

California

In conjunction with the Joint Sunset Review Oversight Hearing on March 11, NACDS submitted a letter to both the Assembly Business & Professions Committee and the Senate Committee on Business, Professions and Economic Development Committee emphasizing the importance of modernizing pharmacy laws to authorize pharmacists to practice at the top of their education and training; to allow pharmacies to optimize the pharmacy technician workforce to enhance pharmacies’ capacity to meet patient demand for pharmacy care services; and to enable pharmacies to deploy new practice models and technologies to deliver care to their patients.

Also in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web PortalMedi-Cal Rx Weekly Wrap-up for February 28-March 6.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

March 13, 2025|California|

District of Columbia

The Department of Health Care Finance (DCHF) published a final rule permitting billing for MTM services. The rule was effective February 24, 2025.

Also, in the District of Columbia, the DCHF is hosting the next Pharmacy Provider Forum on March 18 and 19. The content is identical for both sessions. The invitation provides more detail and information to RSVP no later than March 17.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

March 13, 2025|District of Columbia|

Georgia

The Board of Pharmacy will hold a public hearing on adoption of proposed new rules at its meeting on April 9 at 9:00 am at the South University School of Pharmacy, 709 Mall Blvd., Savannah, Georgia 31406.

Proposed Adoptions:

480-5-.03 Code of Professional Conduct
480-7C-.01 Definitions
480-7C-.02 Third-Party Logistics Provider Licensing Requirements
480-11-.10 Exceptions
480-15-.02 Registration of Pharmacy Technicians and Continuing Education Requirements
480-15-.04 Duties of the Pharmacist in Charge Related to Registered Pharmacy Technicians
480-24-.02 Personnel
480-24-.03 Physical Requirements
480-24-.04 Drug Distribution
480-24-.05 Duties of Consultant Pharmacist
480-4-.06 Destruction of Drugs

Notices of Public Hearing regarding the above listed rules are available on the Board of Pharmacy website; see Press Releases (georgia.gov).

If you have any questions regarding this matter or any other matter related to the practice of pharmacy in the state, please contact the Board of Pharmacy staff at 404-651-8000.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

March 13, 2025|Georgia|

Hawaii

NACDS submitted a letter of support for SB1509_SD1, PBM reform legislation, to the House Committee on Health. SB1509_SD1 includes important reforms creating a reimbursement rate floor equating to NADAC plus the state’s Medicaid Fee-For-Service Professional Dispensing Fee and prohibiting a PBM from offering reimbursement rates or incentives to a non-affiliated pharmacy in an amount less than those offered to an affiliated pharmacy for providing the same prescription drug.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

March 13, 2025|Hawaii|

Illinois

The Department of Healthcare and Family Services (HFS) will post its updated Preferred Drug List (PDL) on March 13. This update will include all changes that have been made during the past 12 months. While the Pharmacy Benefit Management System (PBMS) prior authorization system is pending restoration. HFS’ PDL is available online.

Also, the Department of Healthcare and Family Services’ (HFS) new Preferred Drug List (PDL) will be posted March 13. Starting immediately, HFS has changed the covered preferred blood glucose monitoring and testing supplies. The preferred products for all fee-for-service (FFS) and managed care organization (MCO) members are the Ascensia items below:

  • NDC 00193758450 Item: Contour Plus Blood Glucose Test Strips and
  • NDC 00193703601 Item: Contour Plus Blue Blood Glucose Monitoring System.

These products will be updated accordingly on the PDL on March 13. Providers should check with the respective MCOs for details on their transition timelines.

For additional information, please contact a pharmacy billing representative in the Bureau of Professional and Ancillary Services at 877-782-5565, or the applicable MCO.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

March 13, 2025|Illinois|

Iowa

Both Iowa HF 852/SF 383, PBM reform legislation, successfully passed the first important hurdle by advancing out of the House Committee on Commerce and the Senate Committee on Health and Human Services, respectively. These bills include significant reforms permitting patient choice of pharmacy; prohibiting a PBM from reimbursing a pharmacy in an amount less than NADAC plus a professional dispensing fee in the amount of $10.60; requiring a process for pharmacies to appeal a reimbursement rate for a specific prescription; and requiring a pass-through pricing model to help ensure that payments received by the PBM for providing services are used or distributed pursuant to the PBM’s contract with the payor or with the pharmacy.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

March 13, 2025|Iowa|

Nevada

Senator Rochelle Nguyen (D) filed SB 316, a broad PBM reform bill that includes enforcement provisions and pass-thru rebates, was filed this week and referred to the Senate Commerce and Labor Committee.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 13, 2025|Nevada|

New York

The state’s Department of Health provided notice to pharmacies that NYRx, the state Medicaid pharmacy benefit program, had changes to over the counter (OTC) drugs.

Effective April 1, NYRx will remove the following products from the List of Reimbursable Drugs:

  • Cough and Cold Products: Oxymetazoline, Phenylephrine
  • Gastrointestinal Products: Simethicone
  • Anti-hypoglycemics: Glucose Tablets
  • Dermatologicals: Neomycin, Bacitracin
  • Multivitamins: For members aged 21 years and up

Impact on Providers and Patients

  • Transition to Alternative Therapies: Providers are encouraged to discuss these changes with their patients. Alternative treatment options are available for medically necessary use. For example, alternatives to oxymetazoline or phenylephrine may include other decongestants or nasal corticosteroids that offer more effective management of nasal congestion.
  • Patient Education: NYRx has notified members of these changes. Additionally, provider education to patients about these formulary changes is helpful and provide safer and more effective alternatives. Ensuring that patients understand the rationale behind these changes and the benefits of alternative therapies is essential for a smooth transition.
  • Adjusting Prescribing Practices: Given these changes, providers may need to modify their prescribing practices. Staying informed about which medications remain covered and considering the most appropriate therapies for patients’ needs will be crucial. The New York Medicaid list of reimbursable drugs is available online.

NYRx is committed to continuously monitoring medication utilization and effectiveness to ensure that the OTC formulary remains aligned with evidence-based practices.

For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.

March 13, 2025|New York|

Texas

Rep. Tom Oliverson (R) filed HB 4533, a Medicaid managed care organization rate floor bill for retail and specialty pharmacies.

Also in Texas, Rep. James Frank (R) filed HB 4051, a test-and-treat bill for flu, strep, COVID and minor, uncomplicated infections. The bill also includes provisions for doctor dispensing.

Also in Texas, last week, the Texas Pharmacy Association and the Texas Pharmacy Business Council testified in support of SB 1122 at the Senate Health and Human Services Committee. This legislation codifies Attorney General Ken Paxton’s February 5, 2025, opinion letter regarding the enforceability of existing laws against health benefit plans and PBMs administering the pharmacy benefits on behalf of an ERISA plan in certain circumstances that do not dictate plan choice or add requirements to a beneficiary’s status. The Texas Association of Business and the National Federation of Independent Business (NFIB) testified in opposition to SB 1122, falsely claiming that it would impose costs to employer-sponsored ERISA health plans of over $5 billion over the next decade. Since Texas is business-friendly, several Senators expressed concerns about rising costs to small businesses. The bill was left pending in the Senate Health and Human Services Committee.

Finally in Texas, Gov. Greg Abbott (R) notified state agencies to transition remote workers back to the office to ensure the efficient use of taxpayer dollars and that state agencies remain engaged and effective in serving the public.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

March 13, 2025|Texas|

Virginia

NACDS issued a NACDS RxIMPACT action alert for SB 875 and HB 2610, and urges members with operations in the Commonwealth to contact Gov. Glenn Youngkin (R) to express how critical these bills are to patient access and pharmacy viability. Should he sign the bills, Virginia would join Ohio and Kentucky as the third state to reform PBM practices in Medicaid Managed Care under a single PBM. The bills had bipartisan support and overwhelmingly passed the General Assembly a few weeks ago.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

March 13, 2025|Virginia|
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