On July 22, Nurse Practitioners (TNP) filed a lawsuit seeking to invalidate Texas' physician delegation of collaborative practice requirements for nurse practitioners. The plaintiffs are asking a Texas court to declare the current framework unconstitutional under the Texas Constitution's Due Course of Law Clause and private nondelegation doctrine. The lawsuit argues that Texas improperly requires licensed nurse practitioners to obtain permission from private physicians before exercising authorities already granted by the state. While pharmacists are regulated differently than nurse practitioners, a broad judicial ruling limiting the state's ability to condition practice authority on physician approval could influence future pharmacy policy debates on expanding patient access through pharmacist-provided clinical services. NACDS is monitoring the lawsuit.  

Also in Texas, Lt. Gov. Dan Patrick (R) announced a third round of interim charges for the Senate to address before the 2027 Legislative session. Pharmacy issues are in the January and March reports. 

• Interim charges – July 27, 2026 

• Interim charges – March 27, 2026 

• Interim charges – January 30, 2026 

Also in Texas, the Health and Human Services Commission's (HHSC) Vendor Drug Program (VDP) Medicaid provided information on dispensing emergency prescriptions for the July flooding disaster declaration. 

Also in Texas, due to a potential supply gap, Sandoz is currently allocating brand-name Ritalin LA products, resulting in a product backorder. In response, the Health and Human Services Commission (HHSC) temporarily removed the non-preferred status from certain generic Ritalin LA products on the preferred drug list (PDL). 

Also in Texas, the Texas Pharmacy Congress will meet on the campus of the Texas A&M College of Pharmacy on August 6-7. 

Also in Texas, the Board of Pharmacy posted the agenda for the August 4 meeting in Austin. 

Also in Texas, effective July 1, HHSC requires a prescription for dispensing at-home COVID-19 test kits through the outpatient drug benefit for people enrolled in Medicaid and CHIP. The change is due to the end of federal regulations requiring coverage of at-home COVID-19 test kits and applies to fee-for-service and managed care. There are no changes to the maximum limit of four test kits per month. 

Also in Texas, the Department of State Health Services (DSHS) Immunization Section is hosting a back-to-school webinar for the Vaccines for Children (TVFC) and Adult Safety Net (ASN) Program Providers on August 7 from 10:00 am – 11:30 am.  

Finally in Texas, Stephanie Stephens will assume the role of Chief Medicaid and CHIP Officer, also known as Medicaid Director, on August 15. Stephens will lead Medicaid and CHIP Services through the Sunset review and the legislative session while HHSC identifies a successor. She will succeed Emily Zalkovsky.  

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

In response to the heavy rains and floods in South Texas, Gov. Greg Abbott (R) declared a state of emergency in 59 counties. The Board of Pharmacy issued guidance for emergency dispensing.

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

Pharmacy technicians may hold a national certification through the Pharmacy Technician Certification Board (PTCB) or the National Healthcareer Association (NHA). The Board of Pharmacy reminds technicians that state and national renewal applications are separate processes. Renewing your registration with the Texas State Board of Pharmacy (TSBP) does not automatically renew your national certification. For state registration timelines, please verify your TSBP renewal deadline. 

Also in Texas, the Health and Humans Services Commission Vendor Drug Program Medicaid will publish the semi-annual Preferred Drug List (PDL) update on July 24. 

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

The Health and Human Services Executive Commissioner Stephanie Muth announced a leadership change at the Department of State Health Services (DSHS). Imelda Garcia, MPH, the current chief deputy commissioner at DSHS, will become the interim commissioner. Jennifer Shuford, MD, MPH, who has led DSHS since September 2022, was recruited by the Trump Administration to serve as the new Deputy Director and Chief Medical Officer at the Centers for Disease Control and Prevention (CDC). 

Also in Texas, the Board of Pharmacy provided a summary of adopted and proposed rules from the May 5 board meeting. 

Also in Texas, the House Public Health Committee convened a hearing on June 4 to address several interim charges. Topics included the implementation and rulemaking of legislation passed in 2025 related to rural health care (HB 18) and health and nutrition standards (HB 25). Members received updates on the progress of the Rural Health Transformation Program. The committee also heard testimony regarding telehealth, with a focus on evaluating virtual care models and their effects on access, cost, quality and patient outcomes. Finally, the committee was briefed on Texas's current and projected healthcare workforce shortages. 

Also in Texas, the Health and Human Service Commission (HHSC) add all recommended adult vaccines to the Medicaid formulary as a payable pharmacy benefit beginning June 1. While adult vaccines were previously only covered under the Medicaid medical benefit, this rollout allows Medicaid to reimburse pharmacies for both the vaccine ingredient and administration costs for adults ages 19 years and older. To administer vaccines through the pharmacy benefit, a pharmacy must have an executed a Collaborative Practice Agreement (CPA) with a licensed provider serving as a standing order. If there is no CPA, the pharmacy must obtain a patient-specific prescription from the treating clinician before administering the vaccine. 

Also in Texas, the revised VDP Pharmacy Provider Procedure Manual, including information about benefits, policies and procedures for outpatient pharmacy claims and rebates, is now available. 

Also in Texas, the Texas Pharmaceutical Initiative released its revised business plan that was submitted to Gov. Greg Abbott (R) on June 1. 

Finally in Texas, Gov. Greg Abbott (R) appointed Jay Bueche to the Texas Pharmaceutical Initiative (TPI) Governing Board for a term set to expire on February 1, 2031. The Board is tasked with developing a business plan to provide cost effective drugs and other medical supplies for the public employee sector. 

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

On May 20, the Texas Pharmaceutical Initiative (TPI) Board convened to review and approve staff recommendations for the upcoming TPI Business Plan, due June 1. The Board also heard updates from the Texas Pharmaceutical Initiative Advisory Council (TPIAC) and representatives from covered agencies regarding activities related to pharmaceutical procurement and management. Finally, they discussed feedback collected by TPI staff from external stakeholders about the TPI Business Plan's implementation. 

Also in Texas, the Senate Health and Human Services Committee is scheduled to meet on May 27 to hear invited testimony on several interim charges related to rising healthcare insurance costs. The Committee will examine provider models for health care services, including, but not limited to, PBMs and health care facility fees, to determine whether these business practices are contributing to increased health care costs and insurance premiums. The Committee aims to identify strategies to lower health care costs and increase market flexibility, considering additional offerings such as Health Savings Accounts and new flexible plans. 

Also in Texas, the House Select Committee conducted two days of hearings, featuring invited testimony, to evaluate the key drivers of health care costs. These included statutory, regulatory and administrative burdens, as well as the effects of fraud, waste and abuse. The Committee also examined how insurance design, cost sharing, market structure and payment policies affect consumers and employers, with particular attention to how consolidation influences patient choice, market competition and the pricing and value of health care services. 

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

The Texas Conservative Coalition Research Institute (TCCRI) issued a paper on Federal 340B Reform: Why Accountability Matters for Texas Employers and Patients. 

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

Lt. Gov. Dan Patrick (R) announced the Senate’s Interim charges, and Speaker Dustin Burrows laid out the House’s interim charges to prepare for the 2027 session.

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

The Texas Pharmaceutical Initiatives (TPI) Board met on March 18 to review the Interagency Cooperation Contracts with the Texas A&M University System College of Pharmacy. TPI staff provided updates on the revised business plan due on June 1. The Board was also briefed on the input received by TPI staff from external stakeholders, including NACDS, regarding the implementation of the TPI Business Plan.

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

NACDS, the Texas Federation of Drug Stores (TFDS) and the Texas Pharmacy Association (TPA) met with Stephanie Muth, Executive Commissioner of the Texas Health and Human Services Commission (HHSC), and her leadership team. Muth previously served as Medicaid Director during her more than 15-year tenure at HHSC, as well as holding roles as deputy executive commissioner and chief of staff before departing the agency in 2020. Bringing all Texas pharmacy groups together for this meeting was important to demonstrate unity on key priorities: no below-cost reimbursement; PBM reforms to eliminate waste, fraud and abuse; and the recognition of pharmacies as healthcare providers for Rural Health Transformation projects. 

Also in Texas, the Health and Human Services Commissions (HHSC) Vendor Drug Program (VDP) revised Pharmacy Provider Procedure Manual that includes information about Medicaid benefits, policies and procedures for outpatient pharmacy claims and rebates was released. 

Also in Texas, HHSC announced that in accordance with the requirements of HB229, ImmTrac2 forms have been updated. 

Also in Texas, HHSC has transitioned to a new web-based software application, State of Texas Electronic Provider System (STEPS), to collect information from providers for Medicaid and non-Medicaid cost reports, Supplemental and Directed Payment Program (DPP) enrollments and legislatively directed reports. 

Finally in Texas, HHSC's Executive Council will meet on March 19 at 10:00 am. Members of the public are welcome to view the meeting by webcast and click on the Winters Live tab or you may attend in-person at the John H. Winters Building, Public Hearing Room 125, First Floor, 701 West 51st Street, Austin, Texas 78751. Information to watch the meeting virtually or to attend the meeting in-person is also located on the agenda.  

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