Please see TennCare's recent updates to the Preferred Drug List (PDL), including changes to prior authorization (PA) criteria and quality limits, effective June 1. These updates may affect medication coverage, utilization management and prescribing processes across several therapeutic areas for patients with TennCare coverage. 

Also in Tennessee, TennCare is currently conducting a cost-of-dispensing survey. The state, in collaboration with Mercer, opened the survey on June 1 and it will remain open through June 30. 

An informational webinar was held on May 28 to review the survey process.  If you anticipate needing an extension, please contact Mercer as soon as possible to discuss your options. Please note that the state is expected to continue applying a reduced dispensing fee of $5.00 for pharmacies that do not complete the survey. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Please review TennCare’s recent updates to the Preferred Drug List (PDL), including changes to prior authorization (PA) criteria and quality limits that were effective May 1. These updates may affect medication coverage, utilization management and prescribing processes across several therapeutic areas for patients with TennCare coverage.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act SB 2040 / HB 1959 passed both chambers of the General Assembly, receiving approval in the Senate by a 24–9 vote and in the House by an 86–7 vote. During Senate floor consideration, lawmakers adopted an amendment delaying the bill's implementation date to July 1, 2028. As a reminder, once the legislation reaches the Governor's desk, he has 10 calendar days (excluding Sundays) to sign it into law, veto it or allow it to take effect without his signature. The exact timing for when that review period begins remains uncertain, as the final week of session typically involves a high volume of bills moving through the necessary procedural steps before being delivered to the Governor. The Governor is aware of the broad support behind this legislation, including strong backing from stakeholders and an overwhelming majority of the General Assembly. The Tennessee Pharmacy Association submitted a letter to the Governor, which was co-signed by 16 additional pharmacy organizations, including NACDS, urging him to sign SB 2040/HB 1959 into law.  

Also in Tennessee, TennCare received legislative authorization to continue operating the Diaper Benefit Pilot through June 30, 2027, and intends to fully operate the program for the duration of available funding. Since launching in August 2024, participating pharmacies have helped serve more than 100,000 children dispensing nearly 22 million diapers. TennCare thanked pharmacy partners for their critical role and will provide future guidance as the program approaches its planned wind-down. If your pharmacy still wants to participate, visit here for more information.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Board of Pharmacy met last week and held a rulemaking hearing on the Compounding and Ambulatory Surgery Treatment Center (ASTC) Pharmacy rules, as well as standard Board business.  

• The Board approved its first petition to remove consent orders related to substance use from public view on a pharmacist's profile on the Licensure Verification tool. This is in accordance with Public Chapter 100. A rulemaking hearing is occurring later this month related to this process.  

• The Board approved the proposed rules for Compounding and ASTC Pharmacy with amendments. The Board voted to approve a 12-month educational period following final approval of the rules by the Secretary of State where compounding pharmacies may work towards compliance. If you have questions about which specific amendments were made, please contact olivia@tnpharm.org. 

• The Board's Rulemaking Committee reported at their recent meeting that it plans to have a draft of updated rules by December 2026. At the next Rulemaking Committee meeting on April 30, the committee will focus on at least license reinstatement and pharmacy technicians, while the May 21 meeting will focus on workplace conditions. 

Fees for certain licensure categories will be changing. The Board is still working to finalize these new fees. 

Also in Tennessee, the Department of Health Vaccine-Preventable Diseases and Immunization Program (VPDIP) invites you to the 4th Annual Immunization Provider Expo, taking place virtually on April 14. The Expo will run from 8:00 am to 12:00 noon CST. This year's theme, "Restoring Trust in Vaccines", highlights how emotional storytelling, community engagement and data-driven insights can help rebuild public confidence in immunizations.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Health (TDH) continues to closely monitor respiratory syncytial virus (RSV) activity across the state. Recent emergency department data indicates that RSV activity remains elevated but has begun decreasing in Tennessee. Due to continued RSV activity in the state, pediatric providers and hospitals may continue to administer RSV immunizations to eligible infants through April 30. RSV immunizations remain available for ordering through TennIIS for the Vaccines for Children (VFC) program.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

Tennessee Pharmacy Association's advocacy team has developed a comprehensive, user-friendly set of responses addressing the most common misinformation surrounding SB 2040 (Harshbarger) and HB 1959 (Scarbrough). This resource is intended to equip members with clear, accurate messaging to confidently respond to misleading claims, particularly those circulating on social media about the bills' intent and impact. Members are encouraged to use these prepared responses when engaging in online discussions or conversations where misinformation appears, helping ensure consistent, fact-based communication.  

Also, Tennessee patients and pharmacists who have received unwanted texts, calls or app restrictions related to lobbying efforts can report these concerns to the Tennessee Attorney General. Using pharmacy communication channels for political advocacy may violate consumer protection laws and health privacy laws, and filing a complaint helps ensure these practices can be investigated and addressed. To submit a report, use the official Attorney General complaint form.  

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Commerce and Insurance’s new audit of CVS Caremark details extensive violations of the state’s PBM laws, which spans discriminatory reimbursement, banned spread pricing and appeals noncompliance. CVS Caremark has 30 days to comply with the findings, after which the matter will be referred to legal services. The Tennessee Pharmacy Association issued this statement of the findings. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

The Department of Health recently released a “Dear Colleague” provider communication highlighting recent changes to the hepatitis B vaccine recommendations. Specifically, this communication emphasizes the severity of hepatitis B infection for infants and adolescents, as well as how hepatitis B often goes undiagnosed, which leads to a delay in treatment.

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.

This notice is to inform you of changes to the TennCare pharmacy program. We encourage you to read this thoroughly and contact OptumRx’s Pharmacy Support Center (866-434-5520) should you have additional questions. 

For more information, contact NACDS’ Leigh Knotts at 803-243-7207.