Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda and meeting materials for the January 21 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
TennCare has made updates to Obesity and Oncology drug management. GLP-1 prior authorizations will remain active for one year with no changes to the criteria for approval as of December 1, 2025. Initial claims for oncology products will no longer be for 14-days’ supply, but instead subject to plan limitations, quantity limits and prior authorization criteria taking effect January 1, 2026. For comprehensive, clinical criteria, please visit the TennCare/Optum Rx® website and scroll to find “PDL Criteria” under “Useful Links”.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Gov. Greg Abbott (R) announced the appointment of Amanda Crawford as the new Insurance Commissioner, replacing Cassie Brown, who recently announced that she would be retiring on February 2.
Also in Texas, House Speaker Dustin Burrows (R) requested that all House Committee chairs submit their interim charges by February 9. Lt. Gov. Dan Patrick (R) requested Senators provide their interim charge recommendations by February 20.
Also in Texas, the Health and Human Service Commission's Vendor Drug Program (Medicaid) Policy team is hosting a quarterly Pharmacy Stakeholder meeting on January 21 at 9:00 am Central Time. Anyone interested in joining the calls needs to contact vdp-policy@hhs.texas.gov to preregister to receive the calendar invite and slide deck.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Vermont
This week, the Board of Pharmacy emailed the following to all state-licensed pharmacies. The revised Vermont Pharmacy Administrative Rules were recently approved and become effective February 1. The Office of Professional Regulation's outreach regarding key changes and details is forthcoming and will include timelines for compliance-readiness with certain, significant licensing-related and other changes. Please see Rule 4-3(b)(3) (page 11), regarding pharmacy technician training program completion. If your pharmacy provides employer-based training, please send it to Carrie Phillips for review and approval, ahead of February 1. Please see Rule 4-4 for the standards that such programs must include. If you have questions, please contact Carrie Phillips, Executive Officer, via email (carrie.phillips@vermont.gov) or by phone at 802-828-5032.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Washington
The legislature convened a short session on January 12 and will adjourn on March 12.
Also in Washington, pharmacies' priority legislation granting pharmacists independent authority was pre-filed in both chambers. SB 5924 by Senators Vandana Slatter (D) and Shelly Short (R) and, the companion bill, HB 2302, filed by Representatives My-Linh Thai (D) and Nicole Macri (D).
Also in Washington, Gov. Bob Ferguson (D) and Insurance Commissioner Patty Kuderer (D), a friend of pharmacies, jointly requested that the legislature give state agencies decision-making authority over vaccines and preventive services. SB 5967/HB 2242 allows the Department of Health (DOH) to propose vaccine recommendations based on medical and scientific expertise and evidence, without relying solely on recommendations from federal committees. The bill will ensure that children and adults in the state have access to vaccines grounded in science, based on safety and efficacy. The bill also preserves health plan coverage for DOH-recommended vaccines and freezes coverage for federal preventive services recommendations. This bill does not establish new vaccine mandates or change any laws related to consent for immunizations. Public hearings were scheduled in the Senate Committee on Health & Long-Term Care on January 15 and in the House Committee on Health Care & Wellness on January 16.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Rural Health Corner
NACDS would like to highlight an important requirement regarding the Rural Health Transformation Program (RHTP) state funding process. If a state does not receive the actual amount requested in its RHTP application, it must submit a revised budget that reflects its actual award amount by January 30. CMS will have 30 days to review and approve the state's revised budget.
Members can confirm whether a location qualifies as "rural" under the Health Resources and Services Administration's (HRSA's) definition by using the HRSA Rural Health Grants Eligibility Analyzer. The tool allows users to enter an address or select a state/county to determine rural eligibility status for HRSA rural health grants.
For more information, contact NACDS’ Jermaine Smith at 703–837–4388.
Alaska
The Department of Health Commissioner Hedi Hedberg announced Alaska received the second highest amount of money awarded by the federal government to spend on its Rural Healthcare projects in 2026. Pharmacies interested in learning more about how they can participate in the program need to pre-register for a virtual webinar on January 14 from 9:30 am-11:30 am AKT. You will learn about the Rural Health Transformation Program, including the state’s vision, approved initiative areas, anticipated timelines, what we know to date about the funding process and explore how your community can participate in regional health transformation efforts.
Also in Alaska, the state was awarded the second most discretionary Rural Healthcare Transformation Funds (RHTF) by the federal government – $272,174,856 – to help states redesign rural healthcare systems. The funding is discretionary and tied, in part, to each state’s pharmacist’s scope-of-practice score. Having the legislature pass SB 147B / HB 195A would increase the state’s score to access more federal dollars—supporting hospitals, rural health clinics and behavioral health initiatives statewide. Pharmacies are working closely with the Department of Health Commissioner and the Board of Pharmacy to advance this legislation in 2026.
Finally in Alaska, the Board of Pharmacy currently has one pharmacist vacancy and is anticipating another pharmacist vacancy in March 2026. Please consider applying online to serve on the Board of Pharmacy.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
Gov. Sara Huckaby Sanders (R) recently appointed Jimmy Harris to serve as the new Commissioner of the Insurance Department (AID). Harris is expected to be more aggressive on enforcement of complaints against PBM’s violating the laws and rules.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
On December 29, 2025, the Department of Health Care Services (DHCS) became aware of a preliminary injunction issued by the US District Court in Maine blocking the Health Resources and Services Administration (HRSA) from implementing the 340B Rebate Model Pilot Program, which was set to begin on January 1, 2026, pending further legal action. The preliminary injunction applies to the implementation of the 340B Rebate Model Pilot Program in the state. In light of the issuance of the preliminary injunction, DHCS will not implement the policy guidance previously provided specific to the drugs that are part of the 340B Rebate Model Pilot Program until further notice. Accordingly, providers should continue submitting Medi-Cal Rx and medical claims, as applicable, consistent with all existing Medi-Cal 340B billing policies.
Also in California, required system upgrades to the Medicaid Management Information System (CA-MMIS) are scheduled to take place on January 11. The upgrade may go into an extended maintenance period, which begins at midnight on January 11 and may continue through 10:00 am on January 11. During the extended window, the Medi-Cal Point of Service (POS), Automated Eligibility Verification System (AEVS), Leased Line vendors, Case Management Information and Payrolling System (CMIPS) and certain Transactions Services on the Medi-Cal Providers website applications may experience intermittent issues.
Also in California, as announced last year, CalRx partnered with Civica to make insulin more affordable and accessible statewide. Beginning January 1, 2026, CalRx/Civica Insulin Glargine pens will be available to California pharmacies at a cost of $45 per 5-pack of 3 mL pens, with a suggested maximum retail price of no more than $55 for consumers. To help patients locate pharmacies that plan to carry CalRx insulin, CalRx intends to publicly post participating pharmacy locations; see CalRx Pharmacy Survey to provide input. For more information, see resources listed below. For additional questions, please contact CalRx (info@calrx.ca.gov) or Civica (insulinquestions@civicarx.org).
- Pharmacy Fact Sheet (key details about the product, ordering and distribution)
- CalRx® Insulin Glargine Patient Flyer(this is a pdf file)
- CalRx® Insulin Glargine Patient FAQs(this is a pdf file)
- CalRx® Biosimilar Insulin Fact Sheet: English(this is a pdf file), Chinese-Simplified(this is a pdf file), Chinese-Traditional(this is a pdf file), Korean(this is a pdf file), Spanish(this is a pdf file), Tagalog(this is a pdf file), Vietnamese(this is a pdf file)
- Biosimilar Insulin Agreement with Civica Foundation(this is a pdf file)
- Biosimilar Insulin Agreement with Civica Foundation Amendment 1(this is a pdf file)
Also in California, the Board of Pharmacy published its Board of Pharmacy News Roundup (January 2026). Please review the news in its entirety for important updates and information.
Finally in California, the Board of Pharmacy seeks to remind affected licensees about Proposition 34, a ballot initiative that was approved by the voters in November 2024. Proposition 34 added the Protect Patients Now Act of 2024 (Act) to the Welfare and Institutions Code (see sections 14124.39-14124.52). Among its provisions, the Act establishes requirements for a “Prescription Drug Price Manipulator” (as defined in subdivision (l) of WIC section 14124.48) to report specified information to certain agencies, including the Board, by no later than April 30, 2026. Public comments related to the Act, and information relating to entities that qualify as Prescription Drug Price Manipulators, may be submitted to Prop34@dca.ca.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Legislature will convene on January 14 and adjourn on or before May 13.
Also in Colorado, the Attorney General’s Office and the Colorado Opioid Abatement Council (COAC) announced up to $23 million in new statewide opioid abatement funding available through grant opportunities. Round 4 Infrastructure Funding Opportunity prioritizes capital or operational investments in rural, underserved or disproportionately impacted communities, and encourages collaborative or multi-organization proposals.
Also in Colorado, the Department of Health Care Policy and Financing (HCPF) and Behavioral Health Administration (BHA) are currently developing a Prospective Payment System (PPS) Guardrails Plan and seeking feedback from our partners. PPS is a flexible, advanced reimbursement model tying payment to daily encounters instead of to individual services. It is provider-specific and based on each provider’s unique cost structure, designed to cover a safety net provider’s actual cost of services. The Guardrails Plan will detail the structure of the PPS payment, financial and data reporting requirements and quality requirements. It will also explain the monitoring and oversight processes, and potential impacts of noncompliance. The first stakeholder session is scheduled for January 23 from 11:00 am to 12:00 noon. Please register in advance in Zoom. Contact hcpf_bhbenefits@state.co.us with any questions.
Finally in Colorado, the Board of Pharmacy voted unanimously to make permanent rules regarding pharmacists’ authority to provide immunizations. The emergency rule changes from September 5, 2025, delink pharmacists’ immunizations authority from the Center for Disease Control (CDC) guidelines, and grant authority for pharmacists to independently prescribe any vaccine under their own license/NPI (National Provider Identifier), and got rid of the need for a physician authorization protocol. These rules were sent to the Secretary of State to be published in the Colorado Register and take effect no later than January 14.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Delaware
CMS awarded the state $157 million as part of a national program aimed at bolstering rural health care across all 50 states. The initial award represents the first batch of funding the state hopes to receive over the next five years. The full award amount for the state remains unclear at this time, but the state will receive at least $500 million from the federal program. Delaware officials said they plan to use those funds to invest heavily into health infrastructure in Kent and Sussex counties, including building the state’s first medical school and two new homeless service shelters in the lower counties. State leaders also hope to fund 13 additional programs, including additional preventative care, financial assistance for medical students that commit to working in Delaware for five years after graduation and robust nutritional education.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Department of Revenue has launched its new eFile and Pay system for quarterly, semiannual and annual filers. Please take a moment to review the latest Department of Revenue Tax Information Publication (TIP) link online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
2026 Critical Access Pharmacies eligibility list is available online as well as the most recent Medicaid Preferred Drug List.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Legislature convened its short session on December 1, 2025, and will adjourn on March 14.
Also in Indiana, the Family and Social Services Administration (FSSA) projects over $465 million in state savings over the biennium driven by declines in enrollment in key Medicaid programs, including the Healthy Indiana Plan (HIP) and Hoosier Healthwise (HHW).
Also in Indiana, the Health Coverage Programs (IHCP) issued a Bulletin reminding pharmacies that effective January 1, 2026, MDwise is no longer be a managed care health plan option for Healthy Indiana Plan (HIP) or Hoosier Healthwise (HHW) members. This bulletin addresses the transition of MDwise member claims and prior authorization (PA) requests for medications reimbursed through the pharmacy and medical benefits.
Finally in Indiana, at a December 2025 hearing, the Interim Director of Medicaid and Secretary of the Family and Social Services Administration (FSSA), Mitch Roob, asked the State Budget Committee to approve Medicaid’s submission of a State Plan Amendment (SPA) to CMS to change how 340B claims are processed by Medicaid managed care organizations (MCOs). The proposal would limit reimbursement to covered entities at actual acquisition cost, or close thereto, which would permit Medicaid to receive rebates from manufacturers in lieu of covered entities realizing 340B program savings for MCO claims. Director Roob testified that he expects this to provide an additional $63 million in revenue to Medicaid.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Iowa
Gov. Kim Reynolds (R) and the Department of Health and Human Services (HHS) announced the state has been awarded funding through the Rural Health Transformation Program. The state’s innovative proposal, Healthy Hometowns, will receive $209 million for the first year of implementation. Healthy Hometowns is a plan to strengthen health care in rural communities by making care more accessible, connected and patient focused. Healthy Hometowns includes five key initiatives: building partnerships to expand health care options in rural areas; improving cancer prevention, treatment and outcomes; supporting projects that bring different types of providers together under one roof; making health records accessible across the state so patients can get care wherever they are; and investing in telehealth and mobile health care programs, including high-risk maternal transport.
Also in Iowa, the Department of Health and Human Services (HHS), Medicaid posted the following: INFORMATIONAL LETTER [IL] NO. 2710-MC-FFS-D RE: Pharmacy 90-Day Supply Requirement – AMENDED, effective December 1, 2025. This letter serves as an amendment to IL-2710. Published on November 14, 2025. The update includes excluding the Indian Health Service providers from the 90-supply requirement. The effective date of the informational letter remains the same.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kansas
The Legislature will convene on January 12 and adjourn by April 10.
Also in Kansas, Mandy Czechanski is the new Executive Director of the Kansas Pharmacy Association (KPhA).
Finally in Kansas, the Department of Health and Environment (KDHE) hired Myers and Stauffer to conduct a study on the cost of dispensing. The results confirmed what pharmacists have been saying all along, that the cost to dispense has risen rapidly while reimbursements continue to decline. The results showed the cost to dispense a prescription is $11.38 for chain pharmacies and $15.85 for independent pharmacies, which is well above the current Medicaid rate of $10.50.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
The Department of Health’s (LDH) published Informational Bulletin 25-34, detailing changes to the Medicaid Managed Care Contracts for United Healthcare effective January 1, 2026.
Also in Louisiana, LDH revised Informational Bulletin 25-27, related to the 340B Drug Pricing Program.
Also in Louisiana, Act 464 of 2025 permits a pharmacist to dispense ivermectin to a person 18 years of age or older pursuant to a standing order. Subsequently, LDH issued a standing order and documentation authorizing pharmacists to dispense ivermectin to individuals 18 years of age and older.
Also in Louisiana, the Department of Insurance issued an Advisory Letter to all PBMs licensed in Louisiana and all health insurance issuers that contract with PBMs alerting them that Act 474 of 2025 established a new professional dispensing fee reimbursement for local independent pharmacies only effective January 1, 2026.
Finally in Louisiana, the Department of Health (LDH) appointed Seth Gold as the new Medicaid Director. He has a decade of experience in federal health policy, most recently serving as a professional staff member for the US House Committee on Energy and Commerce, where he advised members of Congress on Medicaid, CHIP and the 340B Drug Pricing Program.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
The Legislature convened the regular session on January 7 and will adjourn by May 15.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Board of Pharmacy posted the agenda for its January 12 meeting. Please note the discussion addressing the reduction of retail pharmacy hours and filling of controlled substance prescriptions issued by emergency rooms. Also, the Board posted the draft November 17, 2025, meeting minutes.
Also in Nebraska, the Medicaid Provider Manual has recently been updated; see Provider Bulletin 25-30A for more information.
Finally in Nebraska, the Department of Health and Human Services announced the “First-In-The-Nation Waiver Restricting Soda and Energy Drinks from SNAP [Supplemental Nutrition Assistance Program]” effective January 1, 2026.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Jersey
SB 2019, legislation permitting pharmacists to prescribe HIV pre- and post-exposure therapy according to the pharmacy “standard of care” model passed the General Assembly unanimously on December 22, 2025, and is now on the Governor’s desk for signature. The bill also requires public and private insurers to reimburse pharmacies at the same rate as other providers offering the same service.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New Mexico
The Legislature will convene a 30-day fiscal session on January 20 and adjourn on February 19.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nevada
The Board of Pharmacy posted the agenda for the January 14-15 meeting in Las Vegas.
Also in Nevada, the legislature is not in session in 2026.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
The latest Medicaid Pharmacy Newsletter, dated December 2025, is now available on the Medicaid website. In addition to the January 2026 checkwrite schedule, this edition of the newsletter includes the following articles:
- Reminder: Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies
- NC Medicaid’s Participation in Centers for Medicare & Medicaid Services Cell and Gene Therapy Access Model for Sickle Cell Disease
- Discontinuation of Coverage: Xifaxan (Rifaximin)
- North Carolina to Launch First-of-its-Kind NC Medicaid Managed Care Plan for Children and Families on Dec. 1, 2025
- Billing Reminder of a Third-Party Prescription to Medicaid
- NC Medicaid Reinstitutes Coverage for GLP-1s in Weight Management
Also in North Carolina, following the recent announcement of the Rural Health Transformation Program (RHTP) award by CMS, the state reaffirmed its commitment to continue collaboration with a broad coalition of state agencies, rural providers, community partners, academic institutions and the private sector. To advance this collaboration, the Department of Health and Human Services will host a virtual town hall on January 16 to outline program goals, discuss next steps and highlight the anticipated statewide impact. Additional details and registration information will be shared soon. For updates and more information, visit the NC Rural Health Transformation Program webpage.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
North Dakota
The North Dakota State University (NDSU) Center for Collaboration & Advancement in Pharmacy (CAP Center) is hosting a Community Health Worker (CHW) Q&A. Pharmacies have a new opportunity in North Dakota to get reimbursed for services. This opportunity is for a pharmacy technician to become certified as a Community Health Worker. To learn more about this opportunity, NDSU invites pharmacists and pharmacy technicians to an informal Q&A session focused on Community Health Workers (CHWs) and how to get started.
What is a community health worker? Community Health Workers connect individuals to appropriate services and resources to help them improve their health. Many pharmacy technicians already provide these types of services. Becoming a CHW presents an opportunity for pharmacy technicians to bill for these services and help the people they serve; see Medicaid Billing and Policy Manual for more information.
This will be an open conversation—not a presentation—where you can:
- Ask questions about CHW certification, implementation, and best practices
- Share ideas and learn from others
- Simply listen if you prefer
Format:
- 60 Min Interactive Q&A (no formal presentation)
- Preferably, questions are submitted in advance to help guide the discussion (submit here or below)
- Live questions are welcome during the session
Date & Time:
- January 27: 12:00 noon-1:00 pm (CST) – Zoom Link: https://ndsu.zoom.us/j/98102199233
- February 10: 12:00 noon-1:00 pm (CST) – Zoom Link: https://ndsu.zoom.us/j/99640636505
- Registration is not required. If you forget or lose the link, feel free to email Lisa Nagel (lisa.nagel@ndsu.edu).
Please submit your questions by January 22: Submit Your CHW Questions Here!
Also in North Dakota, the Department of Health and Human Service issued a Health Advisory regarding the use of antivirals for the treatment of influenza.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
The state released its first Rural Health Transformation Project (RTHP) Request for Proposals (RFP) seeking a project manager for the Rural Health Workforce Recruitment, Retention and Upskilling Pipeline Program. As outlined in the RFP, the program envisions pharmacies playing a key role in both the workforce initiative, and in the “upskilling” portion of the program. The RFP specifically calls for the development of training programs for pharmacists to practice at the top of their license to support point-of-care test and treat services. We urge members to review the RFP for awareness and preparation. Members may review the RFP and supporting materials on OhioBuys website.
Also in Ohio, the Board of Pharmacy released a draft Electronic Verification Rule (4729:5-3-25) that would authorize and regulate electronic product verification. The rule would allow a pharmacist to use technology to complete final product verification from a remote site. The rule is not specific to any practice site but specifies that it does not apply to remote dispensing pharmacies or automated dispensing systems. Please send any feedback you may have to Jill McCormack as soon as possible, as the comment deadline is January 15.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.