Nevada
For the past several years, the Board of Pharmacy has been debating adopting rules to establish standards for licensees relating to staffing, supervision, duties of a pharmacy, duties of a pharmacist and requirements related to the timing of dispensing prescription drugs and devices in local retail pharmacies only. At the October Board workshop meeting, the Board decided to move forward to vote on workforce staffing regulations at the meeting on December 3-4 in Las Vegas.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
North Carolina
The Cost of Dispensing Survey has been completed, and the current Professional Dispensing Fee (PDF) of $10.24 will remain unchanged. While the survey included a review of uncollected copayments, over 85% of participating pharmacy providers did not submit data in response to the copayment-related questions. As a result, this factor did not influence the final determination of the PDF.
Also in North Carolina, the Department of Medicaid recently received questions regarding Medicaid beneficiaries who cannot pay pharmacy copays for medication. A provider cannot refuse to provide services if a beneficiary cannot pay a copay at the time of service. The issue is addressed in Pharmacy Policy 9 under section 5.5 Copayments. An eligible Medicaid beneficiary, who receives prescribed drugs, is required to make a copayment of $4.00 for each prescription received unless they are exempt for one of the reasons listed in Subsection 5.5.2. A provider may not deny services to any Medicaid beneficiary because of the individual’s inability to pay a deductible, coinsurance or copayment amount. A provider may not willfully discount copays for a Medicaid beneficiary, and an individual’s inability to pay does not eliminate his or her liability for the cost sharing charge. The provider shall open an account for the beneficiary, collect the amount owed later and document all attempts to collect the copay.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Oregon
The Board of Pharmacy posted the agenda for its November 5 Strategic Planning Meeting agenda. The Board will meet virtually, and the meeting begins at 9:00 am.
Also in Oregon, the Board of Pharmacy Board of Pharmacy is proposing to adopt the following rules:
The filing notices and proposed rule text are available on the Board’s website.
The November 25 Rulemaking Hearing will be held virtually via Teams and begins at 9:30 am.
If you wish to provide virtual oral testimony during the hearing, please complete and submit the Rulemaking Hearing Testimony Sign Up Form on the Board’s website. You may also sign up by submitting your first and last name, email address and which rule(s) you would like to comment on to pharmacy.rulemaking@bop.oregon.gov no later than 9:00 on November 25. You will receive a confirmation email and a calendar invitation to join the virtual hearing.
Written comments must be received by 4:30 pm on November 25. Submit written comments to pharmacy.rulemaking@bop.oregon.gov.
If you would like to listen to the rulemaking hearing, join the virtual Teams meeting or call:
(503) 446-4951 Phone Conference ID: 739 529 152#
Please email all rulemaking inquiries to pharmacy.rulemaking@bop.oregon.gov.
Finally in Oregon, the Board of Pharmacy permanently adopted the following rules at the October 2025 board meeting: Div 110 – Licensee & Registrant Fee Increase.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Tennessee
Pharmacy rules related to certified pharmacy technician administered immunizations and point-of-care tests are now effective. Please see rule 1140-02-.02.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Alaska
NACDS is working collaboratively with the Alaska Pharmacy Association to ensure pharmacists and pharmacies are included in the Rural Health Transformation Program funding.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
California
The Board of Pharmacy posted the following:
- Licensing Committee – October 15 agenda and meeting materials
- Enforcement & Compounding Committee – October 16 agenda
Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal:
Also in California, the Board of Pharmacy issued a Notice of Third Modified Text – Discontinuance of Business – Updated. The Board of Pharmacy has proposed additional modifications to Title 16 CCR § 1708.2, related to the Discontinuance of Business.
Any person who wishes to comment on the proposed modifications may do so by submitting written comments beginning on October 6 and ending on October 22 to the following:
Contact Person: Debbie Damoth
Agency Name: California State Board of Pharmacy
Address: 2720 Gateway Oaks Drive, Ste. 100, Sacramento, CA 95833
Email: PharmacyRulemaking@dca.ca.gov
Fax: 916-574-8618
Please be advised the additional changes made to Title 16 CCR § 1708.2 reflect nonsubstantive changes with the exception of changes made to Title 16 CCR § 1708.2(b)(4). As a result, comments submitted should pertain only to the additional changes made to Title 16 CCR § 1708.2(b)(4). Any responses to comments directly concerning the proposed modifications to the text of the regulations will be considered and responded to in the Final Statement of Reasons.
Finally in California, the Board of Pharmacy posted this "Vaccine Alert".
Updated information on pharmacist authority to administer vaccines
The Board wishes to advise licensees about important upcoming changes to pharmacist authority related to vaccine administration enacted by Assembly Bill 1503 (Berman, Chapter 196, Statutes of 2025). AB 1503 was recently signed by Governor Newsom and will take effect on January 1, 2026. Under the provisions established in AB 1503, pharmacist authority to independently initiate and administer vaccines for persons three years of age and older will transition to a standard of care practice model. Such an approach is consistent with other health care practitioners with similar practice authority.
In anticipation of this change, the Board strongly encourages pharmacists to begin the transition to a standard of care practice model for immunizations for patients three years old and older. The Board intends to use enforcement discretion during this intervening period.
The Board also reminds pharmacists that Business and Professions Code section 4052(a)(11) currently provides a pharmacist with the authority to administer immunizations to any person, regardless of age, pursuant to a protocol with a prescriber. This current authority will exist until January 1, 2026, when AB 1503 takes effect.
Note that while AB 1503 repeals current subdivision (a)(11) of section 4052, it also adds new subdivision (a)(12), which, effective as of January 1, 2026, provides general authority for a pharmacist to initiate, adjust, or discontinue drug therapy for a patient (which includes vaccine administration) under either (1) a collaborative practice agreement, or (2) under specified conditions, an order or authorization made by the patient's prescriber. (See Stats. 2025, Ch. 196, Sec. 13 (AB 1503), effective January 1, 2026.)
Finally, as announced in a separate alert released on September 18, 2025, the Board reminds licensees about the following recent developments related to vaccines:
- In early September, the West Coast Health Alliance was launched to provide evidence-based unified recommendations for residents of California, Oregon, Washington, and Hawaii regarding who should receive immunizations.
- On September 17, the California Department of Public Health announced official immunization recommendations in accordance with this Alliance.
- Recent enactment of Assembly Bill 144 (Committee on Budget, Chapter 105, Statutes of 2025) provides authority for pharmacists to independently initiate and administer to individuals three years of age or older an immunization that, on January 1, 2025, had in effect an ACIP recommendation and that is recommended by the California Department of Public Health. This authority became effective on September 17, 2025, and provides separate and independent authority (complementing other current and forthcoming authorities) for pharmacists to administer vaccines.
- AB 144 also contains provisions related to Medi-Cal coverage of vaccines and immunizations. Learn more about Medi-Cal coverage of vaccines here.
Thank you for your commitment to California patients.
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.
Illinois
Effective October 1, the Department of Health and Family Services updated the Medicaid Preferred Drug List.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Indiana
The Medicaid proposal to cut pharmacies' reimbursement remains unchanged, but the timeline for stakeholders to comment has been extended until October 27. A public hearing is scheduled on the same date to allow for public comments.
Also in Indiana, NACDS submitted a letter on September 30 opposing the Family and Social Services Administration (FSSA), Office of Medicaid Policy and Planning's (OMPP) proposed changes to the reimbursement methodology that would result in a devastating 8.8 percent cut in pharmacy dispensing fees.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Maryland
The Department of Health’s Office of Pharmacy Services announced upcoming changes to the Medicaid Preferred Drug List regarding brand vs. generic product coverage. Updates include new requirements for Sabril, Concerta and Ritalin LA claims when submitted with DAW 6 codes.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Michigan
The public is invited to attend the Medicaid Health Plan Common Formulary stakeholder meeting from 9:30 am to 12:00 noon on October 20. It will be held virtually via Zoom using the password SLVU14. Participants may also access the meeting by phone by dialing 408-961-3928 and entering access code 351013. Attendees are asked to RSVP by emailing KrepsD@michigan.gov by October 15.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
New York
On October 7, the State Board of Regents voted to amend paragraph (8) of subdivision (a) of section 63.6 of the Regulations of the Commissioner of Education. This amendment, adopted as an emergency rule and effective immediately, requires pharmacists transferring prescriptions to transfer the entire prescription, including all remaining refills, to the new pharmacy chosen by the patient. As an emergency adoption, the amended regulation is now in effect. A Notice of Emergency Adoption and Proposed Rulemaking will be published in the State Register on October 22 for a 60-day public comment period as required under the State Administrative Procedure Act (SAPA). It is anticipated that the regulation will be presented to the Board of Regents for permanent adoption at its February 2026 meeting. Once adopted, the regulation would become permanently effective on February 25, 2026.
The state has also provided the following:
- An advisory notice highlighting key elements of the amendment: https://www.op.nysed.gov/advisory-notice-pharmacists-transferring-prescriptions
- Updated FAQs on prescription transfers, developed with input from the Board's committee https://www.op.nysed.gov/professions/pharmacist/frequently-asked-questions/prescription-refills and https://www.op.nysed.gov/professions/pharmacist/frequently-asked-questions/transfer-of-prescriptions
Also in New York, Gov. Kathy Hochul (D) extended the declaration of a disaster in the state of New York due to federal actions related to vaccine access by issuing Executive Order 52. 1 to continue access to COVID-19 vaccine through November 2.
For more information, please contact NACDS’ Ben Pearlman at 617-515-2603.
North Carolina
Dr. Larry Greenblatt, North Carolina Health Director, will rescind the statewide standing order effective October 13. Beginning on that date, pharmacies and pharmacists must revert to the protocols previously used to administer COVID-19 vaccines in the state. Please refer to the North Carolina Board of Pharmacy's guidance regarding CDC/ACIP recommendations and state law governing pharmacy-based COVID-19 vaccine administration.
Also in North Carolina, the Department of Health and Human Services (NCDHHS) remain committed to transparency, collaboration and fiscal responsibility in administration of the state's Medicaid program. Fee schedules impacted by rate reductions were released October 1, but are subject to change if additional appropriations are made available.
NC Medicaid provider reimbursement rate reductions are being implemented by the Division of Health Benefits (DHB) to maintain the NC Medicaid program within the current funding allocated to the Medicaid program by the North Carolina General Assembly (NCGA).
For more information, please see:
- Medicaid Provider Bulletin article NC Medicaid Rate Reductions – Effective October 1, 2025
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Ohio
The House Insurance Committee held a proponent hearing on HB 192 as amended. You can watch the hearing here. NACDS’ submitted written testimony in support of the bill.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Oregon
The Division of Financial Regulation (DFR) recently hired Sarah Young as the executive director of the Prescription Drug Affordability Board and the Drug Price Transparency Program.
Also in Oregon, the Prescription Drug Affordability Board published its October 2025 quarterly newsletter.
Also in Oregon, the Prescription Drug Affordability Board (PDAB) posted its draft agenda and meeting materials for the October 15 meeting. Check the PDAB website for updates to the agenda and the meeting materials. Register in advance.
Finally in Oregon, the Board of Pharmacy posted The Public Health & Pharmacy Formulary Advisory Committee (PHPFAC) October 22 meeting agenda. Please note that the Committee will meet in Executive Session after approving the agenda and anticipates resuming Open Session between 9:45 am-10:00 am. Please see the agenda for additional information including the link to join the virtual Teams meeting. For more information, contact pharmacy.formulary@bop.oregon.gov.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Texas
In response to the Board of Pharmacy’s (TSBP) request for input on the strategic plan, NACDS made several recommendations to pursue policy changes that will benefit public health.
For more information, contact NACDS’ Mary Staples at 817-442-1155.
Utah
The Division of Professional Licensing (DOPL) issued guidance clarifying the use of the 2025-2026 COVID-19 vaccine following the recommendations from the Advisory Committee on Immunization Practices (ACIP).
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Virginia
The Board of Pharmacy amended the vaccine statewide protocol for adults. Pharmacists, or a pharmacy technician or pharmacy intern under the supervision of the pharmacist, may now administer the COVID-19 vaccine to persons 18 years of age or older in accordance with the directions for use in adults of a manufacturer’s product approved by the U.S. Food and Drug Administration (“FDA”) or the Immunization Schedule published by the Centers for Disease Control and Prevention (“CDC”). Visit the protocols page for more information.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Wyoming
Gov. Mark Gordon (R) along with Department of Health Director Stefan Johansson continue to seek citizen input regarding the state’s Rural Health Transformation Program through an online survey. The survey runs October 8 through October 15. Results will inform the state’s application and determine which directions the State should pursue in transforming rural health.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
Alabama
A new episode has dropped on “Off Script”, The Alabama Pharmacy Podcast, with some CE available. All episodes and links to CE (in show notes) or wherever you like to listen. Watch Episode 44 – Board of Pharmacy Meeting Update: September 2025. Join Garrett Aikens and Allyson Gilliam as they recap the Board of Pharmacy meeting that took place on September 17.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Arizona
Gov. Katie Hobbs (D) appointed Virginia “Ginny” Rountree as the new director of the state’s Health Care Cost Containment System (AHCCCS), the Medicaid agency, effective October 6. A health and human services expert based in Tucson, Ginny brings more than a decade of experience in public roles at AHCCCS and the Department of Economic Security (DES), as well as leadership positions in the private sector.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
California
Pursuant to the enacted 2025-26 State Budget, the Department of Health Care Services (DHCS) will be implementing Medi-Cal Rx policy updates, effective January 1, 2026. These changes are intended to reduce pharmacy spending, improve program integrity, and ensure continued, equitable access to quality pharmacy benefits and services. Also, effective November 1, 2025, the coordination of benefits (COB) claims submission process will be updated for Medicare. See Upcoming Changes to Medi-Cal Rx for background information.
Also in California, the Department of Health Care Service posted the following on the Medi-Cal Rx Web Portal. Please review the “90-day Countdown: Upcoming Changes to Medi-Cal Rx” alert. Note changes are effective January 1, 2026. Please see the alert for details.
Also in California, the Health & Human Services Agency (CalHHS) launched a new webinar series focused on recent federal policy changes in health and human services and how California is responding to ensure continued access to care. The first webinar in the series addressed vaccine access and guidance, a timely topic as the state enters respiratory virus season. A full recording of the webinar and presentation slides are available for those who were unable to attend. The webinar featured insights from CalHHS Secretary Kim Johnson, Department of Public Health (CDPH) Director and State Public Health Officer Dr. Erica Pan and Department of Managed Health Care Director Mary Watanabe. Topics covered included public health updates, health plan coverage requirements and Medi-Cal vaccine coverage.
Under updated California law, health plans and insurance companies regulated by the state, including Medi-Cal, are required to continue covering routine immunizations recommended by the CDPH. This includes vaccines for flu, COVID-19 and RSV. Californians are encouraged to review CDPH’s vaccine recommendations and check with their health plan or insurer if they have questions about coverage. To schedule a vaccine appointment, individuals can contact their health care provider, visit a local pharmacy, or go to MyTurn.ca.gov.
Finally in California, on September 26, Gov. Gavin Newsom (D) signed AB 260 (Chapter 136, Statutes of 2025), legislation related to sexual and reproductive health care. NACDS is sharing this as information for members as there are provisions in the newly enacted law related to “pharmacists”.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.
District of Columbia
The Department of Health issued a statement declaring that pharmacists, interns and technicians with immunization authority should follow the American College of Obstetricians and Gynecologists (ACOG), the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians (AAFP) guidelines to administer COVID-19 vaccines. The following bulletins were also published:
- 9-12-25 Transmittal 25-22- DC Healthcare Alliance Medical and Pharmacy Services Transition from Managed Care to Fee-for-Service that was effective October 1. (rx volume approximately 11,000 fills)
- 9-10-25 Transmittal 25-21 – Notice of Intent to Discontinue Coverage of OTC COVID-19 Testing Kits that was effective October 1.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.
Florida
Effective September 30, the state minimum wage increased to $14.00 per hour. Florida employers are permitted to take a tip credit of up to $3.02 per hour for tipped employees. Beginning September 30, the minimum hourly cash wage rate for eligible tipped employees is $10.98.
In accordance with the amendment, the minimum wage is set for annual increases on the path to a $15.00 minimum wage by September 30, 2026. The requirement applies to both public and private employers, regardless of size.
In addition to increasing pay, Florida employers also face posting obligations to reflect the new amounts. The new posters that comply with the posting requirement are available online.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Illinois
In accordance with Public Act 104-0027, the Department of Healthcare and Family Services (HFS) is implementing a major update to the Critical Access Pharmacy (CAP) program. Effective January 1, 2026, the revised CAP program will consolidate the two existing initiatives into a single, streamlined model. See Provider Notice Issued 09/29/2025 for details. To minimize confusion during the transition, the Department has established a dedicated email address for all CAP-related inquiries.
Also in Illinois, the WIC [Special Supplemental Nutrition Program for Women, Infants and Children] program does not anticipate any disruption to its operations in the event of a federal government shutdown. The program continues to have funds available for food, and vendors should expect no issues with selling WIC products and receiving payment. As of October 1, 2025, businesses should proceed as usual for all Illinois WIC transactions.
For more information, contact NACDS’ Leigh Knotts at 803-243-7207.
Iowa
The Iowa Insurance Division (IID) released Bulletin 25-06 RE: Prohibited Use of Deceptive and Unfair Practices and Implementation of SF 383.
For more information, contact NACDS’ Sandra Guckian at 703-774-4801.