South Carolina
Effective for dates of service on or after December 1, the Department of Health and Human Services (SCDHHS) is updating its billing policy for providers who purchase physician-administered drugs through the Health Resources and Services Administration’s (HRSA) 340B drug pricing program. The changes described in this bulletin only apply to services rendered to Healthy Connections Medicaid members in an outpatient setting who are enrolled in the fee-for-service Medicaid program.
These policy updates will be published in the Physicians Services, Clinic Services, Hospital Services and Federally Qualified Health Center (FQHC) Services provider manual by December 1, 2025.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Tennessee
The deadline to submit an attestation of low-volume status and proof of actual prescription volume to your contracted PBMs is December 1. Volume status is based on your pharmacy’s actual prescription volume from July 1, 2024, to June 30, 2025. For more information, please refer to the Department of Commerce and Insurance (TDCI) rules. The Tennessee Pharmacists Association’s PBM resource page also has some helpful information to assist you with this process.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
California
The Department of Health Care Service posted the following on the Medi–Cal Rx Web Portal: Mass Adjustment for Member Eligibility Data That Impacted Claim Funding for Claims Submitted March 10, 2022, through October 5, 2025.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Massachusetts
The Board of Pharmacy shared the following updates. As a reminder, pharmacy practice documents, regulations and other resources are available on the website.
Policy 2020-15: Scope of Practice
Updates to this policy define "handling" of medications and that it requires an individual pharmacy license as well as defining the "prescription area" and who may access it.
New Pharmacy Labeling Requirement
Pharmacies must now label Schedule VI medications prescribed for reproductive or gender-affirming care with the name and address of the healthcare practice instead of the individual prescriber upon request from the prescriber.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
New York
Effective November 6, Yeztugo® was covered as a pharmacy benefit by NYRx, the Medicaid Pharmacy Program, in addition to being covered by the Medicaid managed care medical benefit as a Practitioner-Administered Drug (PAD). To prevent pharmacy claim denial, it is important for the pharmacy to submit the claim for both oral and subcutaneous products on the same date of service.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda and meeting materials for the November 19 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.
Arizona
The Arizona Medicaid agency, the Arizona Health Care Cost Containment System and the Governor's Office invite you to attend this public webinar to learn more about Arizona's application for the Rural Health Transformation Program. This webinar will highlight the application submitted and will discuss the next steps regarding the program award and the funding of Arizona's programming. Click here to register and add to your calendar.
Date: November 13
Time: 11:30 am – 12:30 pm
Location: Virtual Via Google Meet. Please register in advance. (Meeting ID and passcode will be provided upon registration)
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
he Board of Pharmacy distributed its monthly News Roundup for November. This issue includes important information related to vaccines, albuterol and epinephrine standing orders for schools, the California Medication Error Reporting (CAMER), drug theft/drug loss online portal and PIC training webinar.
Also in California, the November 2025 issue of the Board of Pharmacy's newsletter, The Script, is now published online. The November 2025 newsletter includes information on:
- New Laws
- Regulations
- Immunization Alert
- Importance of Patient Consent Forms
- CAMER
- Inspection Results
- Citations Issued
- Technology the Pharmacist's Role in Medication Safety
- Standing Orders for Schools Regarding Albuterol and Epinephrine
- Well-Being Index
Also in California, the Board of Pharmacy sent the following reminder to licensees.
Business and Professions Code (BPC) section 4113.1 establishes requirements for a community pharmacy to report medication errors known as CAMER to an entity approved by the Board. The statute requiring medication error reporting by community pharmacies can be viewed at BPC section 4113.1. The Board approved the Institute for Safe Medication Practices (ISMP), an ECRI Company, as the entity to receive and review medication error reports under BPC section 4113.1. Information regarding CAMER registration can be found at https://mederrors.ismp.org/.
The Board reminds community pharmacy licensees that medication errors that occur on or after September 1, 2025, must be reported to the CAMER system consistent with legal requirements established.
Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal:
Finally in California, pursuant to the announced pharmacy benefit policy changes effective January 1, 2026, the Department of Health Care Services (DHCS) mailed letters to Medi-Cal members to notify them of two upcoming changes:
- All Medi-Cal members received a letter concerning the exclusion of coverage for GLP-1 medications for weight-loss indications.
- Impacted Medi-Cal members received a letter concerning the need for prior authorization (PA) approval for select medications previously filled without a PA request.
Both letters provide members with information about the policy change and guidance concerning potential actions the member may take.
Questions may be submitted to the Pharmacy Benefits Division at Medi-Cal.PharmacyBenefits@dhcs.ca.gov or to the Medi-Cal Rx Education and Outreach team at Medicalrxeducationoutreach@primetherapeutics.com
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Iowa
Gov. Kim Reynolds (R) announced the state submitted its application to CMS for the Rural Health Transformation Program. The proposal, titled Healthy Hometowns, is aimed at building a high-quality, sustainable system of care that improves the health, well-being and quality of life in rural communities across the state. Healthy Hometowns is Iowa's strategic response—developed in collaboration with rural hospitals, health systems, and community partners—to address these challenges through a hub and spoke model of care. More information about Iowa's Rural Health Transformation proposal, including its application, is available online.
Also in Iowa, the Department of Health and Human Services (Iowa HHS) launched a new funding opportunity to help communities across the state respond to the opioid crisis. This funding comes from HF 1038 passed earlier this year, which directs 75% of Iowa's opioid settlement money toward efforts to reduce opioid misuse and its impacts.
The Iowa HHS will allocate this funding through a competitive application process. There will be two rounds of funding: one starting now and another in the spring. Each project can receive up to $1 million, with $7 million available in each round.
Projects must focus on one or more of the following goals:
- Identifying and addressing needs in communities affected by opioids.
- Using proven or community-based methods to support people impacted by opioid use.
- Working with local service providers to improve recovery outcomes.
- Promoting the use of medications for opioid use disorder (MOUD) and distributing overdose reversal drugs (OORM).
- Respecting the privacy and dignity of people receiving services.
- Using data to show results and improve services.
For more information or to apply, visit: https://www.iowagrants.gov/viewStorefrontOpportunity.do?OIDString=1758745329639%7COpportunity
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Kentucky
MedImpact issued an updated statewide physician protocol for COVID point-of-care testing and a revised covered over-the-counter drug list.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Maine
The Board of Pharmacy held its regular meeting on November 7. The agenda includes second notice of rulemaking on prescribing, dispensing and administering HIV medicine.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Massachusetts
The Board of Registration in Pharmacy held its regular meeting on November 6. The agenda included the following:
- New pharmacy labeling requirement (Shield Law 2.0)
- Pharmacy Advisory Committee meeting summary
- Recommendation for automated non-sterile compounding devices
MassHealth provided notice via All Provider Bulletin 412 to all providers using 340B drugs that it will stop paying for the high-cost drugs listed in this most recent bulletin, in addition to those outlined in All Provider Bulletin 390 and All Provider Bulletin 400. This follows M.G.L. c. 118E, § 13L, 130 CMR 405.000: Community Health Centers, 130 CMR 406.000: Pharmacy Services and 130 CMR 410.000: Outpatient Hospital Services.
MassHealth will implement these changes no sooner than May 4, 2026, through a follow-up All Provider Bulletin. MassHealth is inviting comments about these changes no later than December 3. See All Provider Bulletin 412 for details.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
Nebraska
The Board of Pharmacy posted an agenda for its November 17 meeting.
Also in Nebraska, the Department of Health and Human Services (DHHS), in partnership with the University of Nebraska Public Policy Center, has launched the Prevention & Care Provider Survey to find out more about care of certain infectious diseases in the state.
This anonymous online survey asks about your experiences and perspectives related to prevention, testing and diagnosis, patient care and services in Nebraska, with some questions asking about HIV in particular. Your input is critical for informing policies on HIV prevention and care across the state.
To access the survey, please visit: https://go.unl.edu/hiv-providersurvey or scan the QR code with a mobile device.
The survey should take approximately 15 minutes to complete. All responses go directly to researchers at the University of Nebraska Public Policy Center. DHHS will receive only a summary of aggregated results, no individual responses or identifying information will be collected or shared.
The survey will remain open until December 5. If you have any questions about the survey, please contact Quinn Lewandowski of the University of Nebraska Public Policy Center at qlewandowski2@nebraska.edu or 402-472-9459.
Also in Nebraska, the Department of Health and Human Services posted the draft minutes from the Drug Utilization Review (DUR) Board's October 28 meeting. The next meeting will be held on January 13, 2026.
Finally in Nebraska, the Department of Health and Human Services added the Buprenorphine: Practical Clinical Guidance for Prescribers under DUR Resources.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
New York
The NYRx Education & Outreach team shared the following update.
Effective November 6, 2025, Rybelsus 3mg will be subject to the following clinical criteria:
- Prescriptions will be limited to a duration of 30 days, with no refills.
- Use for glycemic control will not be covered. System updates will be made to ensure alignment of coverage and criteria. Any claims that do not meet the criteria may be impacted and rejected at the pharmacy.
Any claims that do not meet criteria may be impacted and reject at the pharmacy.
The NYRx Education & Outreach Call Center is available by phone at 1-833-967-7310 or by email at NYRxEO@primetherapeutics.com from 8:00 am to 5:00 pm ET, Monday through Friday, excluding holidays.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Ohio
Gov. Mike DeWine (R) announced that he is nominating Scott R. Partika to be the director of the Department of Medicaid, following the announcement that Director Maureen Cocoran is retiring. Partika's nomination must be confirmed by the Senate.
Also in Ohio, the Board of Pharmacy has posted the following:
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Prescription Drug Affordability Board (PDAB) posted its draft agenda for the November 19 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Also in Oregon, the Oregon Health Authority issued a notice of proposed rulemaking amending prior authorization criteria and preferred drug list to implement recommendations from the Drug Utilization Review / Pharmacy & Therapeutics action. A hearing is scheduled to be held on November 17 from 11:00 am – 11:45 am. See notice for details.
Finally in Oregon, the Office of Governor Tina Kotek and Oregon Health Authority's (OHA) Public Health Division are seeking applicants for one position (member at large) on the state Public Health Advisory Board (PHAB). Please refer to the announcement for more information.
OHA invites applicants from a wide range of backgrounds including pharmacists with experience in prevention, patient care or a public health issue. This term for this position is scheduled to begin January 1, 2026.
Learn about the application process here.
To apply, complete the electronic application process by November 30.
These recruitments will remain open until filled.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Wyoming
The state announced the submission of its application to CMS for the $50 billion Rural Health Transformation Program. The application outlines the state's plan to use the funding to address the biggest health challenges identified by rural Wyoming communities through 11 local town hall meetings and prioritized through an online survey with over 1,300 responses.
Also in Wyoming, Gov. Mark Gordon (R) recently issued Executive Order (2025-07) directing the Department of Family Services (DFS) to begin the process of submitting a waiver request to restrict the use of Supplemental Nutrition Assistance Program (SNAP) benefits for the purchase of certain foods that offer little or no nutritional value, such as sugary beverages and candy.
Finally in Wyoming, Gov. Mark Gordon (R) recently declared a Public Welfare Emergency and issued an Executive Order (2025-08) authorizing up to $10 million in state emergency funds to ensure Wyoming families continue to have access to food if federal Supplemental Nutrition Assistance Program (SNAP) dollars run out due to the federal government shutdown.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
Effective for dates of service on and after October 1, the Medicaid Agency (Medicaid) updated the laboratory fee schedule rates. Providers with billing questions may contact the Gainwell Technology Provider Assistance Center at 1-800-688-7989.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arkansas
The Board of Pharmacy finalized rules that permit pharmacies to utilize up to four (4) support staff members per supervising pharmacist. This includes pharmacy technicians and other non-intern personnel. Licensed interns participating in an Accreditation Council for Pharmacy Education (ACPE) accredited experiential programs and graduate interns are excluded from the ratio count, as are non-clinical personnel such as clerks and delivery staff. This change is part of a broader effort to modernize pharmacy regulations and provide greater operational flexibility.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
Gov. Gavin Newsom (D) signed SB 41, PBM reform legislation. SB 41 requires licensure of PBMs, protects patient choice by prohibiting PBMs from steering or inducing patients to affiliate pharmacies, prohibits retroactive fees and claw backs, mandates PBMs use a passthrough pricing model and prohibits spread pricing among its various provisions. Recall earlier this year, Gov. Newsom signed AB 116, the health omnibus trailer bill that contains the specific statutory language to implement the governor’s PBM reform policies as outlined in the state’s main budget bill.
Also in California, the Department of Health Care Services posted the following:
- October 2025 Pharmacy Medi-Cal Update Bulletin
- October 2025 Durable Medical Equipment and Medical Services Medi-Cal Update Bulletin
Also in California, the Department of Health Care Service posted the following alert on the Medi-Cal Rx Web Portal: Important Update: GLP-1s for Weight Loss Are Not a Covered Benefit.
Finally in California, the Board of Pharmacy has proposed adding Title 16 CCR § 1707.4, related to Central Fill Pharmacies.
Any person who wishes to comment on the proposed text may do so by submitting written comments beginning October 17 and ending on December 1 to the following:
Contact Person: Lori Martinez
Agency Name: California State Board of Pharmacy
Address: 2720 Gateway Oaks Drive, Ste 100
Sacramento, CA 95834
Email: PharmacyRulemaking@dca.ca.gov
Fax: (916) 574-8618
Any responses to comments directly concerning the proposed text of the regulation will be considered and responded to in the Final Statement of Reasons.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Indiana
On October 27, the Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning’s (OMPP), will host a public hearing for a proposal to cut a pharmacy’s Medicaid professional dispensing fee from the current ten dollars and forty-eight cents ($10.48) to nine dollars and sixty-three cents ($9.63).
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Louisiana
New Pharmacy Technician certificate qualification rules were adopted on October 20. In response to Act 253 of the 2024 Louisiana Legislature, the rule change removes the practice requirement placed upon a pharmacy technician applicant from another state and recognizes the exception provided by the Act regarding the examination requirement.
Also in Louisiana, Gov. Jeff Landry (R) reappointed Walgreens pharmacist Troy Menard to the Board of Pharmacy for a second six-year term.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Massachusetts
On October 9, the Board of Pharmacy updated two items below:
The Opioid Prescription Drug Fact Sheet that must be distributed when dispensing a Schedule II or III prescription has been updated to reflect statutory changes. Please also note the change to state law that requires an opioid antagonist (e.g., naloxone) to be offered whenever a Schedule II opioid is dispensed.
Policy 2023-09: Action Level Environmental Monitoring Results
The requirement for growth identification in all ISO 7 areas is now only required for ISO 7 buffer rooms. This is in addition to the current identification mandates for ISO 5 areas and any action level growth in any ISO classified areas. Compounding during remediation now also differentiates between ISO 7 buffer rooms and other ISO 7 areas.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
New Mexico
Gov. Michelle Lujan Grisham (D) signed into law SB 3, legislation passed during the October special session that allows for consideration of guidance from the state’s Department of Health (NMDOH) or the American Academy of Pediatrics, instead of the Advisory Committee on Immunization Practices (ACIP), in drafting regulations. The new law also requires NMDOH to publish rules providing immunization recommendations for adults wishing to be vaccinated, using the guidance from the American Academy of Family Physicians, the American College of Obstetricians and Gynecologists, the American College of Physicians or the Department of Health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
New York
The NYRx Education & Outreach team at Prime Therapeutics announced the NYRx Education & Outreach Notification Service (NYRxEONS). This is a new and free service that keeps stakeholders informed and updated on news regarding NYRx, the Medicaid Pharmacy Program. To sign up, click here.
Also in New York, on October 22, the State Education Department (NYSED) published in the New York State Register an Emergency Rule Making to change regulations to require pharmacists and pharmacies to transfer a patient’s entire prescription, including all authorized refills, upon request. While published on October 22, the change was effective October 7, 2025, when approved by the State Board of Regents. There is now a 60-day public comment period before a Notice of Adoption is issued by NYSED.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.