Oklahoma
The Legislature will convene on February 2 and is scheduled to adjourn on May 29.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The state received $197.3 million in 2026 to improve rural healthcare and could receive more in the following four years. The Oregon Health Authority (OHA) will invest the federal funding in community-driven projects that improve healthcare access, boost chronic disease management and prevention, grow and sustain the healthcare workforce and expand the use of health technology and data in the state’s rural and frontier communities. OHA will move as fast as possible to distribute funding and plans to make two sets of awards in quick succession during 2026. Oregon initially requested $200 million annually, or a total of $1 billion over five years, from the federal program. OHA will scale down its original proposal to fit its given budget.
Also in Oregon, the Prescription Drug Affordability Board is seeking applicants to fill a vacancy, especially individuals with knowledge and experience in health care and prescription drug payment systems. The board consists of eight members appointed by the governor and confirmed by the State Senate. Members serve four years and can seek reappointment. The time commitment is about 15 hours per month, including virtual board meetings held on the third Wednesday each month. The new member will begin serving in mid-2026. Applicants should apply through Workday by January 30.
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted its draft agenda for the January 21 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Finally in Oregon, the Oregon Health Authority issued the following statement: West Coast Health Alliance continues to endorse AAP [American Academy of Pediatrics]-recommended child, adolescent immunization schedules.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Pennsylvania
The Board of Pharmacy’s proposed Licensure by Endorsement Rule was published in the Pennsylvania Bulletin on December 20, 2025. The rule will permanently implement the expedited licensure process required by Act 34 of 2025. NACDS and the Pennsylvania Association of Chain Drug Stores (PACDS) helped advance the law to allow pharmacies to more easily manage increased prescription volume following Rite Aid’s closure.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Tennessee
TennCare is continuing the process of reviewing all covered drug classes. Changes to the Preferred Drug List (PDL) occur as new classes are reviewed, and previously reviewed classes are revisited. As a result of these changes, some medications your patients are taking may be considered non-preferred agents in the future. Please inform your patients who are on these medications that switching to preferred products will decrease delays in receiving their medications. We encourage you to share this information with other TennCare providers. The individual changes to the PDL are listed below. The new PDL will be posted on January 1, 2026. For details on clinical criteria, please visit OptumRx/TennCare and click on “Criteria PDL” under “Useful Links”.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Insurance Commissioner Cassie Brown announced that she will be retiring on February 2, after more than four years of leading the Texas Department of Insurance (TDI).
Also in Texas, the Texas Pharmaceutical Initiative (TPI) Board announced that they are sending a Request for Information (RFI) to companies that believe they can operate a single PBM for the 1.4 million state beneficiaries covered by public higher education insurance, the Employees Retirement System of Texas, the Teacher Retirement System of Texas, the Texas Criminal and Juvenile Justice systems and other individuals served by the Health and Human Services Commission. TPI’s plan is due on Gov. Greg Abbott’s (R) desk by June 1, 2026.
Finally in Texas, the legislature is not in session in 2026.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Department of Health and Human Services (DHHS) announced the state’s first-year award for the Rural Health Transformation Program from CMS totaling $195,743,566.
Work is underway to support implementation, and DHHS will share the next steps as they are finalized. As the state legislature appropriates funding, the state will begin the process of making awards for the initiatives that will serve rural communities. For questions or to join the contact list for updates, email ruralht@utah.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Washington
The Health Care Authority (HCA) Office of Health Professions submitted to the Legislature the Pharmacist Prescriptive Authority Sunrise report on December 19, 2025. This was provided in response to the request of the Senate Health and Long Term Care Committee last spring, directing the Department of Health to review a proposal to increase the pharmacist scope of practice to assess whether it meets the sunrise criteria in RCW 18.120.010. The request would allow the Pharmacy Quality Assurance Commission, the authority to regulate licensed pharmacist prescribing outside of a collaborative agreement.
Also in Washington, the 2026 first-quarter Preferred Drug List (PDL) utilized by Uniform Medical Plan and the Department of Labor and Industry for worker’s compensation claims was posted by the Health Care Authority (HCA).
Also in Washington, the Health Care Authority (HCA) announced that the Apple Health (Medicaid) provider enrollment application fee for 2026 increased to $750.00.
Also in Washington, the Health Care Authority (HCA) published quarterly updates to many of the Apple Health billing guides, effective January 1, 2026.
Also in Washington, in response to recent flooding, the HCA authorized Apple Health (Medicaid) Fee-for-Service pharmacy providers to furnish medications and supplies to clients, as needed, if such products have been lost, destroyed or have become inaccessible due to flood-related conditions.
Also in Washington, Apple Health Fee-for-Service (FFS) does not have an electronic pharmacy prior authorization (PA) system and does not contract with healthcare software companies that offer automated PA solutions.
How to submit a PA for FFS:
Drug coverage and billing guidelines:
- Apple Health Preferred Drug List (PDL)
- Apple Health (Medicaid) drug coverage criteria (clinical policies)
- Provider billing guides and fee schedules
Finally in Washington, the Health Care Authority (HCA) and Department of Health (DOH) released a new resource library to help healthcare providers and emergency medical services (EMS) personnel build knowledge and confidence to prescribe and administer medications for opioid use disorder (MOUD). A National Institutes of Health’s (NIH’s) study found that MOUD like buprenorphine and methadone can help manage opioid withdrawals and cravings and cut opioid-related deaths by half. Yet, these medications remain underused across the medical community. The new MOUD resource library gives Washington providers practical, easy-to-follow guidance for discussing and providing MOUD to their patients, which helps break down common barriers to treatment like stigma and lack of information. HCA and DOH also launched an awareness campaign to connect providers to training, clinical support and patient education materials.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
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 December 31, 2025.
Additional information about Proposition 34 is available online.
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.
Also in California, pursuant to Health and Safety Code section 11161.7(b), the Board of Pharmacy is distributing an October 22, 2025 list of prescribers whose authority to prescribe controlled substances has been restricted by the Medical Board of California. The Board of Pharmacy is making this information available to prevent the dispensing of prescriptions for controlled substances issued by restricted prescribers.
Also in California, NOTICE IS HEREBY given that the Board of Pharmacy (Board) will hold a hearing to receive public comments on a petition received related to Title 16, California Code of Regulations, Section 1709.1, Designation of Pharmacist-in-Charge.
The public hearing will be held on January 6, 2026, beginning at 9:00 am in the first floor Hearing Room of the California State Board of Pharmacy, located at 2720 Gateway Oaks Drive, Sacramento, CA 95833. Additionally, attendees may participate via the WebEx meeting platform. To participate via WebEx, please use the following link: WebEx Link or https://dca-meetings.webex.com/dca-meetings/j.php?MTID=m1240449cdb3802fe4e363f663d60bb6e
If joining using the link above
Webinar number: 2491 140 0958
Webinar password: CSBP16
If joining by phone
+1-415-655-0001 US Toll
Access code: 2491 140 0958
Passcode: 272716
To view and download the hearing materials, please visit the following link: Laws and Regulations or https://pharmacy.ca.gov/laws_regs/index.shtml, and click on Hearing or https://pharmacy.ca.gov/laws_regs/hearing.shtml.
Written comments may be submitted to PharmacyRulemaking@dca.ca.gov or to the California State Board of Pharmacy, located at 2720 Gateway Oaks Drive, Sacramento, CA 95833. Written comments will be accepted through January 6, 2026. The public will also be able to provide public comment when prompted during the hearing.
Requests for further information should be directed to the Board at (916) 518-3090 or PharmacyRulemaking@dca.ca.gov, or by writing to the California State Board of Pharmacy, located at 2720 Gateway Oaks Drive, Sacramento, CA 95833.
Also in California, the Board of Pharmacy, Board of Registered Nursing, Physician Assistant Board, Medical Board of California, Osteopathic Medical Board of California and Dental Board of California licensees can now register to attend the joint forum. Spots are limited, register today at https://www.dca.ca.gov/jointforum/register.shtml.
Healthcare practitioners involved in prescribing or dispensing medications are invited to a forum on December 17 at California State University, Sacramento, focusing on clinical and practical challenges practitioners and patients face in accessing medications for opioid use disorder and other controlled substances used to manage pain. This is a virtual and in-person event.
Topics to be addressed include:
- Legal and regulatory requirements governing controlled substances.
- Communication and collaboration between prescribers and dispensers.
- Reducing stigma and barriers to care for patients with chronic pain or substance use disorder.
EVENT DETAILS
- Date: Wednesday, December 17
- Time: 8:00 am to 5:00 pm
- Location: California State University, Sacramento
REGISTRATION IS REQUIRED
Register today at https://www.dca.ca.gov/jointforum/register.shtml. Attendance is capped at 32 in-person participants per Board and 83 virtual participants per Board. Further event details will be provided after registering. Please note that this event is not open to the general public.
WEBSITE FOR MORE INFO: Visit https://www.dca.ca.gov/jointforum for updates.
Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please review the numerous upcoming changes to Medi-Cal Rx.
Finally in California, the Department of Health Care Services posted the following:
- November 2025 Pharmacy Medi-Cal Update Bulletin
- November 2025 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Florida
The Department of Health, Division of Disease Control, scheduled a public meeting and workshop to discuss proposed revisions to Rule 64D-3.046 of the Florida Administrative Code, which governs immunization requirements for school entry. The session will take place on December 12 from 9:00 am to 12:00 noon Central Time, or until all business is concluded. The meeting will be held at the Hyatt Place Panama City Beach, in The Dunes Conference Room, located at 15727 Front Beach Road in Panama City Beach, Florida. Additional details are available in the official notice posted at the Florida Administrative Register.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Georgia
During the 2024 legislative session, the General Assembly passed HB 1028. This legislation allows the Commissioner of the Department of Public Health to issue a Standing Order for Post-Exposure Prophylaxis (PEP) to prevent Human Immunodeficiency Virus (HIV). This Standing Order may be used by Eligible Persons who may have been exposed to HIV as a prescription to obtain PEP medication for the prevention of HIV from a licensed Pharmacy. The Department of Public Health created a Standing Order, supporting documents, and training for pharmacists, which are now available on the Department’s website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services (HHS), Medicaid posted the following: INFORMATIONAL LETTER NO. 2717-MC-FFS RE: Annual Submission Requirements Regarding Prevention and Detection of Medicaid Fraud and Abuse, effective immediately.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Oregon
The Oregon Health Authority (OHA) is taking proactive steps to prepare for the potential launch of the Rural Health Transformation Program (RHTP) in the state. A key part of this effort is the release of a statewide Intent to Apply Survey to gather input from organizations across the state that plan to apply for future RHTP funding. For details about the survey, visit the RHTP website.
Survey Deadline: December 11, 2025, at 11:59 p.m. PT
Who should complete the survey?
Organizations that:
- Serve rural, frontier, or remote areas of Oregon
- Are in good standing with the State of Oregon
Even if your organization provided public comment in the fall, OHA encourages you to complete this survey.
Also in Oregon, the December 10-12 Board of Pharmacy Meeting agenda and meeting materials are now available.
Please note that on December 10, the board will meet in Executive Session for most of the day and anticipates resuming Open Session around 4:30 pm.
Please note that on December 11, the board anticipates meeting in Executive Session after roll call and resuming Open Session at 2:00 pm.
The board anticipates meeting in Open Session on December 12 and will break for lunch between 12:00 noon – 1:00 pm.
The Public may attend the board meeting in person during Open Session. Please see the meeting agenda for additional information. *Please be advised that additional meeting materials may be added to the agenda prior to the board meeting. Visit the board website for current meeting materials.
Also in Oregon, the Department of Consumer and Business Services (DCBS) announced TK Keen has been chosen as the state’s insurance commissioner. Keen has been serving in the acting insurance commissioner role since June and was deputy insurance commissioner for five years before that. He is also the administrator of the Oregon Division of Financial Regulation (DFR), part of DCBS.
Finally in Oregon, the Prescription Drug Affordability Board (PDAB) posted the draft agenda for the December 17 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.
Alabama
Medicaid issued an Alert announcing, effective October 1, Continuous Glucose Monitors (CGMs) were covered through the Durable Medical Equipment (DME) Program with prior authorization (PA) for recipients (children and adults) with one of the following:
- type 1 diabetes mellitus
- type 2 diabetes mellitus and are insulin treated with multiple (three or more) daily injections of insulin
NOTE: CGMs are not covered through the pharmacy benefit; requests must be submitted by a DME-enrolled provider with an active National Provider Identifier (NPI).
Also in Alabama, the Board of Pharmacy technician registrations expire December 31. The Board is accepting pharmacy technician renewals online at www.albop.com. Please don't wait until the last minute to renew.
Important information for technicians and their employers: If you are completing the Alabama Pharmacy Association (APA) Pharmacy Technician Training or employing a technician completing the program, please take note. With the upcoming holidays, please be aware of the following important dates and plan accordingly.
The APA office will be closed on Christmas Eve through January 1, 2026. If you complete the program after December 22, you may not receive a certificate of completion until January 5, 2026. If you need to complete the training before you renew your license, please do so before December 22.
APA will email certificates of completion on the following dates in December:
- Monday, December 1
- Monday, December 8
- Monday, December 15
- Monday, December 22
Please contact the APA office if you have any questions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
The Board of Pharmacy posted the meeting materials for its quarterly teleconference meeting held on November 20. Included on the agenda were updates from industry on pending pharmacist prescriptive authority legislation, SB 147 and HB 195.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Arkansas
The Insurance Department (AID) issued Bulletin 12-2025 which seeks public input on revisions to the Data Submission Guide for the All-Payer Claims Database.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please note the update on GLP-1 coverage effective January 1, 2026; see details below in the alert.
Also in California, as part of the Board's actions during the November 5-6 Board Meeting, the Board approved a policy statement related to the transition to a Standard of Care Practice Model for some pharmacist-provided health care services. Specifically, under provisions of Assembly Bill (AB) 1503 (Berman, Chapter 196, Statutes of 2025), certain pharmacist-provided patient care services are transitioning to a standard of care practice model.
Finally in California, the Board of Pharmacy approved a policy statement related to the role of the Pharmacist-in-Charge (PIC). Specifically, under AB 1503, new provisions reinforce the decision-making autonomy of the PIC related to staffing decisions.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
Facing a $850M budget deficit, Gov. Jaris Polis (D) proposed cuts to the Medicaid professional dispensing fee (PDF) for pharmacies. For fiscal year 2025-2026, the Health Care Financing and Policy (HCFP) will cut the tiered fee by $85,000 and propose a $506,000 reduction for 2026-2027. Reimbursements for high-volume pharmacies will drop from $10.25 to $9.93 and from $9.31 to $8.72.
Also in Colorado, a Rural Health Transformation Program Webinar for all stakeholders will be held from 10:00 am – 11:30 am Mountain Time on December 2.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Illinois
The purpose of this Provider Notice is to inform pharmacy providers that the claims adjudication system is now able to process and pay compound claims. The processing system had been paying compound claims at zero since the Change Healthcare outage in March 2024.
At this time, pharmacy providers are encouraged to void and rebill those claims that were either paid at zero or held pending restoration. This applies to fee-for-service (FFS) billing only.
Please call the Bureau of Professional and Ancillary Services at 877-782-5565 and speak to a pharmacy consultant to obtain any necessary overrides on rejections that may occur while rebilling these claims.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Department of Health and Human Services (HHS), Medicaid posted the following. Please note effective December 1, the optional 90-day supply allowance will now be a required 90-day supply prescription list. The list of medications for this requirement is posted on the PDL website; see letter below for details.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Louisiana
The Department of Health (LDH) announced a webinar on December 4 from 10:00 am to 11:00 am Central Time. This event aims to inform stakeholders about LDH’s Rural Health Transformation Program (RHTP) submission.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Minnesota
The Department of Health (MDH) released the final updated Form and Manner for Prescription Drug Data Sets, as well as an updated Frequently Asked Questions Document. Updates impact reporting by all reporting entities, including manufacturers, wholesalers, pharmacy benefit managers and pharmacies.
The updates reflect statutory changes from the 2025 legislative session (Laws of Minnesota, 2025 – 1st Special Session, chapter 3, article 2, sections 6-14) and responses to input received during the comment period. The updates include changes to align reporting elements, modified registration requirements and a change to the reporting period for reporting data on drugs of substantial public interest.
MDH has updated the Rx Data Portal to integrate the statutory changes and make additional enhancements to support reporting entities. These updates are now live and available to all reporting entities.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nevada
Gov. Joe Lombardo (R) convened a special session of the state Legislature on November 13 to address several key issues, including expanding healthcare access and workforce training.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
The latest Medicaid Pharmacy Newsletter, dated November 2025, is now available on the Medicaid website. In addition to the December 2025 check write schedule, this edition of the newsletter includes the following articles:
- Reminder: Immunizing Pharmacist Enrollment in NC Medicaid Contraceptives and NRT Protocol Reimbursement to Pharmacies
- Reminder on NC Medicaid Pharmacy Co-payment Requirements
- 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 December 1, 2025
- Updates to Coverage for Wegovy and Zepbound for Clinical Indications Other than Weight Loss
- Immunizing Pharmacist Enrollment and Medical Claims Billing Update
Providers are encouraged to review this important information. The 2025 Medicaid Pharmacy Newsletters can be viewed here.
Also in North Carolina, effective December 7, the Electronic Funds Transfer (EFT) Attestation will be added to the reverification provider application and to full Manage Change Requests (MCRs) when active electronic funds transfer (EFT) information is present. This attestation requires a signature from the Office Administrator (OA) on the provider's record.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The state's single Medicaid PBM, Gainwell, announced that, effective December 8, claims for preferred GLP-1 receptor agonists (listed below), will require a diagnosis of 'diabetes mellitus, type 2' to be documented in the member's medical record (as determined by medical claims data) or submitted on the pharmacy claim. For members with a diagnosis of 'diabetes mellitus, type 2' documented, claims will continue to be eligible for coverage under the state's Medicaid pharmacy benefit. For all other non-FDA approved uses (such as prediabetes or weight loss), coverage will not be available. Please note claims and associated diagnoses are subject to audit, and results will be reviewed by the Department of Medicaid for compliance. Diagnosis codes must be submitted by the prescriber on the original prescription or added by the pharmacy in consultation with the prescriber, with documentation of the date, time and name of the individual providing the diagnosis, in addition to the name of the pharmacy staff member verifying the diagnosis.
Preferred GLP-1 receptor agonists include:
- Byetta/exenatide
- Trulicity/dulaglutide
- Victoza/liraglutide
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
The legislature convened an interim hearing to examine the influence of PBMs on prescription drug pricing and patient access to local pharmacies. Chaired by Sen. Spencer Kern (R) and pharmacist Rep. T.J. Marti (R), the session highlighted significant concerns regarding below-cost pharmacy reimbursements, opaque pricing structures and patient steering practices. Expert testimony by Antonio Ciaccia, 46brooklyn Research, and others underscored systemic incentives that diminish transparency and raise costs. The Attorney General’s office and the Insurance Department reported recovering $32 million through enforcement actions, positioning Oklahoma as a national leader in PBM oversight. Legislators signaled intent to pursue comprehensive PBM reform legislation again in 2026, aimed at enhancing transparency, safeguarding independent pharmacies and ensuring equitable drug pricing.
For more information, contact NACDS’ Mary Staples at 817-442-1155.