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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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’ Mike Sargent at 207-272-6435.
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.