California
The Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please review the numerous changes to Medi-Cal Rx effective January 1, 2026.
Also in California, the Board of Pharmacy published a Special Edition of The Script newsletter dedicated to AB 1503, the Sunset Measure for the Board of Pharmacy. This Special Edition focuses on:
- Standard of Care
- Nonresident Pharmacies
- Inspection of Nonresident Pharmacies
- Establishing Pharmacy Technician Advisory Committee
- Self-Assessment Process
- Define Pharmacy Technician Trainee
- Define Pharmacist
- Title Change to Advanced Pharmacist Practitioners
- Enforcing Pharmacy Law
- Pharmacist-in-Charge, Staffing
- COVID-19 Oral Therapeutics
- Emergency Refill Provisions
- Dispensing Hormone Therapy
- Pharmacy Records and Digital Conversion
- Ownership Prohibition
- Reporting to CAMER
- Chain Community Pharmacy Employee Notice
- Pharmacy Technician Duties
- High Risk Patients
- Retired Pharmacists License
- Mail Order Pharmacies
- Fees: Medically Underserved Area
Also in California, the Board of Pharmacy issued a notice to licensees to renew registration with the Institute for Safe Medication Practices (ISMP) for the California Medication Error Reporting (CAMER) System by January 31. Business and Professions Code (BPC) section 4113.1 establishes requirements for a community pharmacy to report medication errors to an entity approved by the Board.
Finally in California, the Department of Managed Health Care issued All Plan Letter RE: APL 25-020 (OPL [Office of Plan Licensing]) – Newly Enacted Statutes Impacting Health Plans (2025 Legislative Session). Please review information related to AB 116 and SB 41, PBM reforms enacted in 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Colorado
The Department of Health Care Policy & Financing (HCPA) issued a press release announcing it will receive just over $200 million in Rural Health Transformation Program (RHTP) grant funds for the first year of the 5-year program. HCPF is now focused on responding to the CMS Request for Applications (RFA) materials and will soon provide details on establishing the RHTP Committee’s structure, membership and meeting schedules. NACDS will continue to closely monitor the state’s RHTP website and provide details as they become available.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Hawaii
Gov. Josh Green (D) announced the state has been awarded $188,892,440 through the CMS’ Rural Health Transformation Program (RHTP). When evaluated on a per-rural-resident basis using federal rural population data, Hawaii’s funding translates to one of the highest levels of investment in the nation, per capita. The Governor’s Office will coordinate with CMS, state departments, healthcare providers and community organizations to implement the plan’s transformational improvements in access, quality, workforce stability and system sustainability. The state will review approved uses of funds once released. More information will be released soon.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Idaho
On December 30, 2025, the state was awarded $185,974,368 in annual grants to be distributed over five years to implement the plan outlined in its grant application, which focuses on five initiatives: “improve rural access to care through technology; ensure accessible quality care through innovative models; sustain rural workforce with training, recruitment, and retention; implement population-specific, evidence-based projects to make rural America healthy again; and invest in rural health infrastructure and partnerships.” The state will use the funds to provide subgrants to support the goals and projects outlined in its application. For more information about the state’s Rural Health Transformation Program (RHTP) application, visit the Department of Health and Welfare’s RHTP website.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Massachusetts
As a reminder, pharmacy practice resources, regulations and other resources are available on the website. See below for new and updated information.
Policy 2023-09: Action Level Environmental Monitoring Results – identification to the species level is required for any growth found in ISO-5 areas and ISO-7 buffer rooms, and any action level growth in any other ISO classified areas.
Advisory: Environmental Monitoring – the edits align with the changes to Policy 2023-09: Action Level Environmental Monitoring Results.
Also in Massachusetts, the Department of Public Health (DPH) issued Guidance on Recommended Reference Materials for Pediatric Immunization Schedules. Please review this information, share it with colleagues and take any action steps that may be appropriate to integrate the recommendations into your practice. DPH also shared Childhood Immunization Discussion Guides that are available from the American Academy of Pediatrics.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Minnesota
The Rural Health Transformation webpage includes all current information available on the various programs the state is seeking to implement. The full program project narrative includes details on each program, eligible participants and the stakeholders and/or entities who will help develop each initiative. Members can:
- Sign up for MDH's RHTF listserv here.
- Track RFPs the state may issue related to the programs that are posted. In addition, major contracts (estimated value over $50,000) are advertised each Monday in the State Register .
Also in Minnesota, the Department of Health (MDH) issued an announcement RE: MDH Endorses AAP [American Academy of Pediatrics] Schedule, RSV-mAb on Regular Order Form, Educate Staff on Program.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Nebraska
The Department of Health and Human Services published the following new fee schedules effective January 2026:
- Durable Medical Equipment, Medical Supplies, Orthotics and Prosthetics
- Immunizations
Also in Nebraska, the Department of Health and Human Services published the following Medicaid Program Provider Bulletins:
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Hampshire
CMS awarded the state $204,016,550 for 2026 as part of the federal Rural Health Transformation Program, the largest award among New England states. New Hampshire’s application requested $200 million annually throughout the duration of the five-year program to strengthen rural health care access, quality and long-term sustainability. Gov. Kelly Ayotte (R) established the Governor’s Office of New Opportunities & Rural Transformational Health (GO-NORTH) to oversee implementation of the program. Implementation planning is underway, with initial investments expected to support rural providers and communities beginning in 2026. In anticipation of the CMS award, the Governor and Council and the Joint Legislative Fiscal Committee earlier this month approved an acceptance and expend for the anticipated grant award for the current biennium.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New Jersey
On January 9, Gov. Phil Murphy (D) signed SB 2019, priority legislation that authorizes pharmacists to dispense HIV medications under the standard of care model. It also requires insurers to reimburse pharmacies for the service. The governor’s news release highlighted that the bill “will streamline access to critical health care services and prescription medications while enhancing New Jersey’s health care workforce.”
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New York
Gov. Kathy Hochul (D) recently announced new insurance coverage requirements that took effect on January 1, 2026, including a $100 annual cap on out-of-pocket costs for EpiPens. The law applies to state-regulated commercial insurance policies and contracts that are issued, renewed, modified, altered or amended on or after January 1. Because not all policies renew or change on that date, implementation will occur on a rolling basis throughout the year, with full compliance expected by year-end. The cap does not apply to Medicare, Medicaid or ERISA self-insured plans and applies only after deductibles are met for high-deductible plans.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The state released its first pharmacy-related Rural Health Transformation Program (RTHP) Request for Proposals (RFP), seeking a project manager for the Rural Health Workforce Recruitment, Retention and Upskilling Pipeline Program. 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 deliver point-of-care “test and treat” services in rural areas.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
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.
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.