Texas
Bills supported by all pharmacy groups are beginning to advance in the Senate.
- SB 493 prohibits "gag clauses" in contracts that prevent pharmacies from telling patients when the cash price for a drug is lower than the price under their insurance plan. SB 493 addresses contractual provisions between some health insurers, pharmacy benefit managers and pharmacies that prohibit pharmacists from freely informing patients if paying out-of-pocket (cash price) for the prescription may be cheaper than the insured's copay.
- SB 1122 builds upon the landmark US Supreme Court Rutledge decision and PBM reforms passed in recent years, HB 1919 and HB 1763, by extending the applicability of patient and pharmacy protections already in law to all PBM activity in the state, regardless of the health plan types. It further codifies the February 2025, Texas Attorney General Ken Paxton opinion letter KP-0480, which asserts that Texas has the authority to regulate PBM practices impacting its residents and local pharmacies, even when ERISA-governed plans are involved.
- SB 1236 amends current law relating to the relationship between pharmacists or pharmacies and health benefit plan issuers or pharmacy benefit managers. SB 1236 would amend Chapter 1369, Insurance Code, to provide reasonable contract protections for pharmacies and pharmacists in their relationships with PBMs. It would also amend existing statutes to clarify language regarding PBM audits and provide transparency in the applicability of Texas laws to contracts and benefit enrollees. This bill was heard in the Senate Health and Human Services Committee on April 1.
Also in Texas, another priority bill we are trying to advance includes HB 4533 by Rep. Tom Oliverson, MD, (R), legislation that would establish the fee-for-service reimbursement as the rate floor for Medicaid managed care organization claims.
Also in Texas, all pharmacy groups collaborated on making our united voices heard on our priority legislative issues at the March 26 Pharmacy Day at the Capitol. More than 400 pharmacists, interns and pharmacy students participated in 150 scheduled meetings, urging lawmakers to pass legislation to help save neighborhood pharmacies and the health of their patients.
Finally in Texas, Gov. Greg Abbott (R) launched a Department of State Health Services (DSHS) online interactive map identifying where Texans can acquire life-saving naloxone (NARCAN) to prevent fentanyl poisonings. This tool is part of the statewide "One Pill Kills" campaign.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
After passing the General Assembly with overwhelming support, Gov. Glenn Youngkin (R) gutted the Medicaid Managed Care Single PBM bills (HB 2610 and SB 875) and sent them back to the General Assembly, leaving only language to study the issue. On April 2, the General Assembly held steadfast, rejecting the Governor's version, and voted to send the original bills as they passed the Legislature back to the Governor. Gov. Youngkin now has thirty days to sign or veto the measures. With the 2025 session at an end, his action will be the final word on the bills.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
NACDS submitted comments for the Sunrise Review process of pharmacy practice regulations to the Department of Health, recommending adopting a standard of care model that would better utilize pharmacists’ clinical expertise in promoting healthcare access for its residents through community pharmacies.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
West Virginia
A bill granting pharmacists broad prescriptive authority passed the Senate overwhelmingly and is now in the House Health and Human Resources Committee for consideration. SB 526 allows pharmacists to prescribe any appropriate therapy to treat a condition diagnosed by a CLIA-waived test.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Alabama
Effective April 1, the Medicaid Agency will:
- Continue to monitor the stimulant shortage affecting ADHD (attention-deficit/hyperactivity disorder) medications. Should you need assistance, please contact Acentra Health at the number below for alternative prescribing and dispensing options.
- Require PA (prior authorization) for generic liraglutide. Brand Victoza will remain preferred and will be billed with a Dispense as Written (DAW) Code of 9.
Acentra Health
Medicaid Pharmacy Administrative Services
P.O. Box 3570, Auburn, AL 36831
Fax: 1-800-748-0116
Phone: 1-800-748-0130
View the alert for additional details.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
SB 1214, legislation that would permit pharmacists pursuant to a statewide written protocol to independently test and treat for flu, strep, COVID, PEP/PrEP or a condition related to an emerging or existing public health threat for individuals 12 years of age and older, passed the House Health and Human Services Committee with a vote of 7-5. Also, a pharmacist may delegate the task of performing the test to a licensed staff member under the supervision of the pharmacist.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
The Board of Pharmacy posted a agenda for the Enforcement and Compounding Committee meeting on March 27. Please note the discussion and consideration of implementation of AB 1902 (Chapter 330, Statutes of 2024) related to prescription drug labels: accessibility.
Also in California, the Board of Pharmacy has proposed additional modifications to Title 16 CCR § 1708.2, related to the Discontinuance of Business.
Any person who wishes to comment on the proposed additional modifications may do so by submitting written comments beginning on March 11 and ending on March 26 to the following:
Contact Person: Lori Martinez
Agency Name: California State Board of Pharmacy
Address: 2720 Gateway Oaks Drive, Ste 100, Sacramento, CA 95833
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.
Also in California, the Board of Pharmacy extends its sincere appreciation to its licensees for assisting the survivors of the Los Angeles Fires. Your commitment to California consumers is commendable. The Board has received notification that the Emergency Prescription Assistance Program (EPAP) ended on March 15. Once the EPAP activation ended, the vendor stopped processing further prescription claims for individuals in the designated Los Angeles zip codes.
Also in California, the Department of Health Care Service posted the following weekly notice on the Medi-Cal Rx Web Portal: Medi-Cal Rx Weekly Wrap-up for March 7-13.
Finally in California, the Department of Health Care Services posted the following:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
Gov. Brad Little (R) signed HB 231, legislation expanding grocery tax credit to offset the sales tax Idahoans pay on food. The new law increases the grocery tax credit to $155 a year, an increase above the current amount of $120 per year.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
NACDS launched an NACDS RxImpact Action Alert urging members to contact their hometown legislators to help advance SB 140, critical legislation that ensures PBMs pay pharmacies a reasonable reimbursement rate. Opponents are spreading misinformation across radio, print and TV, falsely labeling this bill as a “pill tax” on consumers. The bill passed the Senate and is stuck in the House Insurance Committee.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Kentucky
Gov. Andy Beshear (D) signed SJR 26, a significant step toward payment parity for pharmacists’ clinical services in Medicaid and CHIP. The Resolution directs Medicaid to provide a detailed report regarding pharmacist payment parity for review by the General Assembly during the upcoming legislative interim. The detailed report will include information on the technology necessary to adjudicate these claims with a pharmacy. It will also highlight the value that access to pharmacy clinical services can contribute to patient outcomes and overall healthcare savings.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Massachusetts
On March 21, the Department of Insurance hosted its second of three public hearings on PBM regulations. This hearing focused on the licensing process and standards. NACDS submitted testimony and participated in the hearing. The final hearing is scheduled for April 4.
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
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.
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.
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.
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
- NYRx Medicaid Pharmacy Prior Authorization Programs Update
- Notice for Upcoming Over-the-Counter Coverage Changes
- NYRx Pharmacy Drug Coverage: Claims Processing Enhancements and Reminders
All Providers
For more information, please contact NACDS’ Mike Sargent at 207-272-6435.
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.
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.
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.
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.
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.
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.
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’ Mike Sargent at 207-272-6435.
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.
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.
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 Portal: Medi-Cal Rx Weekly Wrap-up for February 28-March 6.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.