California
The Board of Pharmacy announced the modification and/or extension of the waivers of Pharmacy Law issued in response to the Los Angeles Fires.
The waiver that provides flexibility to increase the number of pharmacy technicians a pharmacist may supervise has been modified and the expiration date has been extended to June 30, 2025 (or the termination date of the state of emergency, whichever is sooner).
The expiration date of the waiver that provides flexibility for pharmacy personnel to perform some functions from outside of a licensed pharmacy has been extended to June 30, 2025 (or the termination date of the state of emergency, whichever is sooner).
The expiration date of the waiver to allow for the delivery of drugs to an alternate location has been extended to March 31, 2025 (or the termination date of the state of emergency, whichever is sooner).
Also in California, the Department of Health Care Services posted the following:
- February 2025 Pharmacy Medi-Cal Update Bulletin
- February 2025 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
Finally in California, the Department of Health Care Services posted the following alerts and a weekly notice on the Medi-Cal Rx Web Portal. Please note the 2025 prescription volume attestation survey will be available to providers March 1 through March 31. Also, to avoid mail delivery delays and save paper, Medi-Cal Rx encourages pharmacy providers to opt into receiving the Medi-Cal Rx remittance information via the Electronic Remittance Advice (ERA) format.
- Centers for Medicare and Medicaid Services Payment for Error Rate Measurement Review
- Upcoming Pharmacy Professional Dispensing Fee Provider Self-Attestation
- Medi-Cal Rx Weekly Wrap-up for January 31-February 6
- State of Emergency Override Extension: Los Angeles and Ventura Counties
- Reminder: Providers Encouraged to Sign Up for Medi-Cal Rx Electronic Remittance Advice
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Connecticut
On February 20, 2025, the Joint Committee on Human Services held a hearing on several bills, including H6101, An Act Concerning Medicaid Coverage of Food as Medicine and Expanding Access to the Connecticut Farmers’ Market/Women, Infants and Children Nutrition Program. NACDS testified and submitted testimony in coordination with the Connecticut Chain Pharmacy Council and the Connecticut Food Association.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Indiana
SB 96, immunization legislation NACDS supports because it removes the list of vaccines a pharmacist can administer, allowing them to provide any vaccine recommended by the federal Centers for Disease Control and Prevention Advisory Committee on Immunization Practices that has been approved by the federal Food and Drug Administration under a drug order, under a prescription, or according to a protocol approved by a physician. The bill was amended, giving the Indiana Commissioner of Health the authority to remove a specific vaccination from the list of vaccines recommended and approved by the federal agencies, and then unanimously approved by the Senate.
Also in Indiana, NACDS rallied members to contact their senators to urge support for the rate floor bill that is scheduled for a Senate vote this week. SB 140 would establish a minimum dispensing reimbursement rate of NADAC plus a professional dispensing fee equal to the Medicaid Fee for Service fee, which is currently $10.64.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
NACDS sponsored and attended the recent Iowa Pharmacy Association’s (IPA) Pharmacy Day on the Hill that included 200 pharmacy professionals in Des Moines to advocate for PBM reform at the Iowa State Capitol. The comprehensive PBM reform bill (HSB 99 / SSB 1074) passed out of subcommittee in the House and Senate and moves on to consideration by the full committees in both chambers as early as this week. IPA also hosted a PBM Reform Press Conference, revealing the latest poll data demonstrating resounding support for PBM reform among Iowans. These companion bills include important NACDS PBM reform legislative priorities including patient choice of pharmacy, anti-mandatory mail order, and commercial cost-based rate floor reimbursement methodology for the product and professional dispensing fee as published by the Iowa Medicaid Enterprise provider fee schedule. Also, a PBM cannot deny a pharmacy or pharmacist the right to participate as a contract provider under a plan if the pharmacy or pharmacist agrees to the terms and requirements of the plan and the terms of reimbursement.
Also in Iowa, the Department of Health and Human Services (HHS), Iowa Medicaid posted INFORMATIONAL LETTER NO. 2660-MC-FFS RE: Quantity Limit Update on Needles and Syringes effective March 1.
Finally in Iowa, the Department of Inspections, Appeals & Licensing’s Professional Health Committee – Pharmacy announced a meeting to be held on February 26.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
Gov. Andy Beshear (D) declared a state of emergency due to the severe storms that swept through the Commonwealth on February 14. In response, Medicaid has activated NCPDP procedures for pharmacies to override certain denials for members impacted by the storms. Gov. Beshear also activated the state’s emergency operations center and implemented the state’s price gouging laws to protect Kentuckians from overpriced goods and services as they recover from the storm.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Louisiana
The state Surgeon General Ralph Abraham sent a directive to state health workers on February 13, 2025, ending long-standing mass vaccination clinics and banning staff from promoting seasonal vaccines. Abraham also issued a letter to the public criticizing the state’s COVID response and public health institutions.
Also in Louisiana, NACDS submitted a letter supporting the proposed rules implementing House Bill 579 which we passed in 2024, enabling pharmacists to offer HIV prevention services.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
MO HealthNet (Medicaid) is conducting a survey regarding the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act’s prescription drug monitoring program mandate. The SUPPORT Act required that states mandate that covered providers consult a qualified prescription drug monitoring program (PDMP) before prescribing controlled substances to covered individuals. States must report annual data about the use of PDMPs by covered providers before prescribing controlled substances to the Department of Health and Human Services (HHS).
Also in Missouri, effective January 9, 2025, the MO HealthNet Division (MHD) carved-out certain drugs from the 340B Drug Pricing Program reimbursement. It was necessary to allow the state to collect supplemental and value-based agreement rebates on certain therapies. The state cannot collect federal, supplemental, or value-based agreement rebates when a covered entity utilizes 340B stock.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services added the following items under the Vaccines for Children (VFC) Provider Resources dropdown.
- Daily Freezer Temperature Log
- Daily Refrigerator Temperature Log
- Daily Ultracold Freezer Temperature Log
- Quick Reminders
- Transport During Emergencies
- Vaccine Restitution Form
- VFC Borrowing Report
- Vaccine Storage Troubleshooting Report
- Clinic Line Listing Template
- Clinic Line Listing Blank
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The New York Department of Health held its monthly pharmacy industry call for NYRx, the state Medicaid pharmacy benefit program on February 19, 2025. The agenda included (1) DME supplies, processing of incontinence supplies, as this is the highest category of waste, fraud and abuse in the program today; (2) enhancements to the internal system for prior authorizations which allow the state to override and amend as needed; and (3) unenrolled providers are rejected by EMEDNY, if there are any concerns, make sure your pharmacy is enrolled when activating. The next monthly meeting will be March 19, 2025, at 1pm.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
The Department of Insurance has published rules regulating Pharmacy Benefit Managers were published this week. The reason for this proposed action is to implement statutes for the licensure of pharmacy benefits managers (PBMs) and directed the Department to adopt rules for licensure (see G.S. 5856A-2). Entities to be licensed as PBMs have previously been licensed or registered as third-party administrators (TPAs). Borrowing from the licensure requirements for TPAs, the proposed rules further set out the requirements for licensure as a PBM. Additionally, where G.S. 58-56A-2 gives the Commissioner the authority to charge an initial application fee of $2,000 and a renewal application fee of $1,500, those fees will be established by the proposed rule 11 NCAC 24 .0102. The date of the public hearing will be April 1, 2025, at 10:00 a.m., NC Department of Insurance, Hearing Room 211, 3200 Beechleaf Ct., Raleigh, NC 27604.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
Register Now for the Informative Training Session: Supporting the American Indian Population in North Dakota. This one-hour recorded on-demand training is designed to equip you with the knowledge and skills necessary to develop new practices and approaches that will enhance health outcomes and improve the quality of life for the American Indian population in North Dakota. By participating in this training, you will gain valuable insights into the unique health challenges faced by this community and learn effective strategies to address these challenges.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oklahoma
On February 20, the Senate Business and Insurance Committee scheduled a hearing for two PBM bills of interest to pharmacies, SB 789 addressing below cost reimbursements by establishing a reimbursement rate floor of no less than 106% of the NADAC plus a professional dispensing fee of $15.00, and SB 993 establishing requirements and limits for audits. NACDS submitted a support letter on SB 789.
Also in Oklahoma, Sen. Adam Pugh (R) filed SB 806 creating the Food is Medicine Act, directing Oklahoma Health Care Authority (OHCA) Medicaid to implement a financial incentive for contracted entities who improve health outcomes of covered members through nutrition services. OHCA is directed to seek federal approval from CMS to implement the Nourish My Health program. The state Department of Education will provide technical assistance with applying for grants and administering programs that expand student access to fresh, healthy food.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
The Board of Pharmacy announced that they have developed and posted a new tool in the form of a dashboard that provides data on pharmacy trends and access in the state. The dashboard includes data on closures, openings and “pharmacy deserts” across communities.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
NACDS prepared and delivered verbal and written testimony before the House of Representatives Behavioral Health and Health Care Committee in full support of HB 3212. Additionally, the testimony included how this crucial bill aims to reform PBMs and address their dangerous tactics that threaten the vitality of neighborhood pharmacies and patient access. Specifically, HB 3212 would prohibit spread pricing and patient steering, restrict PBMs from mandating pharmacies to provide a health care service at a loss, prohibit PBMs from requiring further accreditation standards beyond those currently required by the Oregon Board of Pharmacy, help to ensure network adequacy, and most importantly, help to ensure reasonable and relevant reimbursement to community pharmacies that covers the true costs for pharmacies to purchase and dispense prescription drugs. NACDS urged lawmakers to advance HB 3212 to help ensure reasonable pharmacy reimbursement and protect patients’ access to trusted pharmaceutical care across the state.
Also in Oregon, the Prescription Drug Affordability Board held a meeting on February 19. Generally, the agenda and materials for this meeting was focused on policies, processes, and administrative matters, plus a legislative update. Register here in advance.
Also in Oregon, the Oregon Health Authority (OHA) published proposed rules establishing guidelines for enhanced payment to qualified providers under the Culturally and Linguistic Specific Services program. A 22 percent and 27 percent increase in fee-for-service payments for traditional health worker providers, programs, and organizations in urban and rural areas, respectively, will enable OHA to continue investments to improve access to care, incentivize culturally and linguistically specific services, invest in workforce diversity and support staff recruitment.
Also in Oregon, the Board of Pharmacy posted the agenda for the February 24 Executive Director Recruitment Subcommittee Meeting.
Also in Oregon, the Immunization Policy Advisory Team will meet on March 6. Draft agenda items include welcome, introductions of new members; public comment; respiratory season wrap-up—COVID-19, influenza, pertussis, RSV; data dashboards; legislation update; Project Horizon—program resize; ALERT IIS Replacement Project update; school requirements—new administrative rules; wrap-up. The final agenda will be available at the meeting or via email request three days before the meeting date.
Finally in Oregon, on February 6, the Board of Pharmacy adopted a statement on semaglutide.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
CDC and Tennessee Department of Health has released a call for cases investigating reports of serious adverse events, including deaths, following receipt of injectable ceftriaxone. To date, events have not been associated with a sole product manufacturer or lot, and a definitive causal link to ceftriaxone has not been established. A public health investigation is underway to identify and characterize serious adverse events associated with ceftriaxone exposure. Please make reports to the HAI/AR Program at HAI.Health@tn.gov.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
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.