Texas
NACDS issued a press release acknowledging the favorable opinion (KP-0408) released by Texas Attorney General Ken Paxton (R) on February 5, 2024. This opinion addresses the enforceability of two laws passed in 2021 against health benefit insurers and PBMs. Paxton’s opinion clarifies how HB 1763 and HB 1919 regulate certain contracts between ERISA issuers, their PBMs, and pharmacies. It also addresses steering practices concerning affiliated pharmacies, clarifying that ERISA does not preempt HB 1763 and HB 1919, as these laws do not dictate plan choices or add requirements to a beneficiary’s status. At the request of pharmacy groups, State Senator Charles Schwertner (R), a physician and pharmacist who chairs the Senate Business and Commerce Committee, sent a letter to the Attorney General requesting this opinion.
Also in Texas, Speaker Dustin Burrows (R) finally posted the new chairs and the House Committee membership lists on February 13, 2025.
Also in Texas, Sen. Bryan Hughes, and Rep. Cody Harris (R), two champions of PBM reforms, filed identical bills, SB 1354 and HB 2978 will establish a rate floor for the commercial market.
Also in Texas, Sen. Bryan Hughes also filed SB 1236, PBM reform legislation that addresses clawbacks, establishes audit guardrails, and would prohibit a health plan or PBM from denying or reducing a claim payment to a pharmacy or pharmacist after adjudication under certain circumstances. The bill also protects patient choice to pharmacies by ensuring that pharmacies have a voice in their network and contract discussions.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Board of Pharmacy published its February 2025 newsletter, including a reminder of the importance of required self-audits during inspections by the Division of Professional Licensing (DOPL) and an update on compounding operating standards
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
Legislation that would require Medicaid to hire a single PBM to manage the pharmacy benefit has advanced. Both HB 2610 and SB 875 passed their respective chambers and advanced significantly in the opposite chamber. They are now poised to go to the Conference Committee to work out the remaining details, including the implementation date. NACDS cautions that the Department of Medical Assistance Services (DMAS) has been resistant to the legislation, though Gov. Glenn Youngkin (R) has not officially taken a stance. We will continue to work with in-state partners and members over the next month to advocate for the bill or bills to become law.
Also in Virginia, Gov. Glenn Youngkin (R) issued Executive Order 45 on February 16, declaring a state of emergency due to winter weather and flooding. In response, the Board of Pharmacy has implemented emergency waivers. They will remain in effect for the duration of Executive Order 45, which is effective for 30 days from February 10, unless sooner amended or rescinded. Existing emergency regulations plus those implemented because of the declaration waivers are as follows:
- Pursuant to 18VAC110-20-320, an authorized refill may be dispensed early provided the pharmacist documents a valid reason for the necessity of the early refill.
- Emergency Waiver: a prescription for a drug controlled by Schedule III-V with no remaining refills may be refilled one time without authorization from the prescriber, if after reasonable effort has been made to contact him, the pharmacist ascertains that he is not available and the patient’s health would be in imminent danger without the benefits of the drug. Authorization to refill under this subdivision also exists when the pharmacist only has access to the label on a prescription container. The pharmacist shall inform the patient of the prescriber’s unavailability and that the refill is being made without his authorization.
- A prescription for a drug controlled by Schedule II may be dispensed pursuant to the emergency allowance in 18VAC110-20-290.
- Emergency Waiver: A one-time early dispensing of a Schedule II prescription for a chronic condition that is due for dispensing within the next 7 days is authorized. Dispensers must document the reason for the early refill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
Key legislative deadlines for legislation to advance this session: On or before February 21st, all bills filed in the house of origin must be passed by the Policy committee. Next Friday, February 28th is the deadline for all bills filed in the house of origin with a fiscal note to be approved by the fiscal committee.
Also in Washington, HB 1502 and its companion SB 5513, legislation expanding pharmacists’ scope of practice to improve access to health care and the management of chronic diseases, was not heard by the Policy committee because lawmakers wanted to the Sunrise Review process to proceed. A public hearing will be held on May 14, 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arizona
On February 5, the Senate Regulatory Affairs and Government Efficiency Committee approved SB 1214 – Test and Treat by a 5-2 vote. NACDS submitted a letter of support in advance of the committee hearing.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Department of Health Care Services posted the following alerts, monthly bulletin, and weekly notice on the Medi-Cal Rx Web Portal:
Also in California, the Board of Pharmacy shared the California Health Alert Network message related to "Emergency Assistance for Those Impacted by the Wildfires."
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Florida Pharmacy Association is hosting an upcoming ACPE–approved conference on February 22-23 via Zoom, focused exclusively on Women’s Health and care for these patients. Register here!
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
NACDS sponsored the Indiana Pharmacists Legislative Day, where over 350 pharmacists, students and technicians gathered at the Statehouse to engage in advocacy for the profession. The priority legislative issues included securing fairer reimbursement for dispensing, PBM reforms and reimbursement for services. The advocates also promoted bills securing authority for pharmacists to provide “test and treat” services and substance use disorder treatments; lowering the vaccination age from 11 years and allowing administration of any FDA-approved vaccines if operating under a physician protocol or health commissioner standing order; allowing nationally certified technicians the ability to perform any task delegated to them by a supervising pharmacist that does not require the training or judgment of a pharmacist, including receipt of verbal orders and final product verification; and 340B protections.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
This week, both the House Commerce Subcommittee and the Senate Health and Human Services Subcommittee recommended passage of HSB 99 and SSB 1074, respectively. These companion bills relate to PBMs, pharmacies and prescriptions drugs. Among the various provisions includes patient choice of pharmacy. Also, a PBM shall not deny a pharmacy or pharmacist the right to participate as a contract provider if the pharmacy or pharmacist agrees to the terms and requirements of the plan. Additionally, a PBM shall not require a person, as a condition of payment or reimbursement, to purchase pharmacy services exclusively through a mail order pharmacy. Finally, the bill prohibits a PBM from reimbursing a pharmacy in an amount less than the National Average Drug Acquisition Cost (NADAC) or the Iowa average acquisition cost for a prescription on the date the prescription is administered or dispensed, and the PBM also must reimburse the pharmacy or pharmacist a professional dispensing fee in an amount not less than the pharmacy dispensing fee published in the Iowa Medicaid Enterprise provider fee schedule on the date the prescription is administered or dispensed.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Maryland
The Maryland Prescription Drug Affordability Board (PDAB) Stakeholder Council will hold its virtual monthly meeting on Monday, February 24, 2025, at 2pm. The agenda and other meeting materials will be available on the Stakeholder Council page of the PDAB's website prior to the scheduled meeting. Registration is necessary to attend. The PDAB's website has more information about upcoming and previous meetings and related documents and presentation materials.
Also in Maryland, The Senate Finance Committee will hear SB 438 on Wed. Feb 12. The bill would establish a pharmacy reimbursement rate floor in the Medical Managed Care Program. NACDS is coordinating with members and in-state partners on supportive testimony.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
The MassHealth Pharmacy Program updated pharmacists on standing orders for dispensing over-the-counter prenatal vitamins and over-the-counter oral hormonal birth control.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Minnesota
A deal was reached this week to end the partisan stalemate in the Minnesota House of Representatives. The stalemate resulted when the November election left Republicans holding a one-vote majority by virtue of an open seat in a strongly Democratic district. The Democratic candidate is expected to easily win the seat in the March 11 special election and tie the House 67-67. In the interim, Democrats boycotted session, leaving Republicans without the quorum required to conduct business. The deal gives Rep. Leader Lisa Demuth (R) the Speakership through 2026 and her party control of committees until the special election. Following the election, the parties will share power by co-chairing the committees.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nevada
The Legislature convened its biennial session on February 3. Several bills pharmacy groups collaborated on during the interim have been filed, including:
- AB 186 by Assemblymember David Orentlicher (D) expands pharmacist scope of practice.
- SB 118 by Senator Jeff Stone (R) establishes payment parity for Medicaid.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New Jersey
On February 3, Gov. Phil Murphy (D) signed A1899/S1981, an Act to expand authority of pharmacy technicians to administer drugs and vaccines and permit certain pharmacists and pharmacy interns, externs, and technicians to administer COVID-19 vaccines. The law becomes effective upon signature. The Board of Pharmacy may enact regulations necessary to enable the law’s intent.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Oklahoma
The Legislature convened its biennial session on February 3. Several bills of interest to pharmacies have been filed.
- SB 741 by Sen. Todd Gollihare (R) authorizes pharmacists to screen for and initiate drug therapy for minor, nonchronic health conditions in accordance with a standing order. The bill was referred to the Senate Health and Human Services Committee.
- SB 906 by Sen. Paul Rosino (R) requires retail pharmacies to maintain a pharmacy technician-to-pharmacist ratio of up to five pharmacy technicians for every pharmacist and was referred to the Senate Health and Human Services Committee.
- SB 907 by Sen. Paul Rosino (R) authorizes pharmacies to engage in product fulfillment with a central filling pharmacy if the pharmacies have the same owner or have entered into a written contract or agreement, share a common electronic file, or can access information required to dispense or process a prescription. The bill was referred to the Senate Health and Human Services Committee.
- SB 789 by Sen. Todd Gollihare (R) establishes auditing requirements and a commercial rate floor ensuring that pharmacies are reimbursed no less than 106% of the National Average Drug Acquisition Cost (NADAC) plus a professional fee of $15.00.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Prescription Drug Affordability Board posted it’sits agenda for the February 19 meeting. Register here in advance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The House Health Committee unanimously advanced HB 60, legislation that will bring the Commonwealth into compliance with federal law, allowing pharmacies to transfer Schedule II prescriptions electronically. The full House intends to pass it when they return to session the week of March 17. It will then go to the Senate for consideration.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
The Board of Pharmacy has released proposed rules regarding pharmacist-delegated technician authorities. NACDS has carefully reviewed these rules and shared our concerns with members. NACDS will submit feedback to the Board of Pharmacy by the February deadline.
Also in Tennessee, the Belmont University College of Pharmacy & Health Sciences will host a virtual conference on February 25 from 12:00 noon to 1:00 pm CST, focused on new FDA-approved drugs in 2024. Registration is required with a fee of $15 for pharmacists and $10 for other healthcare professionals, and participants must meet specific criteria to earn one hour of ACPE Pharmacy CE credit. Registration deadline is February 23. Register here!
Finally in Tennessee, program updates to the TennCare Diaper Benefit Program are coming soon. Please watch the Division of TennCare Diaper benefit website and the OptumRx/TennCare website for information about an upcoming online seminar and added resources to assist pharmacies. Current TennCare pharmacy resources are also posted on the TennCare website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Gov. Greg Abbott (R) delivered his state-of-the-state address online on February 2.
Also in Texas, the Board of Pharmacy approved proposed rules removing the ratio of pharmacists to pharmacy technicians in a central fill facility.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
As of January 27, the Palisades Fire, Eaton Fire, and Hughes Fire have burned nearly 50,000 acres in the Los Angeles County area. The Palisades Fire is at 94% containment, Eaton Fire is at 98% containment, Hughes Fire is at 95% containment. There have been minimal pharmacy closures in the impacted areas of California due to the wildfires. Healthcare Ready deactivated RxOpen on January 28 but will be monitoring the event in case any other impacts arise.
The Emergency Prescription Assistance Program (EPAP) was activated last week– and will remain active through March 15, 2025 – for those impacted by the California wildfires. Pharmacies and pharmacists play an essential role in educating patients about the availability of EPAP benefits. We encourage and support sharing the resources below with the public to enhance awareness:
- ASPR EPAP Notice: https://aspr.hhs.gov/EPAP/Pages/California-Wildfires-2025.aspx
- EPAP Website: https://aspr.hhs.gov/epap/Pages/default.aspx
- EPAP Hotline: 855-793-7470 (TTY 1-800-876-1089)
- Link to Fact Sheets:
NACDS is working with Healthcare Ready to provide support with outreach. Any insight, feedback or concerns regarding patient utilization of EPAP is appreciated. Please share your feedback with NACDS’ Lincy Abraham no later than February 3. If you are interested and willing to help support efforts to enhance awareness, you may also contact Healthcare Ready at 866-247-2694.
Also in California, the Department of Health Care Services (DHCS) issued a Notice of Proposed Rulemaking pertaining to Pharmacist Services, DHCS-19-002. The written comment period closes on February 5, 2025. DHSC posted the following related to the Public Comment Period
- Initial Statement of Reasons
- Proposed Regulation Text (PDF)
- Proposed Regulation Text (PDF) (Text Only)
Also in California, the Department of Health Care Services posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for January 17-23.
Also in California, the Board of Pharmacy has proposed additional modifications to Title 16 CCR § 1711, related to the Quality Assurance Programs. Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning January 27 and ending on February 11, to the following:
Contact Person: Lori Martinez
Agency Name: California State Board of Pharmacy
Address: 2720 Gateway Oaks Drive, Ste 100, Sacramento, CA 95834
Email: PharmacyRulemaking@dca.ca.gov
Fax: (916) 574-8618
Any responses to comments directly concerning the proposed modifications to the text of the regulations will be considered and responded to in the Final Statement of Reasons.
All documents related to this regulatory action are available on the Board’s website: https://www.pharmacy.ca.gov/laws_regs/pending_regs.shtml.
Also in California, the board of pharmacy issued a reminder that licenses that are eligible for renewal will be processed online effective January 1, 2025. Those who are eligible include:
- Pharmacist
- Advanced Practice Pharmacist
- Pharmacy Technician
- Designated Representative – Wholesaler
- Designated Representative – Veterinary Food-Animal Drug Retailer
- Designated Representative – 3PL
- Designated Representative – Reverse Distributor
In most cases, the license expires at the end of the month of the licensee’s registered birthday for pharmacists, advanced practice pharmacists and pharmacy technicians. For designated representatives, the license expires at the first of the month.
The Board of Pharmacy will no longer mail out a paper renewal application for the above licenses. In its place, a postcard reminder will be sent approximately six weeks prior to the license expiration date and the licensee will renew by going to www.pharmacy.ca.gov. The postcard is only a reminder, if the licensee does not receive a postcard, they are still required to submit his/her payment on-time to avoid a delinquency fee and possible cancellation of the license.
For Pharmacists and Advanced Practice Pharmacists, if your license expired more than two years ago, you are not eligible to renew your license online. Contact the Board at RenewalStatus@dca.ca.gov for assistance.
Renewal payment transactions must be completed prior to 5:00 pm Pacific on the date the license expires to avoid the delinquency fee.
Online payments made after 5:00 p.m. Pacific Time are not credited on the day of the transaction. Print the payment confirmation at the end of this transaction for your records. Once the online payment is submitted, please allow two business days for processing.
Licensees are required to notify the board of any change of address within 30 days. Change of address may take between 7-10 business days to update in the system. If the correct address is not in the system at the time of renewal, the process may be delayed. Address changes can be made on-line or in writing to the board.
When renewing online, the licensee must confirm that his/her address is correct before submitting the paymentFees changed beginning January 1, 2025. The updated fee schedule with the new fees has been posted on the board’s website.
Also in California, the Board of Pharmacy posted the February 5-6, 2025 Board meeting agenda on its website. Of interest, please note the discussion and possible action related to compounded drug preparations, hazardous drugs and radiopharmaceuticals and waiver of pharmacy law provisions in response to the state of emergency related to the Palisades Fire.
Finally in California, Covered California announced a special enrollment period for residents of Los Angeles and Ventura counties until March 8, 2025. Resources are available through Los Angeles County and the State of California. Of the 1.3 million uninsured Californians who qualify for subsidies through Covered California or are eligible for Medi-Cal coverage, 356,000 reside in Southern California. Through the BenefitsCal portal, Californians can get and manage benefits online. This includes food assistance (CalFresh, formerly food stamps), cash aid (CalWORKs, General Assistance, Cash Assistance Program for Immigrants), and affordable health insurance (Medi-Cal).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Agency for Health Care Administration (Agency) contracts with Medicaid health and dental plans to provide State Plan services to health plan enrollees in the Statewide Medicaid Managed Care (SMMC) program. The Agency recently contracted with health and dental plans effective February 1, 2025. In this new iteration of SMMC, the Medicaid regions have been realigned into nine regions from eleven. The regional naming convention has also changed, with regions 1-9 have become regions A-I. The Agency has posted a map of the regional changes ,a list of the plans by type, and plan coverage. Visit the Agency’s SMMC 3.0 webpage for more information. Please refer to the SMMC 3.0 website for more information.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
NACDS submitted comments to the Senate Health Care and Wellness Committee in support of SB 503, which includes to ensure network adequacy, requirements that PBMs reimburse pharmacies at a minimum of the acquisition cost of a drug and an adequate professional dispensing fee (PDF) equal to the Medicaid fee-for-service (FFS) PDF. Also, the bill prohibits steering patients, defines specialty drugs, prohibits certain fees, and provides additional oversight and enforcement in the Office of the Attorney General.
Also in Indiana, SB 140, a more limited PBM reform bill modeled after the Kentucky law, passed the Senate Health Care and Wellness Committee and was referred to the Senate Appropriations Committee for further action. This bill requires the Insurance Commissioner to determine minimum reimbursement for a professional dispensing fee based on a cost of dispensing study done every two years. It also requires PBMS to file an annual report on adequate networks and establishes a process for filing complaints.
Also in Indiana, HB 1606, a bill prohibiting spread pricing, was referred to the House Insurance Committee.
Also in Indiana, SB 96, immunization clean-up legislation addressing age restrictions and the list of immunizations allowed to be administered by a pharmacist was referred to the Senate Public Policy Committee.
Finally in Indiana, HB 1571, a scope of practice expansion and clean-up bill, address multiple issues including immunizations, Test and Treat, pharmacy technician duties, MAT and payment for services. The bill was referred to the House Public Health Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
MedImpact, the Medicaid Single PBM, held its 1st quarter pharmacy providers meeting this week. You can review the slide deck, as well as those from previous meetings on the provider portal page.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maine
On February 6, 2025, the Maine Board of Pharmacy will hold their regular scheduled meeting. The agenda includes election of officers, opportunity to comment on the function of the board, and consideration of a Maine Academy of Physician Associates request related to routine license verification by pharmacists and a Maine Prevention Services request to partner with pharmacists to educate communities about ‘Maine QuitLink’.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
Massachusetts
NACDS and the Massachusetts Chain Pharmacy Council have begun engaging the governor’s office and legislative leaders on the budget proposal that includes a $2/prescription assessment to help pay for MassHealth pharmacy benefit program.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.