Ohio
The Board of Pharmacy published New OARRS Rules that will be effective on July 1.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
NACDS collaborated with the Oklahoma Pharmacy Association to advance four critical PBM reform bills. SB 2074, which establishes a pharmacy reimbursement rate floor—setting NADAC plus a dispensing fee that cannot fall below the Medicaid fee-for-service rate for both commercial and state plans—was heard by the House Public Health Committee on April 8. The committee also considered two additional PBM reform bills, including SB 1500 and SB 2007. On April 7, the House Insurance Committee heard SB 1447. NACDS submitted letters voicing strong support for all four bills, which would implement essential PBM reforms.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda and meeting materials for the April 15 meeting. Check the PDAB website for updates prior to the meeting. Register in advance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
See the April 2026 provider update, which includes Medicaid’s new policy which reinforces its role as payer of last resort by denying pharmacy claims when a primary insurer rejects a claim due to lack of prior authorization (PA). Pharmacies must now resolve PA requirements with the primary payer before billing Medicaid and include valid NCPDP reject codes to demonstrate coordination of benefits. Additional provider updates can also be found on the Executive Office of Health and Human Services (EOHHS) website.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
The Board of Pharmacy met last week and held a rulemaking hearing on the Compounding and Ambulatory Surgery Treatment Center (ASTC) Pharmacy rules, as well as standard Board business.
- The Board approved its first petition to remove consent orders related to substance use from public view on a pharmacist's profile on the Licensure Verification tool. This is in accordance with Public Chapter 100. A rulemaking hearing is occurring later this month related to this process.
- The Board approved the proposed rules for Compounding and ASTC Pharmacy with amendments. The Board voted to approve a 12-month educational period following final approval of the rules by the Secretary of State where compounding pharmacies may work towards compliance. If you have questions about which specific amendments were made, please contact olivia@tnpharm.org.
- The Board's Rulemaking Committee reported at their recent meeting that it plans to have a draft of updated rules by December 2026. At the next Rulemaking Committee meeting on April 30, the committee will focus on at least license reinstatement and pharmacy technicians, while the May 21 meeting will focus on workplace conditions.
Fees for certain licensure categories will be changing. The Board is still working to finalize these new fees.
Also in Tennessee, the Department of Health Vaccine-Preventable Diseases and Immunization Program (VPDIP) invites you to the 4th Annual Immunization Provider Expo, taking place virtually on April 14. The Expo will run from 8:00 am to 12:00 noon CST. This year's theme, "Restoring Trust in Vaccines", highlights how emotional storytelling, community engagement and data-driven insights can help rebuild public confidence in immunizations.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
The Texas Conservative Coalition Research Institute (TCCRI) issued a paper on Federal 340B Reform: Why Accountability Matters for Texas Employers and Patients.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Washington
Effective April 1, all prescribing providers must be enrolled with ProviderOne as an Apple Health provider. This includes any pharmacists who administer vaccines or prescribe products within their scope of practice. While this requirement has been in effect for the fee-for-service program since 2014, starting in April this applies to managed care organizations (MCOs).
Also in Washington, Apple Health (Medicaid), administered by the Health Care Authority will implement changes to the State Maximum Allowable Costs (SMAC) list for the fee-for-service (FFS) Prescription Drug Program. View MAC memo for rate changes effective June 1.
Finally in Washington, the Health Care Authority (HCA) announced that Trinity Wilson was appointed Medicaid Director, overseeing Apple Health (Medicaid) and the Children's Health Insurance Program (CHIP). Wilson brings more than 12 years of experience in Apple Health, with a background spanning eligibility policy and operations, customer and provider services and enterprise systems. She has served as Interim Medicaid Director since November 2025.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Alabama
The Department of Insurance (DOI) updated its PBM compliance website.
Updates include:
- Updated fax number (Please note the PBM Compliance Department has an updated fax number: 334-241-4110; the old fax number should no longer be operational.)
- Updated pharmacy complaint form (to remove patient PHI information)
- Reimbursement complaint spreadsheet template
- Best practices document
- Updated PBM actions page
- Links to PBM related laws and regulations
- Consumer complaint form and
- List of additional resources, including the National Association of Insurance Commissioners (NAIC), the Board of Pharmacy, stakeholder websites and Medicaid Average Acquisition Cost (AAC) reimbursement.
DOI will still accept the old complaint forms but would prefer pharmacies to move over to the new template in the upcoming weeks.
Also in Alabama, the Board of Pharmacy met last week and heard comments on its proposed rule for a Civil Penalty Schedule. This includes proposed fine ranges for violations by all license and permit holders. They voted to have an amended version published by next week and restart the public comment period. Be on the lookout for more information once the revised version is available. You can listen to the entire Board of Pharmacy meeting online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Services posted the following on the Medi-Cal Rx Web Portal. Please note reminders and urgent messages below.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
NACDS testified in support of HB26-1336, a bill designed to expand access to pharmacy healthcare services for both Medicaid and commercial patients, at a House Health and Human Services Committee hearing on March 31. The bill was amended to allow children 5 years of age and older to receive test-and-treat services directly from pharmacies. Additionally, it permits pharmacy technicians, under pharmacist supervision, to perform final product verification and other technical, non-discretionary tasks.
Also in Colorado, SB26-032, a bill designed to expand access to pharmacy vaccine services by increasing pharmacists' authority to prescribe and administer vaccines and by providing liability protections for pharmacists, was signed into law by Gov. Jared Polis (D) on March 27.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Florida
Gov. Ron DeSantis (R) signed HB 697, which will take effect July 1. The legislation includes provisions related to the Ryan White Part B AIDS Drug Assistance Program (ADAP), providing bridge funding to maintain the program without changes through June 30. The law also prohibits PBMs from restricting a pharmacy or pharmacist from declining to dispense a drug when the reimbursement rate is below the actual acquisition cost. Additionally, it bars PBMs from reimbursing a pharmacy or pharmacist at a lower rate than they reimburse an affiliated pharmacy or pharmacist. Finally, the law states that the administrative appeal procedure must allow a pharmacy or pharmacist the option to submit a consolidated administrative appeal representing multiple adjudicated claims that share the same drug and day supply and have a date of service occurring within the same calendar month.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Idaho
The Board of Pharmacy posted minutes from its March 19 meeting.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Illinois
The Department of Healthcare and Family Services (HFS) Bureau of Professional and Ancillary Services (BPAS) occasionally receives requests from clinicians in the provider community for individual drug reviews. To ensure requests for reviews are fair, balanced and relevant to the Medicaid Preferred Drug List (PDL), the BPAS has established procedures for handling these requests. After the BPAS receives the request for a drug review, the BPAS pharmacy staff establish the appropriateness of the request. The review takes place over a three-month period, beginning from the date the drug review is requested. Reviews are evaluated both clinically and financially. A recommendation may be presented to the Drugs & Therapeutics (D&T) Advisory Board at the earliest opportunity.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Kansas
NACDS sent Gov. Laura Kelly (D) a letter urging her to sign the Consumer Prescription Protection and Accountability Act. SB 20, formerly SB 360, is a comprehensive PBM reform bill that clarifies auditing procedures, specifies reporting requirements and strengthens enforcement authority by enabling both compliance and financial examinations.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Missouri
SB 878, was amended and passed the Senate on March 23. The bill expands pharmacists’ scope authority for CLIA-waived tests and allows prescribing certain types of medical equipment. It also enhances the Board of Pharmacy’s authority to allow pharmacies to dispense medications during a declared emergency. In addition, it would allow the over-the-counter sale of ivermectin and hydroxychloroquine, with a warning label, once the FDA authorizes them for over-the-counter dispensing. The bill was sent to the House of Representatives for further action.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Nebraska
The Department of Health and Human Services announced a public hearing to receive comments on proposed changes to Title 471, Chapter 7 of the Nebraska Administrative Code (NAC) – Durable Medical Equipment, Prosthetics, Orthotics, and Medical Supplies (DMEPOS).
Authority for these regulations is found in Neb. Rev. Stat. § 81-3117(7) and § 68-908.
Interested persons may attend the hearing and provide verbal or written comments, or mail, fax or email written comments, no later than the day of the hearing to: DHHS Legal Services, PO Box 95026, Lincoln, NE 68509-5026, (402) 742-2382 (fax) or dhhs.regulations@nebraska.gov, respectively.
A copy of the proposed changes is available online at http://www.sos.ne.gov, or by contacting DHHS at the mailing address or email above, or by phone at (402) 471-8417. The fiscal impact statement for these proposed changes may be obtained at the office of the Secretary of State, Regulations Division, 1201 N Street, Suite 120, Lincoln, NE 68508, or by calling (402) 471-2385.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Ohio
Gov. Mike Dewine (R) signed HB 229, sponsored by Rep. Kelli Deeter (R), into law this week. The law establishes licensure for PBMs beginning in 2027; prohibits certain PBM practices; and allows the Department of Insurance to take disciplinary actions for violations, including fines and license suspension or revocation. Additionally, it requires PBMs to enter into written agreements and provide regular accounting of rebates, fees and other financial arrangements to plan sponsors and permits the Department to access PBM records and data.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oklahoma
On March 26, the Senate passed SB 2074 by a decisive 34-3 vote. This bill aims to establish a reimbursement rate floor of NADAC plus a dispensing fee that cannot be lower than the Medicaid fee-for-service rate. The legislation was reported to the House for further consideration.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Oregon
The Board of Pharmacy posted two current Board Member Opportunities:
- Public Board Member Position - Apply Now!
- Pharmacist Board Member Position - Apply Now!
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted its draft agenda for the April 15 meeting. Check the PDAB website for updates prior to the meeting. Register in advance.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Rhode Island
The Board of Pharmacy implemented a new Pharmacy Law Test effective April 1, as part of updates to pharmacy initial licensing and renewal requirements. The changes are being administered through the National Association of Boards of Pharmacy’s (NABP’s) Electronic Licensure Transfer Program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
South Carolina
Reminder: federal law requires all providers who order, refer or prescribe services or items for Medicaid members to be enrolled in that state's Medicaid program. This requirement applies to pharmacist administering drugs as allowed under state protocols and submitting their NPIs in the prescriber field. Please review the Medicaid Enrollment of Ordering, Referring and Prescribing (ORP) Providers and Collection of ORP Data bulletin (MB# 25-015) published on July 2, 2025, as background.
Also in South Carolina, NACDS met with the Department of Health and Human Services (SCDHHS) on March 11 and inquired about mass enrollment of pharmacists as Medicaid providers. The provider enrollment department has informed NACDS that, unfortunately, due to system limitations and CMS requirements, they are unable to offer a mass enrollment process to any provider type.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
The Department of Health (TDH) continues to closely monitor respiratory syncytial virus (RSV) activity across the state. Recent emergency department data indicates that RSV activity remains elevated but has begun decreasing in Tennessee. Due to continued RSV activity in the state, pediatric providers and hospitals may continue to administer RSV immunizations to eligible infants through April 30. RSV immunizations remain available for ordering through TennIIS for the Vaccines for Children (VFC) program.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Texas
Lt. Gov. Dan Patrick (R) announced the Senate’s Interim charges, and Speaker Dustin Burrows laid out the House’s interim charges to prepare for the 2027 session.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Virginia
Gov. Abigail Spanberger (D) signed SB 669 (Chapter 36)/HB 830, a key initiative of her administration to address PBM structure in the commercial market. The law will require all health insurance carriers to use a pass-through pricing model. It also will prohibit a PBM from reversing and/or resubmitting a pharmacy claim without meeting certain requirements; reducing any pharmacy payment through effective rates; and retroactively denying or reducing a claim or aggregate of claims, except under certain circumstances. Additionally, it requires the State Corporation Commission to compile a report of its examination of PBM steering practices with recommendations to the General Assembly by December 1, 2027.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Washington
The Board of Pharmacy has released updated self-inspection worksheets for 2025, covering various pharmacy practice settings and specialties. The comprehensive collection includes worksheets for general pharmacy operations, hospitals and HPACs, manufacturers, wholesalers and healthcare entities. Additional specialized addenda are available for long-term care facilities and various USP standards including nonsterile compounding (USP 795), sterile compounding (USP 797), hazardous drugs (USP 800) and radiopharmaceuticals (USP 825).
The Board also published a 2025 DSCSA self-inspection worksheet to help pharmacies comply with Drug Supply Chain Security Act (DSCSA) requirements.
For more information, contact NACDS’ Mary Staples at 817-442-1155.