Effective October 1, TennCare will cover OTC medications and supplements at a GPI (generic product identifier) level rather than by specific NDCs. Please review this document for additional information and instructions on how to dispense such products. 

Also in Tennessee, TennCare distributed an updated Preferred Drug List (PDL) that was effective on September 1. Additional TennCare updates are available online. Subscribe to the TennCare Pharmacy Updates newsletter to receive updates directly from TennCare. 

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

The Tennessee Pharmacists Association (TPA), National Community Pharmacists Association (NCPA) and American Pharmacists Association (APhA) jointly filed an amicus brief in federal court supporting Tennessee’s 2021 law regulating PBMs. The law, aimed at protecting patient choice and pharmacy access, bans PBMs from practices like patient steering and excluding pharmacies from preferred networks. The case stems from a challenge by McKee Foods arguing that the law is preempted by the federal ERISA statute.

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

During the July Board of Pharmacy meeting, the Office of the General Counsel announced that the new pharmacy technician rules are expected to take effect around October 21. Additionally, a rulemaking hearing on compounding regulations is anticipated to be scheduled later this year or early next year. The Board’s October meeting has been rescheduled to October 20 and 21.

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

Effective August 1, TennCare will no longer enforce the five prescription limit per month on prescription drugs and refills for adult TennCare enrollees; however, the two brand prescription limit per month will remain in effect. Members may exceed the two brand monthly prescription limit by utilizing the products on the Auto-Exempt and Attestation List. As a reminder, the limit starts over at the first of each month. No changes will be made to the CoverRx and CoverKids programs. TennCare Pharmacy Updates are available online.

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

Last week, Gov. Bill Lee (R) announced that Ralph Alvarado has stepped down as state’s Commissioner of Health (TDH), effective July 11. The current state epidemiologist, John Dunn, will serve as interim commissioner. 

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

The Department of Health is confirming the state's first measles case in 2025 in a Middle Tennessee resident. The likely source of the infection is being investigated. Subsequently, the Department of Health confirmed three additional cases of measles in Middle Tennessee, which is also being investigated by public health officials. 

Also in Tennessee, the Department of Commerce & Insurance added a new PBM Compliance Pharmacist position to serve as a pharmacy consultant and professional resource to the PBM Compliance Section. The position will be responsible for enforcement of current statutes and rules related to PBMs as well as assisting with compliance audits of PBMs, assisting with PBM complaint analysis and investigation and analysis of PBM Annual Reports. 

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

The Emergency Prescription Assistance Program (EPAP) expires April 1. The Tennessee Pharmacists Association (TPA) recently learned that the Administration for Strategic Preparedness and Response (ASPR) does not plan to renew this program beyond the April 1 deadline. Pharmacies are encouraged to use the Healthcare Ready fact sheets to learn how they can best assist their eligible patients while EPAP funding is still available.

Also in Tennessee, TennCare has enhanced reimbursement rates for its Diaper Benefit Program, creating new revenue opportunities for participating pharmacies. Effective February 15, maximum allowable cost (MAC) rates increased for diaper brands on the covered product list, and since February 28, pharmacies have been able to submit claims for private-label and “unlisted” diapers using a Generic Diaper UPC. Diaper program updates provide higher reimbursements, greater inventory flexibility and increased foot traffic for pharmacies statewide.

Finally in Tennessee, the Department of Health is urging clinicians to identify, isolate and inform people regarding suspected measles cases. Immediately report cases by phone at 615-741-7247. According to the CDC (Centers for Disease Control and Prevention), there have been 222 cases of measles across 12 states during 2025 alone, including three identified outbreaks and one pediatric death.

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

The Department of Commerce and Insurance (TDCI) recently posted a consent order with Express Scripts citing multiple violations of PBM laws and rules in the state, including improper payments regarding 277 claims, which adversely affected 40 pharmacies in the state. Express Scripts must pay a civil penalty of $250,000. 

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

CDC and Tennessee Department of Health has released a call for cases investigating reports of serious adverse events, including deaths, following receipt of injectable ceftriaxone. To date, events have not been associated with a sole product manufacturer or lot, and a definitive causal link to ceftriaxone has not been established. A public health investigation is underway to identify and characterize serious adverse events associated with ceftriaxone exposure. Please make reports to the HAI/AR Program at HAI.Health@tn.gov.

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