HB 1358 is the Department of Health’s bill which includes a provision changing the statewide standing order for the dispensing of a smoking cessation products to a tobacco, vaping or nicotine cessation product.

Also in Indiana, SB 157, a bill that requires pharmacies to disclose at the point-of-sale the National Average Drug Acquisition Cost (NADAC) on generics, was amended in the Senate to exempt hospitals and Federally Qualified Health Centers (FQHCs). The bill passed Senate and was assigned to House Public Health Committee.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Office of Medicaid Policy and Planning (OMPP) is conducting a survey of dispensing costs for pharmacies participating in the Medicaid program. The Health Coverage Programs (IHCP) issued a bulletin reminding pharmacy providers to submit dispensing fee surveys by January 30.  

Also in Indiana, SB 221, a bill sponsored by Sen. Ed Charbonneau (R) that requires the state health commissioner to issue a standing order, prescription or protocol to allow a pharmacist to test, treat or prescribe for influenza, COVID-19, streptococcus and respiratory syncytial virus (RSV), was heard in the Senate Health Provider Services Committee on January 14. The bill was left pending and is dead. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

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.

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).

• https://iar.iga.in.gov/register/20250917-IR-405250436PHA
• https://iar.iga.in.gov/register/20250917-IR-405250436FNA

For more information, contact NACDS’ Mary Staples at 817-442-1155.

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. 

• https://iar.iga.in.gov/register/20250917-IR-405250436RAA 

• https://iar.iga.in.gov/register/20250917-IR-405250436PHA 

• https://iar.iga.in.gov/register/20250917-IR-405250436FNA 

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.

The Family and Social Services Administration (FSSA) Medicaid announced that based on the results of a recent cost of dispensing survey, they plan to reduce the dispensing fee by 8%, lowering it from $10.48 to $9.63, effective March 1, 2026. NACDS will submit comments by September 19, 2025, the deadline, and encourages members to do so too. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

Earlier this year, pharmacies successfully passed SB 140, legislation that included a provision tying the commercial dispensing fee rates to Medicaid’s fee-for-service (FFS) rates as a minimum floor. Unfortunately, the Family and Social Services Administration (FSSA) announced last week that, based on the results of a recent cost of dispensing survey, Medicaid plans to reduce the dispensing fee by 8%, lowering it from $10.48 to $9.63, effective March 1, 2026.  NACDS will submit comments by September 19 deadline and encourages members to do so as well.

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Health Coverage Programs (IHCP) posted several important provider bulletins of interest to pharmacies: 

• BT2025117 – Pharmacy updates approved by the Office of Medicaid Policy and Planning August 2025 on Ordering, Prescribing or Referring; Pharmacy/Prescribing, Physician/Practitioner 

• BT2025112 – Pharmacy updates approved by Drug Utilization Review Board July 2025 

• BT2025107 – Final Notice: Gainwell mail forwarding expired on August 1, 2025 

For more information, contact NACDS’ Mary Staples at 817-442-1155.

The Pharmacy Access for Contraceptives for Hoosiers (PATCH), a grant program for pharmacies who have or are planning to implement contraceptive prescribing services, expired on July 30. 

For more information, contact NACDS’ Mary Staples at 817-442-1155.