The Department of Health and Human Services published a bulletin outlining the requirements and procedures for eligible outpatient pharmacies to apply to receive a "directed payment" of $4.50 per managed care prescription filled. Pharmacies must complete the Directed Pharmacy Dispensing Payment Assurance Statement (DHS-8750) (PDF) and fax to 651-431-7462 by July 24, 2026, per Minnesota Statutes, 256B.69, subdivision 6i. MCOs will begin making payments to pharmacies as early as August 2026. The program, recently approved by CMS, is a result of legislation NACDS helped pass in 2025 to increase patient access to pharmacy services in rural and underserved areas. 

Pharmacies must be enrolled with an MCO that contracts with the Department of Human Services. Refer to the MCO contacts for MHCP providers webpage for a list of MCOs.  

Also in Minnesota, as the General Assembly wrapped up the 2026 Legislative Session last week, they sent the following NACDS priority bills to the Governor for enactment: 

• SF 4612 Establishes a reimbursement floor of NADAC + $11.55, effective January 1, 2027, for all Medicaid managed care prescriptions. The rate is intended to serve as a safety net for pharmacies until the single PBM managed care pharmacy program is implemented in 2028. The payment is in addition to the CMS-approved pharmacy "directed payment program," which will also provide an additional $4.50 per managed care prescription payment to qualified pharmacies in medically underserved areas. 

• HF 3825 Permits pharmacists to initiate, prescribe, dispense and administer drugs for the treatment of opioid use disorder. See lines 89.29, 94.18 and 96.3. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Last week, CMS approved the state’s application to direct a state-funded supplemental dispensing fee of $4.50 to pharmacies not owned by a PBM and located in HRSA (Health Resources and Services Administration) medically underserved areas. The $4.50 per prescription payments apply to Medicaid Managed Care prescriptions filled on or after July 1, 2025. The program is a result of a 2025 state budget provision NACDS helped develop as a safety net for pharmacies until cost-based reimbursement is implemented under the Single PBM model. NACDS will continue collaborating with the Department of Health and Human Services while they develop the state’s application and disbursement procedures, with an eye on maximizing member participation. In addition, NACDS is supporting current legislation that would amend the law to continue the payments until the Single PBM delayed implementation date in 2028.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Board of Pharmacy’s April newsletter is now available.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department of Human Services informed NACDS that implementation of the Medicaid Managed Care Single PBM will be delayed a year to January 1, 2028. They stated that the decision stems from recent discussions during the final stages of the RFP process, where it became clear that more time was needed to complete necessary processes and seek federal approvals. 

Also in Minnesota, the Department of Human Services (DHS) asked NACDS to urge any pharmacy that has not yet responded to the Cost of Dispensing Survey to please do so ASAP. The survey is mandatory, and the overall response rate is currently lower than usual. The survey and related documents can be found on DHS' Cost of Dispensing webpage. Please note that the survey will help determine the Professional Dispensing Fee under both the Single PBM and the Medicaid fee-for-service programs.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department of Health (MDH) announced it provided the Prescription Drug Affordability Board (PDAB) with the first list of drugs that meet the statutory criteria for potential cost review. In total, MDH reported that 1,083 prescription drug products met at least one of the statutory criteria—and many drugs met multiple criteria or the same criterion multiple times. The statutory criteria include thresholds for significant price increases (such as price increases exceeding 15% in a year) and expensive drugs (such as prices of more than $60,000 per year or course of treatment). The PDAB was established to conduct cost reviews of prescription drug products and has authority to set payment limits. The Board began its work in 2024 and is comprised of seven voting members appointed by the Governor and two nonvoting legislative members.  

To learn more about the PDAB, to attend a public meeting of the PDAB, or to submit comments to the PDAB, please visit the PDAB website. Stakeholders interested in receiving announcements on prescription drug price transparency at MDH may subscribe to Prescription Drug Price Transparency updates.  

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Department of Health (MDH) released the final updated Form and Manner for Prescription Drug Data Sets, as well as an updated Frequently Asked Questions Document. Updates impact reporting by all reporting entities, including manufacturers, wholesalers, pharmacy benefit managers and pharmacies.  

The updates reflect statutory changes from the 2025 legislative session (Laws of Minnesota, 2025 – 1st Special Session, chapter 3, article 2, sections 6-14) and responses to input received during the comment period. The updates include changes to align reporting elements, modified registration requirements and a change to the reporting period for reporting data on drugs of substantial public interest.  

MDH has updated the Rx Data Portal to integrate the statutory changes and make additional enhancements to support reporting entities. These updates are now live and available to all reporting entities. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The vaccine protocol templates for the COVID-19 vaccine have been updated on Vaccine Protocols. Only minor changes have been made to provide clarity. The protocol content has not been changed.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Gov. Tim Walz (D) issued an executive order  (EO) to address the state’s intention to ensure that vaccine access is preserved and expanded. The EO directs various government agencies to investigate ways to expand access to payment for vaccines. NACDS intends to work with members and state partners to advocate for strengthening pharmacy vaccine reimbursement.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.