Prescription drugs and pharmacy benefit managers laws by state

SB 100: Sunset law; Alabama State Board of Pharmacy continued with modification until October 1, 2027

The Alabama State Board of Pharmacy continues to exist and function until October 1, 2027. The appointing authorities specified in Section 34-23-90(b)(1) must appoint nine board members according to the categories and nomination procedures outlined, with each appointing authority having 45 days to fill vacancies.

Took effect 1 June 2026

SB 252: Pharmacy Benefits Managers; providing a prescription reimbursement rate for independent pharmacies and regulating other practices

HB 195: An Act changing the term 'physician assistant' to 'physician associate'; relating to physician associates; relating to collaborative practice agreements for pharmacists; relating to the prescription of opioid overdose drugs; relating to the prescription and administration of drugs and devices by pharmacists; relating to reciprocity for pharmacists; amending the definition of 'practitioner'; and providing for an effective date.

Pharmacists must receive education in pain management and opioid use and addiction unless they lack a valid federal Drug Enforcement Administration registration number. Pharmacists prescribing or administering drugs under collaborative practice agreements must recognize the limits of their education, training, and experience and consult with and refer to other practitioners as appropriate.

Took effect 1 January 2026

HB 2733: pharmacy board; renewals; ownership change

A business undergoing a change of ownership may continue operating under its existing permit during the new owner's permit application review if the new owner submits a complete application at least fourteen business days before the ownership change, the business remains compliant with all applicable statutes and rules, the existing permit remains valid, and the new owner attests to assume responsibility for regulatory compliance.

HB 2953: pharmacy board; civil penalties.

The Arizona Board of Pharmacy may issue nondisciplinary civil penalties to licensees, registrants, or permittees for specified violations not constituting imminent threats to public health and safety, including failure to update online profiles, failure to complete continuing education, failure to renew licenses within sixty days, and other violations adopted by the board in rule.

HB 2434: controlled substances prescription monitoring program

Medical practitioners must obtain a patient utilization report from the controlled substances prescription monitoring program before prescribing opioid analgesics or benzodiazepines for a new course of treatment and at least quarterly thereafter. Pharmacists must obtain such reports before dispensing schedule II controlled substances. Dispensers must report controlled substance dispensing data to the board within one business day.

HB 2627: pharmacies; emergency authority

When a state of emergency is declared due to natural disaster or terrorist attack, pharmacists may dispense one-time emergency refills of up to thirty days of prescribed medication if essential to life or therapy maintenance, and may dispense one additional thirty-day refill if the emergency continues at least twenty-one days. Out-of-state licensed pharmacists may dispense medications in affected areas during declared emergencies.

HB 2628: pharmacists; emergency medication; administration

A pharmacist authorized to order and administer medication may order and administer emergency medication to manage an acute allergic reaction to medication administered at the pharmacy. The pharmacist must notify the patient's primary care provider or physician within forty-eight hours and follow the pharmacy's standard operating procedures.

SB 1102: pharmacy benefits; prescribing; exemption

Pharmacy benefit managers and health care insurers must not limit or exclude coverage of a prescription drug for a covered individual who is on that drug if it was previously approved and the individual remains enrolled. They must provide sixty days' notice before formulary changes and establish a clear formulary exception process with response times of seventy-two hours or twenty-four hours for expedited requests.

HB 1531: To prohibit pharmaceutical manufacturers from restricting or limiting prescription medications to a limited distribution network of out-of-state pharmacies.

Pharmaceutical manufacturers must not restrict or limit prescription medications to a limited distribution network of out-of-state pharmacies. Manufacturers must allow pharmacies to access medications upon request or application if the pharmacy meets FDA guidance for storage, handling, monitoring, drug delivery, data collection, and patient management services.

HB 1150: To prohibit a pharmacy benefits manager from obtaining certain pharmacy permits.

The Arkansas State Board of Pharmacy must conduct an initial assessment of active retail pharmacy permits issued as of July 1, 2025, and send written notice at least ninety days before January 1, 2026, to pharmacy permit holders reasonably believed to violate the prohibition on pharmacy benefits managers obtaining certain pharmacy permits. Pharmacy permit holders receiving notice must notify patients and prescribing healthcare providers at least sixty days before January 1, 2026.

SB 104: To amend the arkansas pharmacy benefits manager licensure act; to protect patients' rights and access to medications; and to declare an emergency.

Pharmacy benefits managers and pharmacy benefits manager affiliates must not impose or represent requirements or limitations as health-benefit-plan-imposed unless those terms appear in the underlying health benefit plan document. Plan sponsors retain authority to interpret their own plan terms.

HB 1620: To amend the law concerning pharmacy benefits managers; and to regulate processing and payment of pharmacy claims.

Pharmacy benefits managers must pay clean claims within 7-14 days for electronic claims or 30 days for paper claims after receipt. Pharmacy benefits managers must notify pharmacies of claim deficiencies within 10 days for electronic or 15 days for paper claims. Pharmaceutical manufacturers must ensure vendors comply with timely payment requirements.

SB 58: To remove the prohibition on nonprofit, tax exempt, or governmentally-funded hospitals holding a licensed pharmacy permit for the sale at retail of drugs.

The Arkansas State Board of Pharmacy must issue retail pharmacy permits to nonprofit, tax exempt, or governmentally funded hospitals licensed by the Department of Health. Such hospitals may hold one retail pharmacy permit per hospital pharmaceuticals services and one per one hundred beds. Hospitals participating in the 340B Drug Pricing Program must inform patients of their freedom to choose any pharmacy.

SB 1094: Prescription drugs.

Pharmacists may select alternative biological products that are biosimilar to or interchangeable with prescribed reference products if prescribers do not indicate "Do not substitute." Pharmacists must notify prescribers within five days of dispensing. Health care service plans and health insurers must not limit coverage for previously approved drugs if appropriately prescribed and safe and effective, but may require trial of AB-rated generics or biosimilars under specified conditions with 30 days' advance notice.

Takes effect 1 January 2027

AB 1843: Communicable diseases: hepatitis C.

Health care service plans and health insurers must not subject direct-acting antiviral drugs medically necessary for hepatitis C treatment to prior authorization, except that if FDA-approved therapeutic equivalents exist, they need only cover one pangenotypic version without prior authorization. Both must align clinical criteria with standards of the American Association for the Study of Liver Diseases and Infectious Diseases Society of America and cannot request liver biopsy, genotype testing, proof of sobriety, fibrosis staging thresholds, elastography documentation, ultrasound documentation, or specialist referral for prior authorization purposes.

Takes effect 1 January 2027

AB 1887: Prescription drug coverage for rare diseases.

Health care service plans and health insurers must complete prior authorization or utilization review within 30 days for prescription drugs approved for rare diseases when prescribed by specialists who determine medical necessity, unless biosimilars, interchangeable biologics, or generics are available. Health care service plans and health insurers must not impose step therapy for such drugs.

Takes effect 1 January 2027

AB 2250: Cannabis: cannabinoids.

A person engaged in the business of selling cigarettes or tobacco products must not possess, store, own, or make any sale of cannabis, cannabis products, or products presumed to be cannabis at any site where cigarettes or tobacco products are stored or sold. Beginning January 1, 2028, CBN isolate is excluded from the definition of cannabis concentrate.

Takes effect 1 January 2027

AB 2562: Alcohol or other drug recovery and treatment programs and facilities: suicide prevention.

Licensed alcohol or other drug recovery and treatment facilities must develop a suicide prevention plan. Certified alcohol or other drug programs must include a suicide prevention plan in their operation manual. The State Department of Health Care Services shall implement these requirements by bulletin or letter after stakeholder input until regulations are promulgated.

Takes effect 1 January 2027

SB 329: Alcohol and drug recovery: licensed treatment facilities and certified programs: investigations.

The State Department of Health Care Services must assign complaints within its jurisdiction regarding alcohol or drug recovery or treatment facilities to an analyst for investigation within 10 days of receiving the complaint. The department must complete investigations within 60 days of receiving the complaint unless it requires assistance from other agencies or significant additional resources. The department must notify complainants in writing if complaints fall outside its jurisdiction or if investigations cannot be completed within 60 days.

Takes effect 1 January 2027

SB 964: Prescription drug coverage: dose adjustments.

Health care service plans and health insurers must grant treating providers authority to adjust a drug's dose or frequency without prior authorization when the drug was previously approved for a chronic medical condition or cancer treatment, the drug is not an opioid or scheduled controlled substance, the dose has not been adjusted more than twice without prior authorization, and off-label uses are supported by two major peer-reviewed medical journal articles.

Takes effect 1 January 2027

SB 1023: Health care coverage: antiretroviral drugs, drug devices, and drug products.

Health care service plans and health insurers must not subject antiretroviral drugs, drug devices, or drug products medically necessary for HIV/AIDS prevention to prior authorization or step therapy, except that at least one therapeutically equivalent version must be covered without such restrictions. Contracts or policies issued, amended, or renewed on or after January 1, 2027, covering non-self-administered antiretroviral drugs approved by the FDA must also include them as outpatient prescription drug benefits.

Takes effect 1 January 2027

AB 1587: Prescription drug refills: prescriber notifications.

A pharmacist may refill a prescription for a dangerous drug or dangerous device without prescriber authorization if the prescriber is unavailable and the pharmacist judges that failure to refill might interrupt the patient's ongoing care and cause significant adverse effects. The pharmacist must inform the patient of the refill and notify the prescriber within a reasonable period of time if a prescriber is identified.

Takes effect 1 January 2027

SB 40: Health care coverage: insulin.

Health care service plans and health insurers must limit cost sharing for insulin prescription drugs to $35 for a 30-day supply for large group plans issued after January 1, 2026, and individual or small group plans issued after January 1, 2027. They must not impose step therapy as a prerequisite to insulin coverage starting January 1, 2026, and must include at least one insulin per drug type on formularies.

SB 41: Pharmacy benefits.

Pharmacy benefit managers must use passthrough pricing models, derive income only from pharmacy benefit management fees, and direct 100 percent of manufacturer rebates to payers. They must not require use of only affiliated pharmacies, discriminate against nonaffiliated pharmacies, conduct spread pricing, or impose reconciliation reductions on pharmacist services.

AB 1037: Public health: substance use disorder.

Licensed alcohol or other drug recovery or treatment facilities must maintain at least two unexpired doses of opioid antagonist on premises and ensure at least one trained staff member knows its location. The department must offer combined applications for licensure by January 1, 2027. Licensees must prioritize residents maintaining treatment connection after relapse and cannot require abstinence for admission.

AB 447: Emergency room patient prescriptions.

Prescribers may dispense unused portions of non-controlled dangerous drugs to emergency room patients upon discharge if the drug was administered from single patient use multidose packaging, can be self-administered, and dispensing is required to continue treatment. An automated unit dose system used to dispense dangerous drugs to emergency room patients is exempt from licensure if operated by a licensed hospital pharmacy that owns or leases it.

AB 492: Alcohol and drug programs: licensing.

The State Department of Health Care Services must concurrently provide written notification to the city or county where an alcohol or other drug recovery or treatment facility is located whenever it issues a license to operate such a facility. The notice must include the licensee's name and mailing address and the facility's location.

AB 424: Alcohol and other drug programs: complaints.

When the State Department of Health Care Services receives a complaint against a licensed alcohol or other drug recovery or treatment facility or an unlicensed facility allegedly operating in violation of law, the department must provide notice to the complainant within 10 days that the complaint was received, and upon closing the complaint, must notify the complainant whether the facility was found in violation.

SB 568: Pupil health: epinephrine delivery systems: schoolsites and childcare programs.

Local educational agencies must provide emergency epinephrine delivery systems stored at each schoolsite and childcare program location for use by school nurses, trained volunteers, and trained childcare employees to treat anaphylactic reactions. Pupils may carry and self-administer prescription epinephrine delivery systems with appropriate written statements from physicians and parents.

AB 1356: Alcohol and other drug programs.

Licensed facilities must submit a telephonic report to the department within one working day of a resident's death, a written report within seven calendar days, and any additional relevant information within 30 days of the initial incident. The department must issue a written notice of deficiency if violations are identified during death investigations.

Took effect 1 January 2026

AB 1503: Pharmacy.

The California State Board of Pharmacy must establish a Pharmacy Technician Advisory Committee. Pharmacists must provide services consistent with accepted standard of care. Nonresident pharmacies must designate a California-licensed pharmacist-in-charge by July 1, 2026, and notify the board within 90 days. All licensed facilities must complete self-assessments every odd-numbered year and within 30 days of specified changes.

Took effect 1 January 2026

AB 50: Pharmacists: furnishing contraceptives.

A pharmacist may furnish over-the-counter contraceptives without standardized procedures or protocols. A pharmacist may furnish self-administered prescription-only hormonal contraceptives and emergency contraception drug therapy according to specified standardized procedures or protocols. A pharmacist may furnish up to a 12-month supply of FDA-approved self-administered hormonal contraceptives or over-the-counter contraceptives at a patient's request.

HB 1139: Use of Artificial Intelligence in Health Care

SB 138: Reducing Administrative Burdens on Health Care

HB 1336: Increase Access to Pharmacy Services

HB 1335: Abortion Medication Access on College Campuses

SB 31: Use of Prescription Product with Controlled Substance

HB 25-1094: Pharmacy Benefit Manager Practices

Pharmacy benefit managers must earn income only through a single flat-dollar service fee transparently expressed in written agreements with health benefit plans. PBMs must not earn income based on prescription drug prices, mark-ups, copayments exceeding drug costs, or manufacturer revenues. PBMs must reimburse pharmacies at national average drug acquisition cost plus reasonable dispensing fees and disclose cost information to health benefit plans within thirty days.

SB 25-071: Prohibit Restrictions on 340B Drugs

Manufacturers, third-party logistics providers, repackagers, and their agents or affiliates shall not deny, restrict, prohibit, discriminate against, or limit acquisition or delivery of 340B drugs to covered entities or contracted pharmacies. Manufacturers shall not require submission of health information or data unrelated to federal health care program claims. Reporting hospitals shall not use 340B savings for board compensation exceeding thirty-five percent annually, tax penalties, certain advertising, lobbying, board travel expenses, or gifts.

SB 25-301: Remove Authorization Requirement Adjust Chronic Prescription

A prescribing provider may adjust the dose or frequency of a chronic maintenance drug prescription without prior authorization or subsequent utilization management if the drug was previously approved for the covered person's chronic or debilitating disease, is not an opioid or scheduled controlled substance, has not been adjusted more than two times without prior authorization, and the adjustment is based on evidence-based guidelines.

SB 25-084: Medicaid Access to Parenteral Nutrition

The State Department must create specific professional dispensing fees for infusion pharmacies preparing and dispensing parenteral nutrition by January 1, 2026, not exceeding thirty percent of infusion pharmacy administrative costs. The State Department must report annually to the Joint Budget Committee on infusion pharmacy numbers, geographic distribution, and network sufficiency.

SB 25-289: Creation of a Drug Donation Program

Donors and donation recipients must comply with requirements for donating unused medicine through the Colorado Drug Donation Program. Donation recipients must verify donors, maintain records of donated medicine, ensure medicine is unopened or repackaged, and dispense only to eligible patients. Medicine cannot be resold for profit.

HB 25-1316: Changes to Definitions Monitoring of Prescription Drugs

Repeals the definition of drug abuse from Colorado's prescription drug monitoring laws and adds a definition of substance use disorder as a chronic relapsing brain disease characterized by recurrent use of alcohol, drugs, or both causing clinically significant impairment.

SB 25-196: Insurance Coverage Preventive Health-Care Services

Health insurance policies must cover preventive health-care services according to task force recommendations, ACIP recommendations, or comprehensive guidelines. If those recommendations are repealed or modified, the commissioner may adopt rules requiring coverage based on guidelines in effect in January 2025 or recommendations from the Nurse-Physician Advisory Task Force. Health savings account-qualified policies are exempt to the extent necessary for federal qualification.

HB 5561: An act concerning a five-year medicaid rate review, dental representation on a medical assistance oversight council, biomarker testing and opioid prescription coverage requirements and a study concerning payment of spouses for state-subsidized home care.

The Commissioner of Social Services must create a five-year process for regular review of Medicaid reimbursement rates, beginning January 1, 2027, benchmarking rates to Medicare when possible. Prescribing practitioners must consider feasibility of nonopioid treatment options when prescribing opioid drugs to Medicaid beneficiaries.

Took effect 1 July 2026

HB 5515: An act concerning the department of mental health and addiction services' recommendations regarding access to opioid overdose reversal medication and various revisions to mental health and addiction statutes.

School nurses and qualified school employees must maintain and may administer legend opioid antagonists to students experiencing opioid-related drug overdose. School nurses or principals must select qualified school employees to administer opioid antagonists, with at least one present during regular school hours. Administrators and employees must complete training approved by the Departments of Education, Public Health, Consumer Protection, and Mental Health and Addiction Services.

Took effect 1 July 2026

HB 5044: An act establishing connecticut vaccine standards.

The Commissioner of Public Health must establish and maintain a standard of care for immunization based on recommendations from CDC, AAP, ACOG, and AAFP. Health care providers administering vaccines under the federal Vaccines For Children program must utilize vaccines recommended by CDC's Advisory Committee on Immunization Practices. Local and regional boards of education must require children to receive immunizations against specified diseases before school enrollment, with exemptions for medical contraindications and religious beliefs.

Takes effect 1 January 2027

HB 7192: An act implementing recommendations of the bipartisan drug task force.

Pharmacy benefits managers must owe fiduciary duty to health carriers or health benefit plan sponsors and notify them of conflicts of interest. Health carriers and pharmacy benefits managers cannot include certain provisions in pharmacy services contracts, including spread pricing arrangements and fees conditioned on wholesale acquisition cost, savings, or premiums. Health carriers must annually report pricing and profit information to the Insurance Commissioner.

Takes effect 1 October 2027

HB 6855: An act concerning the department of consumer protection's recommendations regarding drug control and cannabis and hemp regulation.

Any person not a moderate-THC hemp product vendor or licensed cannabis establishment may sell hemp flower only through direct in-person exchange requiring assistance to access it, or delivery, and must verify purchaser age twenty-one or older with valid government-issued ID. Cannabis establishments must display standardized DCP signage with quick response code in prescribed form and manner.

Took effect 1 July 2025

SB 271: An act to amend title 18 of the delaware code relating to pharmacy benefits managers.

Pharmacy benefits managers must provide 14 days' notice before initial on-site audits, conduct audits under uniform standards, limit audits to once every 12 months, bear all audit costs, respond to appeals within 10 calendar days, provide 60 days' notice before amending contracts, and reimburse pharmacies at least the national average drug acquisition cost or wholesale acquisition cost as of the date of service.

SB 319: An act to amend title 18, title 29, and title 31 of the delaware code relating to coverage for diagnostic services and treatment for menopause, perimenopause, and menopause and perimenopause symptoms.

Insurers and carriers must provide coverage for medically necessary diagnostic services and treatment for menopause, perimenopause, and related symptoms in individual health insurance policies, group and blanket health insurance policies, state employee health plans, and state Medicaid plans. Coverage for medically necessary hormone replacement therapy cannot be denied, limited, or subject to prior authorization or step therapy if supported by national clinical guidelines, national standards of care, or peer-reviewed medical literature.

SB 94: An act to amend title 24 of the delaware code relating to respiratory care practitioners.

Respiratory care practitioners may perform all forms of extracorporeal life support, including extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECCO2R), while working under the general supervision of a person certified to practice medicine.

SB 320: An act to amend title 16 and title 24 of the delaware code relating to pharmacy and pharmacists.

Licensed pharmacists may exercise independent prescriptive authority for over-the-counter products, opioid antagonists, and non-controlled drug categories meeting specified criteria without collaborative agreements or protocols. Pharmacists may prescribe controlled substances only for opioid use disorder treatment under standing orders from the Division of Public Health. Pharmacists administering immunizations must report to DelVAX within 72 hours.

HB 169: An act to amend title 16 of the delaware code relating to the behavioral health consortium and the prescription opioid distribution commission.

Restructures the Behavioral Health Consortium and Prescription Opioid Settlement Distribution Commission by reducing Consortium membership from 27 to 25, adding term limits of 6 years maximum for appointed members, and making the Commission independent with a single chair rather than co-chairs, removing Consortium approval authority over fund distributions.

SJR 7: Directing the state employee benefits committee and the secretary of human resources to engage with independent consultants and other supply chain tactics for cost containment of prescription drugs for state employees and retirees’ insurance programs.

This amendment clarifies that strategies and policies guiding the State Employee Benefits Committee and Secretary of Human Resources in engaging consultants and supply chain tactics for prescription drug cost containment must be consistent with applicable State and federal law.

SB 180: An act to amend chapter 25, title 24 of the delaware code relating to the board of pharmacy.

Amends Delaware pharmacy law to clarify that the Board may deny licensure based on administrative penalties, discipline, or criminal convictions after hearing or review, allows out-of-state pharmacists to practice during emergencies, and specifies that Section 1 takes effect one year after enactment while Section 2 takes effect immediately.

HB 140: An act to amend title 16 of the delaware code relating to end of life options.

An attending physician or attending APRN must determine that a terminally ill adult has decision-making capacity, is making an informed decision, and is acting voluntarily before prescribing medication for the individual to self-administer to end their life. A consulting physician or consulting APRN must confirm the terminal illness diagnosis and prognosis. The Department of Health and Social Services must promulgate regulations and collect compliance information.

HB 1299: Department of Health

Medical marijuana treatment centers must notify the Department of Health by email within 24 hours of actual or attempted theft, diversion, or loss of marijuana and report attempted thefts to law enforcement within the same timeframe. The act also revises licensure requirements for various health professions and establishes a physical therapy compact among member states.

SB 195: Pharmacies; pharmacists are authorized to dispense preexposure prophylaxis and postexposure prophylaxis under certain conditions; provide

Pharmacists must complete an approved training program before dispensing or administering preexposure prophylaxis or postexposure prophylaxis. Pharmacists may dispense PrEP (30 to 90 day supply or long-acting injectable) if patient is HIV negative and meets clinical criteria. Pharmacists may dispense PEP (30 day supply) if patient meets CDC clinical criteria. Physicians may delegate prescriptive authority to pharmacists via written PEP or PrEP protocol agreements.

HB 584: Health; reassign licensing and oversight of certain treatments and programs from Departments of Community Health to Behavioral Health and Developmental Disabilities

The Department of Behavioral Health and Developmental Disabilities must license and regulate drug abuse treatment and education programs, narcotic treatment programs, community living arrangements, and adult residential mental health programs. Licensees must comply with departmental rules, maintain records, implement disaster preparedness plans, and allow on-site inspections. Certain persons must report suspected abuse or exploitation of residents immediately.

Took effect 1 January 2026

HB 196: State employees' health insurance plan; drugs dispensed for self-administration; provisions

On and after January 1, 2026, insurers must reimburse pharmacies for drugs dispensed to covered persons for self-administration under state health plans using the national average drug acquisition cost plus a professional dispensing fee of at least $10.50 for chain pharmacies and $11.50 for independent pharmacies. Insurers must not circumvent these reimbursement requirements through prescription drug discount cards or programs.

SB 140: Optometrists; doctors of optometry to dispense and sell pharmaceutical agents to patients under certain conditions; provide

Doctors of optometry are authorized to dispense and sell pharmaceutical agents other than controlled substances related to treatment of eye diseases and conditions. They must be on premises during dispensing, inform patients of appropriate use, document the pharmaceutical agent in patient records, maintain retrievable records of all agents purchased, and comply with State Board of Pharmacy requirements.

SB 847: Relating to psychologists.

Licensed clinical psychologists meeting specified education, training, and examination requirements may prescribe psychotropic medications only to patients at federally qualified health centers in Kauai County under supervision of a licensed physician or psychiatrist. The state health planning and development agency must report to the legislature by twenty days before the 2030 regular session with recommendations on the pilot program's expansion, permanence, or termination.

HB 1854: Relating to community behavioral health clinics.

No person, public or private, shall operate a certified community behavioral health clinic expecting payment under a prospective payment system unless certified by the office. The office shall certify clinics meeting federal Substance Abuse and Mental Health Services Administration criteria, monitor compliance, and may decertify for noncompliance.

HB 1643: Relating to pharmacy.

Entities conducting audits of registered pharmacists or pharmacies must provide written electronic notice at least two weeks before on-site audits, identify prescriptions by number or date range, consult a registered pharmacist for clinical judgments, and limit audit periods to two years. Clerical errors alone cannot constitute fraud or be recouped unless they result in actual overpayment or wrong medication dispensing.

SB 1245: Relating to pharmacists.

Insurers issuing individual or group accident and health insurance policies and mutual benefit societies issuing hospital or medical service plan contracts in Hawaii must recognize pharmacists licensed under chapter 461 as participating providers, provide coverage for services provided by participating registered pharmacists within their scope of practice to the same extent as other health care providers, and pay or reimburse pharmacists for covered services. These requirements apply to policies and contracts delivered or issued for delivery on or after July 1, 2026.

HB 712: Relating to health.

Manufacturers must not deny, restrict, or prohibit the acquisition, shipping, or delivery of 340B drugs to pharmacies under contract with 340B covered entities, except where prohibited by the US Department of Health and Human Services. Beginning July 1, 2026, each 340B covered entity must annually report specified financial and operational data to the department of health.

SB 532: Relating to the department of education.

Public school employees and agents trained by a health care professional employed or contracted by the department may administer oral, nasal, and topical medication and emergency premeasured medication to students, provided a parent or guardian authorizes it for minors, a licensed prescriber orders it, a health care professional approves it, and administration is necessary for student health and school attendance.

HB 951: Relating to prescription drugs.

A physician may prescribe an opiate prescription for a three-day supply or less via telehealth to a patient who has been seen in person by a health care provider in the same medical group as the prescribing provider. Telehealth treatment recommendations must meet the same standards of appropriate practice as traditional in-person settings.

HB 1194: Relating to midwives.

Midwives must obtain and maintain licensure as either certified midwives or certified professional midwives. Licensed midwives must complete thirty continuing education contact hours per triennium, maintain current CPR and neonatal resuscitation certifications, participate in peer review of minimum five clinical cases per triennium, and submit required data. Certified midwives only may prescribe drugs within specified formulary.

H 648: INSURANCE – Adds to existing law to establish provisions regarding coverage of anticancer medications under health benefit plans.

Health benefit plans issued or renewed on or after January 1, 2027, must ensure that coverage for prescribed orally administered Food and Drug Administration-approved anticancer medications is subject to the same plan design cost sharing with respect to copayment, coinsurance, and deductible as injected or intravenously administered anticancer medications.

Took effect 1 July 2026

H 639: MIDWIFERY – Amends and adds to existing law to provide for a licensed midwife to obtain and administer medication indicated for maternal care or neonatal care if a midwife possesses requisite education, training, and experience.

Licensed midwives may obtain and administer medications indicated for maternal care or neonatal care if they possess requisite education, training, and experience, as defined in the formulary and protocol established by the board. The board must adopt rules defining the formulary, protocols, scope of practice standards, and peer review systems for midwifery care.

Took effect 1 July 2026

H 200: PHARMACISTS – Amends, repeals, and adds to existing law to update provisions regarding the practice of pharmacy in Idaho.

Pharmacists must attest at license renewal that they have maintained competence through continuing education commensurate with their active practice setting. Persons engaging in compounding must obtain active pharmaceutical ingredients from FDA-registered manufacturers, obtain certificates of analysis, use suitable equipment, and remove questionable products from stock. Persons preparing sterile or hazardous drugs must follow specific documentation, storage, and safety requirements.

Took effect 1 July 2025

HB 4327: Auditor general-340b audit

All 340B covered entities and pharmaceutical manufacturers doing business in Illinois must submit information requested by the Department of Insurance in the format and timeframe specified, including data on drug acquisition costs, reimbursement rates, contract pharmacies, savings usage, and patient demographics.

HB 4953: Drug distribution restrictions

Manufacturers and wholesale distributors licensed under the Act may deliver prescription drugs only to a licensee's business address, premises listed on the license, or to a health care entity's address if the Department received notice of authorization. Delivery to authorized persons at the manufacturer's or distributor's premises is permitted only to meet immediate patient needs.

Takes effect 1 January 2027

HB 4793: Pharmacist dispensing ability

It is unlawful to require a pharmacist or pharmacy to dispense a prescription drug for less than its fair market value, including the cost of dispensing. A pharmacist exercising professional judgment may add missing non-pharmaceutical devices or durable medical equipment to a prescription and complete missing information if evidence supports the change, with documentation required in the patient's record.

Takes effect 1 January 2027

SB 3896: Wholesale drug distributors

Every virtual wholesale distributor engaging in virtual drug distribution of prescription drugs must be licensed by the Department of Financial and Professional Regulation. Virtual wholesale distributors must only contract with licensed entities to take physical possession of prescription drugs being shipped into the State and must not operate from residences or personal dwellings.

HB 4154: Pharmacist application/exam

Applicants for examination as pharmacists for calendar years 2025, 2026, and 2027 must pass only the North American Pharmacist Licensure Examination; results from the Multistate Pharmacy Jurisprudence Examination shall be disregarded for these applicants. The Department and Board of Pharmacy must regularly monitor the examination to ensure it fairly tests applicant qualifications.

HB 3489: Pharmacists-contraceptives

Pharmacists must complete an accredited educational training program on patient self-screening risk assessment, contraceptive counseling, and dispensation before dispensing contraceptives including emergency contraception. Pharmacists may dispense up to a 12-month supply pursuant to valid prescription or standing order, must have patients complete self-screening risk assessment tools, provide counseling on all contraceptive methods, and maintain appropriate records.

Took effect 1 January 2026

HB 3849: Patient prescription pick up

Authorized employees of hospice service organizations or home health service organizations may receive patient prescription orders, including controlled substances, and deliver them to patients. Pharmacists may pick up prescriptions from prescribers and deliver prescription drugs to patients or their agents at residences, workplaces, or medical facilities.

Took effect 1 January 2026

SB 262: INSPECT program.

Dispensers must transmit to the INSPECT program information about each ephedrine, pseudoephedrine, or controlled substance dispensed within twenty-four hours (or next business day if pharmacy closed). Practitioners must obtain patient information from the INSPECT database before prescribing opioids or benzodiazepines, with limited exceptions. Opioid treatment programs must obtain patient consent per 42 CFR before reporting to INSPECT.

Took effect 1 July 2026

SB 282: Compounding drugs; registration of medical spas.

Beginning January 1, 2027, medical spas must register with the medical licensing board of Indiana and designate a responsible practitioner with prescriptive authority and relevant education. Medical spas must notify the board within 15 days of serious adverse events, comply with advertising requirements, and ensure staff are licensed and trained.

Took effect 1 July 2026

HB 1114: Coverage for certain cancer prescriptions.

State employee health plans, policies of accident and sickness insurance, and health maintenance organizations that provide coverage for advanced, metastatic cancer and associated conditions may not require that an insured or covered individual fail to successfully respond to a different prescription drug or prove a history of failure of a different prescription drug before providing coverage for a qualifying prescription drug.

Took effect 1 July 2026

HB 1604: Cost sharing; out-of-pocket expense credit.

A health plan must credit toward a covered individual's deductible and annual maximum out-of-pocket expenses any amount the covered individual pays directly to a health care provider for a medically necessary covered health care service if no claim is submitted and the amount paid is less than the health plan's average discounted network rate. A health plan must establish a procedure for claiming credits, identify required documentation, and publish average discounted rates on its website.

Took effect 1 July 2025

HB 1666: Ownership of health care providers.

Hospitals must file annual financial reports within 120 days of fiscal year end, including ownership information for persons or entities with at least 5% ownership interest, controlling interest, or private equity partnership interest. Health care entities, insurers, third party administrators, and pharmacy benefit managers must report similar ownership information to the secretary of state or department of insurance.

Took effect 1 July 2025

SB 140: Pharmacy benefits.

Ambulatory pharmacies must provide dispensing cost data to the Indiana board of pharmacy before March 1, 2027, and March 1 of every other year thereafter. Insurers, pharmacy benefit managers, and other pharmacy benefit administrators must ensure networks are reasonably adequate and accessible, file annual reports, and comply with minimum reimbursement requirements and prohibitions on retroactive denials and discriminatory practices.

Took effect 1 January 2026

SB 473: Various health care matters.

Managed care organizations must submit home modification requests to certified project specification writers within 15 days, approve or deny with explanation within 15 days, request bids within 5 days of approval, and notify winning and unsuccessful bidders within 30 days. Opioid treatment programs must conduct monthly random drug tests for patients testing positive until passing. Programs may close Sundays and federal holidays. Medical directors need not obtain hospital admitting privileges.

Took effect 1 July 2025

SB 3: Fiduciary duty in health plan administration.

Any third party administrator, pharmacy benefit manager, employee benefit consultant, or insurance producer acting on behalf of a plan sponsor owes a fiduciary duty to the plan sponsor.

Took effect 1 July 2025

HB 1200: Opioid prescriptions.

Prescribers must limit opioid prescriptions to a 7-day supply for adults receiving opioids for the first time, children under 18, and animals receiving opioids for the first time. Prescribers must limit opioid prescriptions for subdermal delivery systems to a 180-day supply. Prescribers may exceed these limits for cancer, palliative care, medication-assisted treatment, or other conditions adopted by rule, or based on professional judgment, and must document the medical record accordingly.

Took effect 1 July 2025

HF 2676: A bill for an act relating to health-related matters, including health-related professions, nutrition, medication, and education, and including effective date and applicability provisions.

School districts must prohibit serving meals containing blue dye 1, blue dye 2, green dye 3, potassium bromate, propylparaben, red dye 40, yellow dye 5, or yellow dye 6 in breakfast or lunch programs, except foods from USDA direct delivery. Employees and vendors must not provide such foods to students during the school day. Schools must prohibit sales of such foods on campus during school hours.

HF 2585: A bill for an act relating to the provision of accessible prescription-related measures for persons who are blind, have a visual impairment, or other print disability.

HF 2680: A bill for an act relating to certified medication aides.

The department of inspections, appeals, and licensing must establish a medication aide certification registry on its internet site allowing department-approved examination providers to submit proof of successful completion. The department must not charge fees for submitting or accessing such proof. The department must adopt rules governing medication aide qualifications and challenge examinations at specified facilities.

SF 383: A bill for an act relating to pharmacy benefits managers, pharmacies, prescription drugs, and pharmacy services administrative organizations, and including applicability provisions.

Pharmacy benefits managers must use pass-through pricing in contracts effective January 1, 2026. PBMs must reimburse retail pharmacies at least the national average drug acquisition cost plus a ten dollar sixty-eight cent professional fee, and must not reimburse pharmacies less favorably than their affiliates. PBMs must provide appeals processes and cannot discriminate against pharmacies or restrict patient choice.

Took effect 1 July 2025

HB 2068: Establishing the remote practice of pharmacy, requiring certain conditions for such practice and limiting activities performed under such practice, permitting a pharmacist to initiate therapy for certain conditions consistent with the pharmacist's education, training and experience, adding pharmacists who initiate such therapy to the healthcare stabilization fund and allowing a pharmacist to dispense a one-time emergency refill of a noncontrolled prescription drug for up to a 90-day supply when no refills remain, adopting compounding standards established by the United States pharmacopeia and allowing for exemptions from such standards and removing the authority of the state board of pharmacy to authorize individuals to access the prescription monitoring program database by rules and regulations.

HB 2250: Substitute for HB 2250 by Committee on Health and Human Services - Permitting the use of expedited partner therapy to treat sexually transmitted infections, authorizing a licensed private psychiatric hospital to maintain a stock supply of emergency medication kits for pharmaceutical emergencies, allowing expired emergency opioid antagonists to be used to treat an opioid overdose, permitting first responders to distribute and administer expired emergency opioid antagonists, permitting a pharmacist to distribute epinephrine delivery systems to a school for use in emergency medication kits and amending definitions related to medication in schools to allow for use of epinephrine delivery systems.

SB 20: Enacting the Kansas consumer prescription protection and accountability act and providing for regulation and registration of pharmacy benefits managers.

SB 67: Substitute for SB 67 by Committee on Public Health and Welfare - Authorizing registered nurse anesthetists to prescribe, procure and administer drugs consistent with the registered nurse anesthetist's education and qualifications.

Registered nurse anesthetists may prescribe, procure, and administer drugs consistent with their education and qualifications, including durable medical equipment. They must not prescribe, procure, or administer anesthetic agents except as permitted under physician or dentist orders. Controlled substances must be prescribed in accordance with the uniform controlled substance act, and registered nurse anesthetists must register with the federal drug enforcement administration to prescribe controlled substances.

HB 470: AN ACT relating to behavioral health services and declaring an emergency.

Licensed alcohol and other drug treatment entities, behavioral health service organizations, behavioral health multi-specialty groups, and entities that bill for peer support services must employ only registered alcohol and drug peer support specialists beginning January 1, 2028. The Cabinet for Health and Family Services shall promulgate administrative regulations establishing these requirements and standards for peer support specialists and other behavioral health service providers.

HB 388: AN ACT relating to prescription drugs.

The Department for Medicaid Services or contracted managed care organizations must provide medication synchronization programs for chronic illness treatments when agreed by member, provider, and pharmacist, provided medications meet specified criteria including not being Schedule II controlled substances or Schedule III hydrocodone products. Health benefit plans must similarly provide synchronization programs and early refill exceptions policies.

HB 501: AN ACT relating to pharmaceutical drugs.

Pharmacists may dispense prescriptions from deceased practitioners within specified timeframes based on professional judgment: new prescriptions within 90 days of death, and previously dispensed refillable prescriptions within 180 days of death. Controlled substance prescriptions may only be dispensed if permitted under federal law.

HB 695: AN ACT relating to the Medicaid program and declaring an emergency.

The cabinet must obtain specific General Assembly authorization before making changes to Medicaid eligibility, coverage, benefits, reimbursement rates, or pursuing waivers or state plan amendments, except when required by federal law or responding to emergencies. The cabinet must submit detailed fiscal impact assessments to specified legislative committees before seeking authorization for such changes.

SJR 26: A JOINT RESOLUTION directing the Department for Medicaid Services to provide the Legislative Research Commission with a report regarding pharmacist payment parity.

The Department for Medicaid Services must prepare and deliver a report on pharmacist payment parity to the Legislative Research Commission no later than August 1, 2025. The report must analyze changes necessary for Medicaid and KCHIP to comply with KRS 304.12-237, anticipated fiscal impacts, and effects on access to care in rural communities.

HB 870: INSURANCE/HEALTH: Provides relative to formulary placement and cost-sharing requirements for certain generic drugs and biosimilars (EN NO IMPACT See Note)

Health insurance issuers must provide detailed accounting of portfolio rebates or discounts by NDC when net cost is based on rebates including multiple drugs. Issuers must not remove reference listed drugs from formularies, increase cost sharing, or impose new utilization management for current users unless the provider agrees a switch is medically appropriate or a medical-necessity exception is granted.

SB 401: PHARMACEUTICALS: Provides for a Prescription Drug Affordability Board. (8/1/26)

Defines research and development expenditures and wholesale acquisition cost for a Prescription Drug Affordability Board, adds a patient advocacy group member to the board, and establishes conflict of interest restrictions for board members and their designees.

SB 195: HEALTH CARE: Provides relative to the administration of medications. (8/1/26)

The bureau must approve requirements and standards of practice that authorize licensed emergency medical technicians, licensed advanced emergency medical technicians, and licensed paramedics to administer patient-carried, time-critical prescription medication to patients with rare diseases, chronic illnesses, and special medical needs in accordance with R.S. 40:1133.19.

LD 1277: An Act Regarding Controlled Substances Prescription Monitoring Activities

Removes anabolic steroids from the definition of controlled substance in Maine's prescription monitoring program laws and appropriates $77,000 for fiscal year 2025-26 and $62,000 for fiscal year 2026-27 to the Department of Health and Human Services for database maintenance.

LD 2071: An Act To Expand Access To Vaccines Approved By The United States Food And Drug Administration By Allowing Pharmacists To Prescribe, Dispense And Administer Vaccines And Require Insurance Coverage

Carriers offering health plans in Maine must provide coverage for vaccines without deductible, copayment, coinsurance or other cost-sharing and must cover off-label vaccine use. The MaineCare program must reimburse vaccines with no copayments or out-of-pocket costs and must cover off-label vaccine use. Licensed pharmacists may prescribe, dispense and administer FDA-approved vaccines recommended by the CDC Advisory Committee on Immunization Practices to persons 18 years or older without a prescription.

LD 2011: An Act To Remove The Mainecare Program From The Prescription Drug Benefit Provisions In The Maine Insurance Code

Amends the definition of 'carrier' in the Maine Insurance Code to exclude the MaineCare program from prescription drug benefit provisions, while keeping the MaineCare program included in other carrier definitions.

LD 2083: An Act To Expand Access To Certified Residential Medication Aide Training

The Department of Health and Human Services shall issue certificates to individuals who successfully complete a department-approved certified residential medication aide course meeting medication administration training requirements. The department shall review course curriculum at least every 5 years and may establish certification and sanction fees ranging from $25 to $100 per individual or instructor for a 2-year certification period.

LD 2019: An Act To Amend The Laws Governing Licensure Of Wholesalers And Manufacturers Under The Maine Pharmacy Act

Manufacturers and wholesalers applying for initial licensure must file their United States Department of Justice Drug Enforcement Administration registration number and United States Food and Drug Administration registration number with the Maine Board of Pharmacy once obtained, even if not yet obtained at time of application.

LD 697: An Act To Direct The Maine Prescription Drug Affordability Board To Assess Strategies To Reduce Prescription Drug Costs And To Take Steps To Implement Reference-Based Pricing

The Maine Prescription Drug Affordability Board must assess strategies to reduce prescription drug costs, including reference-based pricing for the first 10 drugs negotiated under Medicare's drug price negotiation program. The board must develop and submit a preliminary affordability program plan by January 30, 2026 and a final plan by October 1, 2027 to the joint standing committee.

LD 1100: An Act To Clarify The Requirements For Accessing Nonformulary Drugs And Drugs Used To Treat Serious Mental Illness

Carriers must approve prior authorization requests for formulary drugs prescribed to assess or treat serious mental illness. Carriers must approve equivalent nonformulary drugs when drug shortages make formulary drugs unavailable. Carriers must allow enrollees or prescribers to request clinically appropriate nonformulary drugs and decide within 72 hours or 2 business days, whichever is less, or within 24 hours for expedited reviews.

LD 163: An Act To Require Health Insurance Coverage For Federally Approved Nonprescription Oral Hormonal Contraceptives And Nonprescription Emergency Contraceptives

Nonprofit hospital and medical services plans, insurers offering individual and group health policies, and health maintenance organizations must provide coverage for all federally approved nonprescription oral hormonal contraceptives and nonprescription emergency contraceptives without deductibles, coinsurance, copayments, or cost-sharing. Coverage must last 12 months and require no prescription.

LD 1687: An Act To Clarify And Increase Access To Hiv Prevention Medications

Carriers offering health plans in Maine must provide coverage for HIV prevention drugs prescribed by providers or pharmacists with no out-of-pocket cost for drugs rated A or B by the United States Preventive Services Task Force. Carriers must authorize pharmacists to bill directly and cannot impose practice requirements more restrictive than state law. The department must implement MaineCare reimbursement for pharmacists prescribing and administering HIV prevention drugs by January 1, 2027.

LD 93: An Act To Reduce Cost And Increase Access To Disease Prevention By Expanding The Universal Childhood Immunization Program To Include Adults

The Maine Vaccine Board must determine annually by January 1st a list of vaccines to be made available through the Universal Childhood Immunization Program to individuals in the State. Assessed entities must pay quarterly assessments calculated by the board based on covered individual member months, payable within 45 days following each calendar quarter.

Took effect 1 July 2026

LD 180: An Act Regarding The Interactions Of Pharmacy Benefits Managers And So-Called 340B Entities And Reimbursements By Pharmacy Benefits Managers To Pharmacies

A carrier or a pharmacy benefits manager under contract with a carrier may not reimburse a pharmacy provider for a prescription drug or pharmacy service in an amount less than the reimbursement amount paid to a pharmacy provider affiliated with the carrier or pharmacy benefits manager for the same prescription drug or pharmacy service.

LD 1580: An Act To Prohibit Pharmacy Benefits Managers From Imposing Certain Fees And Pricing

Carriers and pharmacy benefits managers may not engage in, facilitate, or contract for spread pricing in Maine. Spread pricing is any amount charged in excess of ingredient cost plus dispensing fee less pharmacy benefits management fee. Beginning December 31, 2026 and annually thereafter, carriers and pharmacy benefits managers must certify compliance to the superintendent.

LD 239: An Act To Allow Retail Pharmacies To Operate Remote Dispensing Sites In Rural Areas

The Maine Board of Pharmacy must adopt rules no later than June 30, 2026 establishing criteria for remote dispensing site licensure. Rules must require demonstration of inadequate pharmacy access, authorize licensed pharmacist supervision via telehealth, set minimum pharmacy technician staffing levels, and establish record keeping, security and surveillance procedures. Retail pharmacies cannot operate remote dispensing sites until rules are adopted.

LD 538: An Act To Amend Maine'S Prescription Drug Labeling Law By Allowing The Removal Of The Name Of A Prescriber Of Mifepristone, Misoprostol And Their Generic Alternatives

Every drug dispensed by prescription must carry on the label the prescription number, date of filling, patient's name, directions for use, drug name and strength, amount dispensed, beyond use date, name of the prescribing practitioner, and pharmacy name, address and telephone number, except as authorized by this section.

LD 765: An Act To Amend The Laws Governing The Controlled Substances Prescription Monitoring Program

Each dispenser shall submit to the department by electronic means or other format specified in a waiver granted by the department specific items of information regarding dispensed controlled substances as determined by the department, including dispenser identification number, prescription details, drug information, patient identification and demographics, and prescriber identification.

HB 1135: Health Occupations - Pharmacists - Vaccination Orders

Pharmacists may order intranasal vaccinations for individuals at least 3 years old without administering them, if they complete 20 hours of approved practical training, maintain current CPR certification, complete 2 hours of continuing education on immunizations, and follow a written vaccine-specific protocol established by the Department. Pharmacists must report all ordered vaccinations to the ImmuNet Program and document efforts to inform prescribers and primary care providers.

Took effect 1 October 2026

HB 1377: Prescription Drug Repository Program - Redirecting Safe Prescription Drugs Pilot Program

Each repository participating in the Pilot Program must coordinate with the DEA to separate and redirect eligible noncontrolled unopened prescription medications collected during National Prescription Drug Take Back Day to a State repository program, ensure collected medications are packaged consistently with Health-General Article 15-603, ensure controlled substances go to the DEA, and transfer eligible medications to a drop-off site.

Took effect 1 July 2026

SB 773: Health Occupations - Pharmacists - Vaccination Orders

Pharmacists may order vaccinations for individuals at least 3 years old without administering them, provided they complete 20 hours of approved practical training, maintain current CPR certification, complete 2 hours of continuing education on immunizations, comply with record-keeping requirements, and operate under a written vaccine-specific protocol established by the Department.

Took effect 1 October 2026

SB 778: Clinical Research Pharmacies and Clinical Trials - Permits and Ownership

A person must hold a clinical research pharmacy permit issued by the State Board of Pharmacy before establishing or operating a clinical research pharmacy. A licensed pharmacist must be present on-site during all hours of operation and be responsible for all compounding, dispensing, and oversight. Health care providers with substantial ownership interests cannot serve as clinical investigators or direct patients to specific pharmacists.

Took effect 1 October 2026

HB 637: Public Health - Recommendations for Immunizations, Screenings, and Preventive Services - Pharmacist Administration and Required Health Insurance Coverage (The Vax Act)

The Secretary of Health must issue recommendations for immunizations, screenings, and preventive services based on guidance from specified authoritative medical organizations and federal agencies, holding a 30-day notice and comment period before adopting non-immunization preventive service recommendations. Pharmacists may administer specified vaccinations to individuals at least 3 years old if they complete required training and comply with reporting requirements. Carriers must provide coverage without cost-sharing for recommended immunizations and preventive services.

Took effect 1 July 2026

SB 562: State Board of Pharmacy - Prescriber-Pharmacist Agreements - Treatment of Opioid Use Disorders

Pharmacists may enter prescriber-pharmacist agreements to treat opioid use disorders using controlled dangerous substances if they individually register with the Federal Drug Enforcement Agency and Office of Controlled Substances Administration, complete applicable training, and follow a protocol. Protocols authorizing controlled dangerous substances therapy must require pharmacists to request relevant data from the Prescription Drug Monitoring Program before initiating or modifying therapy.

Took effect 1 July 2026

HB 1087: Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer

Insurers, nonprofit health service plans, and health maintenance organizations may not impose step therapy or fail-first protocols on prescription drugs used to treat stage four advanced metastatic cancer or its associated symptoms or treatment side effects, if the drug is FDA-approved and use is consistent with FDA-approved indications, National Comprehensive Cancer Network Compendium indications, or best practices, and supported by peer-reviewed medical literature.

Took effect 1 January 2026

HB 1243: Health Insurance - Coverage for Specialty Drugs

Insurers, nonprofit health service plans, and health maintenance organizations may not exclude coverage for covered specialty drugs administered or dispensed by in-network medical oncology providers who comply with state regulations, if the drugs are infused, auto-injected, oral targeted immune modulators, or oral medications requiring complex dosing or used with infusion or radiation therapies. Reimbursement rates must be agreed upon and may not exceed designated specialty pharmacy rates.

Took effect 1 January 2026

HB 1310: Prescription Drug Repository Program - Revisions

Licensed pharmacies designated as repositories must accept donated prescription drugs, over-the-counter drugs, and medical supplies from drop-off sites; inspect them; dispense only those meeting requirements to eligible patients on new prescriptions; and maintain separate inventory and prescription files. Drop-off sites must require donor forms, store drugs securely, and forward donations to repositories. Entities may not charge fees for donations or resell drugs.

Took effect 1 October 2025

HB 1315: Vaccinations by Pharmacists and Health Insurance Coverage for Immunizations

Each individual hospital or major medical insurance policy, group or blanket health insurance policy, and nonprofit health service plan delivered or issued in the State must include coverage for all visits and costs of childhood and adolescent immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention or the American Academy of Pediatrics. These policies and plans may not impose a deductible on such coverage.

Took effect 1 January 2026

HB 424: Prescription Drug Affordability Board - Authority and Stakeholder Council Membership (Lowering Prescription Drug Costs for All Marylanders Now Act)

The Prescription Drug Affordability Board must determine whether to establish a process for setting upper payment limits for all purchases and payor reimbursements of prescription drug products in the State that the Board determines have led or will lead to affordability challenges. The Board may not establish new upper payment limits for current shortages, enforce limits against Medicare Part C or Part D plan reimbursements, or count pharmacy dispensing fees toward limits.

Took effect 1 October 2025

HB 813: Maryland Insurance Administration and Maryland Department of Health - Workgroup to Study Pharmacy Benefits Managers

The Maryland Medical Assistance Program must establish minimum reimbursement levels for generic drugs equal to the national average drug acquisition cost plus the fee-for-service professional dispensing fee from the most recent in-state cost-of-dispensing survey. Pharmacy benefits managers contracting with pharmacies on behalf of managed care organizations must reimburse pharmacies at least that same amount.

Took effect 1 June 2025

HB 970: Health Insurance - Insulin - Prohibition on Step Therapy or Fail-First Protocols

Insurers, nonprofit health service plans, and health maintenance organizations may not impose step therapy or fail-first protocols on insured or enrollee prescriptions for insulin or insulin analogs used to treat type 1, type 2, or gestational diabetes, or other prescription drugs performing similar insulin functions.

Took effect 1 January 2026

SB 975: Health Insurance - Coverage for Specialty Drugs

Insurers, nonprofit health service plans, and health maintenance organizations may not exclude coverage for covered specialty drugs administered or dispensed by in-network medical oncology providers who comply with state regulations, if the drugs are infused, auto-injected, oral targeted immune modulators, or oral medications requiring complex dosing or used with infusion or radiation therapies. Reimbursement rates must be agreed upon or not exceed designated specialty pharmacy rates.

Took effect 1 January 2026

HF 3825: Health occupations; licensing and scope of practice modified for acupuncture and herbal medicine practice, athletic training, mortuary science, social work, dentistry practice, marriage and family therapy, pharmacy practice, physical therapists, and advanced practice registered nurses; registration established for massage therapists and Asian bodywork therapists; licensure established for music therapists; unlicensed practice provisions modified; advisory councils established; civil penalties; reports required; fees imposed; and money appropriated.

Licensed acupuncturists must practice acupuncture and herbal medicine under supervision, collaboration, and prescription of a primary physician in good standing. Athletic trainers must practice under supervision, prescription, and collaboration with a primary physician. Massage therapists and Asian bodywork therapists must register with the commissioner of health.

HB 856: Advanced, metastatic cancer; delete repealer on prohibition against health plans requiring step therapy before covering certain drugs to treat.

A health benefit plan that provides coverage for advanced, metastatic cancer and associated conditions may not require step therapy or fail-first protocols before covering a prescription drug approved by the FDA for such treatment. A prescribing practitioner must have access to an expeditious process to request an override of step therapy restrictions from the insurer.

Took effect 30 June 2026

HB 856: Pharmacy Practice Act; extend repealer on and make various changes to.

Entities assisting with return of outdated drugs to manufacturers on behalf of pharmacies must register with the board and obtain a permit. Manufacturers must make adequate provision for return of outdated drugs from pharmacies within six months after expiration date for full credit or refund. Pharmacists may not dispense unless manufacturer has a return procedure.

SB 878: Modifies provisions relating to pharmaceutical drugs and devices

The board of pharmacy shall have authority to waive compliance with Missouri pharmacy rules and regulations when nonprofit pharmacies dispense, ship, or deliver prescription drugs into another state or territory experiencing a declared state disaster or emergency, provided the nonprofit pharmacy is licensed in good standing, responds to an active declared disaster, complies with the receiving jurisdiction's emergency rules and federal law, and delivers only to the specified geographic area.

HB 807: Prohibiting vaccines allowed under an emergency use authorization or undergoing safety trials to be required

An individual may not be required to receive any vaccine whose use is allowed under an emergency use authorization or any vaccine undergoing safety trials. It is an unlawful discriminatory practice for a person, governmental entity, employer, or public accommodation to refuse services, employment, or access based on vaccination status or immunity passport, except for school and day-care facility requirements.

HB 794: Revise pharmacy laws

Out-of-state mail service order pharmacies must register with the board of pharmacy, submit licensing certificates, provide pharmacist information, and comply with Montana law. Clinical pharmacist practitioners must obtain an endorsement and maintain a collaborative pharmacy practice agreement. Pharmacists may administer certain immunizations to specified age groups.

SB 317: Prohibit health insurers from performing prior authorization on psychiatric drugs in shortage or discontinued

Health insurance issuers must not perform prior authorization on prescription drugs that are designated as in shortage pursuant to the quarterly shortage list published by the United States Food and Drug Administration on April 1, July 1, October 1, or January 1. Manufacturers of such drugs must not engage in predatory pricing or marketing related to shortages.

HB 740: Revise laws relating to pharmacies, pharmacy benefit managers, and other entities

Pharmacy benefit managers and third-party payers must not recoup funds for clerical or recordkeeping errors unless they cause actual financial harm, must not use extrapolation in calculating recoupments, must not charge interest during audits, and must not pay audit agents based on recovery percentages. They must review and update maximum allowable cost lists at least every 10 calendar days and reference pricing at least daily. They must reimburse pharmacies at least 106% of national average drug acquisition cost plus a professional dispensing fee matching Montana Medicaid rates.

SB 456: Revise professions and occupations laws regarding dispensing of drugs

A medical practitioner must register with the board of pharmacy before dispensing drugs and comply with specified requirements including offering patients written or electronic prescriptions. Health care staff members may convey dispensed drugs if they are prepared and sealed with two forms of patient identification and the patient's identity is verified.

LB 867: Change provisions relating to special needs trusts, fingerprints under the Uniform Credentialing Act, child care grants, the Title IV-D Division Customer Service Unit, eligibility for young adults in the bridge to independence program, licensed and self-funded insurers under the Medical Assistance Act, medicaid nursing facility rates, assistance to aged, blind, or disabled persons, and the state Commodity Supplemental Food program; provide for a money follows the person program for medicaid benefits, a youth afterschool eligibility letter for child care employment, use of wholesale drug distributor license fees for the prescription drug monitoring program, and maintenance of epinephrine by certain schools; change provisions of and rename the Alzheimer's Disease and Other Dementia Support Act , the Alzheimer's Disease and Other Dementia Advisory Council, the State Advisory Committee on Mental Health, the Division of Developmental Disabilities of the Department of Health and Human Services, and the Director of Developmental Disabilities; and eliminate provisions relating to divisions of the Department of Health and Human Services, the Division of Medicaid and Long-Term Care Advisory Committee on Aging, the Maternal and Child Health and Public Health Work Fund, and an obsolete Nurse Licensure Compact

Each state agency providing governmental benefits to individuals with disabilities through means-tested programs must adopt rules and regulations regarding special needs trusts that are not more restrictive than federal law, allow pooled trust accounts without financial limits, permit funding without age limits or transfer penalties except for individuals sixty-five or older, and allow assignment of legally assignable income or resources without limit.

LB 912: Adopt the Community Health Worker Training Endorsement Act, the Athletic Trainer Compact, and the Respiratory Care Interstate Compact, change provisions relating to child care licensing and the practice of athletic training, respiratory care, massage therapy, medical radiography, nurse practitioners, pharmacy, and pharmacists, provide for liens for physical therapy services and automated pickup kiosks for certain prescription medication, and eliminate provisions relating to physician liability for physician assistants

Licensed pharmacies operating automated pickup kiosks must annually license each kiosk with the Division of Public Health, develop policies and procedures in consultation with a responsible pharmacist, verify all prescription drugs before dispensing, ensure pharmacist care is offered, and prohibit dispensing of controlled substances except in hospital pharmacies. Pharmacists must supervise kiosk operations and maintain compliance records for five years.

LB 967: Change provisions relating to insurance fees, licensing, and trade practices, pharmacy benefit managers, mutual insurance holding companies, the Population Health Information Act, the Health Information Technology Board, and the Site and Building Development Act and adopt the Nebraska Protection of Seniors from Insurance Exploitation Act

Beginning January 1, 2027, health insurance plans, their contractors, and affiliates must not restrict claim payment methods to credit, charge, or debit cards only. Insurers must provide training to supervisors and employees on identifying financial exploitation of eligible adults. Pharmacy benefit managers must immediately notify the director of material changes in ownership, control, or qualification.

LB 198: Change provisions of the Pharmacy Benefit Manager Licensure and Regulation Act

Pharmacy benefit managers must not exclude Nebraska pharmacies with specialty pharmacy accreditation from their specialty pharmacy networks or apply stricter terms to unaffiliated specialty pharmacies than affiliated ones. Health benefit plans, health carriers, and pharmacy benefit managers must not require covered persons to use mail-order or affiliate pharmacies exclusively, and must prohibit spread pricing in new contracts after January 1, 2026, and all contracts after January 1, 2029.

LB 118: Change supervising authority for a pharmacist

A pharmacist may supervise any combination of pharmacy technicians and pharmacist interns up to a total of three people. A pharmacist intern must be supervised at all times while performing pharmacist intern functions unless receiving experiential training directed by an accredited pharmacy program. If a pharmacist supervises three pharmacy technicians or pharmacist interns, at least one must be a certified pharmacy technician.

SB 231: Establishes provisions relating to the collection and destruction of unused drugs. (BDR 54-564)

A collector registered with the Drug Enforcement Administration that maintains a secure drug take-back bin must comply with all applicable state and federal laws, ensure regular monitoring and inspection, post signage about acceptable substances, limit public access to monitored hours, maintain inspection records for 2 years, and notify local law enforcement within 1 business day of suspected tampering, theft, or significant loss. Collectors must not receive compensation from customers.

AB 555: Establishes provisions relating to the coverage of prescription insulin drugs under certain policies of health insurance. (BDR 57-1167)

Insurers, carriers, societies, hospital and medical services corporations, health maintenance organizations, prepaid limited health service organizations, and managed care organizations that offer health insurance coverage for prescription insulin drugs must not impose a deductible, copayment, coinsurance, or other cost-sharing obligation greater than $35 for a 30-day supply of prescription insulin drugs.

SB 389: Revises provisions relating to the administration of pharmacy benefits under Medicaid and certain other health plans. (BDR 38-240)

The Department of Health and Human Services must select and contract with one state pharmacy benefit manager by January 1, 2030, to manage all prescription drug coverage under Medicaid, the Children's Health Insurance Program, and certain other health benefit plans. The state pharmacy benefit manager must submit pharmacy contracts to the Department for approval before they become effective and must comply with reimbursement methodologies and dispensing fees established by the Department.

HB 1584: directing the department of health and human services to provide notice of medical and religious exemptions from immunization requirements and relative to notice of drug pricing options.

The department of health and human services must prominently display on all communications, publications, websites, social media posts, and printed materials promoting vaccination or immunization the notice that medical and religious exemptions are available under New Hampshire law. Parents or legal guardians may provide any written signed statement attesting to religious objection instead of using a department-provided form.

Took effect 13 October 2026

HB 1735: relative to the practice of pharmacy, the dispensing of certain medications by pharmacists, and permitting treatment of certain severe illness under the right to try act.

Manufacturers may make drugs, biologics, or devices not approved by the FDA available to patients with terminal or qualifying severe illness if requirements are met. Health care providers may conduct telehealth prescreening with patients in any state diagnosed with terminal or qualifying severe illness. Physicians and facilities are protected from licensing action based primarily on recommending or providing such treatments.

HB 194: relative to the crime of interference with custody and relative to the practice of pharmacy and the dispensing of certain medications by pharmacists.

A person commits an offense if, with intent to interfere with lawful custody of a child under 18, the person knowingly entices or persuades the child to leave the custody of a parent, guardian, or person lawfully acting in that capacity. Licensed health care professionals may dispense up to a 30-day supply of noncontrolled oral anti-cancer medication if a full-time licensed pharmacist is on staff for consultation and dispensing follows United States Pharmacopeia standards.

HB 360: prohibiting public schools from performing surgical procedures or prescribing pharmaceutical drugs, relative to licensing requirements for health care facilities established within a 15 mile radius of a critical access hospital, and relative to the administration of prescription medication to minors by youth camp staff.

Any person or entity proposing to establish an ambulatory surgical center, emergency medical care center, hospital, birthing center, drop-in or walk-in care center, dialysis center, or special health care service within 15 miles of a critical access hospital shall give written notice by certified mail to the chief executive of the critical access hospital. Youth camps licensed under RSA 170-E may administer pharmaceutical drugs to minors pursuant to a valid prescription with written authorization of a parent or legal guardian.

SB 250: relative to pharmacist administration of long-acting injectable drugs.

S 2019: Authorizes pharmacists to dispense HIV prophylaxis without individual prescription under certain circumstances; mandates prescription benefits coverage.

Pharmacists must complete an approved training program before dispensing HIV preexposure prophylaxis or postexposure prophylaxis without individual prescription. Pharmacists must follow specific protocols including patient HIV testing, counseling, and provider notification. Hospital service corporations, medical service corporations, health service corporations, health insurers, health maintenance organizations, Medicaid, and the State Health Benefits Program must cover these medications without prior authorization or step therapy.

A 1899: Expands authority of pharmacy technician in administering drugs and vaccines and permits certain pharmacists and pharmacy interns, externs, and technicians to administer COVID-19 vaccine.*

Pharmacists, pharmacy interns, pharmacy externs, and pharmacy technicians may administer drugs and vaccines to patients 18 years or older if appropriately educated and qualified as determined by the board. Pharmacists, pharmacy interns, pharmacy externs, and pharmacy technicians may administer influenza and COVID-19 vaccines to patients 5 years or older with parental permission for patients under 18. All vaccine doses must be reported to the New Jersey Immunization Information System.

SB 20: Prior authorization & prescription drugs

Health insurers and pharmacy benefits managers must not require prior authorization for medications prescribed to treat serious mental illness, autoimmune disorders, cancer, rare diseases, or substance use disorders, except when biosimilar, interchangeable biologic, or generic versions are available. After approving prior authorization for chronic maintenance drugs, they must not require subsequent prior authorization more than once every three years unless specified conditions apply.

SB 3: Immunization rules & recommendations

The public health division must promulgate rules requiring children attending public, private, home or parochial schools to be immunized according to recommendations from the advisory committee on immunization practices and the American academy of pediatrics. Health insurers and group health plans must not impose cost-sharing requirements for immunizations recommended by the advisory committee on immunization practices.

HB 171: Pharmacy custodial care facilities

A licensed custodial care facility authorized to provide medically monitored withdrawal management under a consulting pharmacist's supervision with nursing staff on-site twenty-four hours per day, three hundred sixty-five days per year may acquire, stock, maintain and possess dangerous drugs including controlled substances in Schedules III and V for withdrawal management purposes.

SB 122: Expand prescription drug donation program

Eligible recipients must register with the board, accept and redistribute donated prescription drugs according to board rules, inspect drugs for tampering and adulteration, comply with federal and state laws, and examine drugs to certify proper storage. Donors may donate unexpired unused prescription drugs to eligible recipients. Controlled substances are excluded from donation.

HB 174: Pharmacy reimbursement for certain plans

Group health coverage offered under the Health Care Purchasing Act that includes a prescription drug benefit must reimburse community-based pharmacy providers for the ingredient cost of prescription drugs at the national average drug acquisition cost or wholesale acquisition cost, whichever applies, plus a professional dispensing fee no less than the Medicaid fee-for-service rate.

SB 39: Add classes to prior authorization drugs

Health insurers shall not subject medications approved by the FDA prescribed for autoimmune disorders, cancer, rare diseases or conditions, or substance use disorders to prior authorization or step therapy, except when biosimilar, interchangeable biologic, or generic versions are available. Medical necessity determinations must be automatically approved within seven days for standard determinations and twenty-four hours for emergency determinations.

A 136: Relates to the medical aid in dying act

Attending physicians must examine patients, confirm terminal illness within six months, assess decision-making capacity, provide informed counseling, obtain consulting physician confirmation, and may prescribe self-administered medication. Patients must make oral and written requests witnessed by two unrelated adults. Consulting physicians must examine patients and confirm terminal illness, informed decision, decision-making capacity, and voluntary action.

A 9515: Relates to requirements for the provision of medication for medical aid in dying

Attending physicians must examine patients requesting medical aid-in-dying medication, determine terminal illness and decision-making capacity, obtain consulting physician and mental health professional confirmations, provide informed counseling, and ensure written requests are signed and witnessed. Patients must make oral and written requests and may self-administer medication only. Health care facilities may prohibit the practice based on religious beliefs if they inform patients and transfer willing patients elsewhere.

S 3236: Allows pharmacy technicians to practice in any pharmacy under the supervision of a pharmacist

A registered pharmacy technician may practice under the direct personal supervision of a licensed pharmacist in any pharmacy. The pharmacy must ensure the technician receives appropriate training for competence before assisting. A supervising licensed pharmacist must remain in the immediate area, authorize procedures, evaluate work, and approve all work before drug dispensing.

SB 2402: AN ACT to create and enact two new sections to chapter 43-15 and a new subsection to section 43-48-03 of the North Dakota Century Code, relating to the prescriptive authority of pharmacists and therapeutic substitution; to amend and reenact subsection 1 of section 26.1-36.11-01 and section 43-15-01 of the North Dakota Century Code, relating to the scope of practice of pharmacists; to repeal section 43-15-25.3 of the North Dakota Century Code, relating to approved laboratory tests; and to provide an effective date.

Pharmacists whose practice is physically located in North Dakota may independently prescribe drugs, devices, and therapeutically equivalent drugs for specified conditions if they maintain patient assessment protocols based on clinical guidelines, obtain adequate patient health information, consult with other providers as appropriate, and notify the patient's primary care provider within three business days of prescribing.

SB 2370: AN ACT to provide for a legislative management study regarding prescription drug transparency reporting under the federal drug discount program.

Insurance companies, nonprofit health service corporations, and health maintenance organizations must limit out-of-pocket costs for a thirty-day supply of covered insulin drugs to twenty-five dollars per pharmacy or distributor and covered medical supplies for insulin dosing and administration to twenty-five dollars per pharmacy or distributor, regardless of quantity or type.

HB 1216: AN ACT to create and enact a new section to chapter 26.1-36 of the North Dakota Century Code, relating to out-of-pocket expenses for prescription drugs; to amend and reenact section 26.1-36.6-03 of the North Dakota Century Code, relating to self-insurance health care plans; to provide for application; and to provide an effective date.

HB 1584: AN ACT to create and enact four new sections to chapter 26.1-27.1 of the North Dakota Century Code, relating to pharmacy benefits managers and a pharmacy benefit manager enforcement fund; to amend and reenact subsection 1 of section 26.1-01-07, sections 26.1-27.1-01, 26.1-27.1-02, 26.1-27.1-04, 26.1-27.1-06 and 26.1-27.1-07 of the North Dakota Century Code, relating to pharmacy benefits managers; to repeal section 26.1-27-01.1 and chapter 26.1-36.10 of the North Dakota Century Code, relating to pharmacy benefits managers and prescription drug costs; to provide a penalty; to provide an appropriation; to provide for a transfer; to provide an effective date; to provide an expiration date; and to declare an emergency.

A pharmacy benefits manager must hold a certificate of registration as an administrator under chapter 26.1-27. Pharmacy benefits managers must comply with drug substitution rules, cannot require participation in one contract to participate in another, must offer opt-in contracts with thirty days to respond, and must allow pharmacies to opt-out with ninety-day notice.

HB 1543: AN ACT to provide for a legislative management study regarding prescription drug pricing and the maximum fair price as determined by the federal government.

Directs legislative management to study prescription drug pricing and maximum fair prices during the 2025-26 interim, including federal drug price negotiations and potential state cost savings, with input from specified entities and a report to the seventieth legislative assembly.

HB 1087: AN ACT to amend and reenact sections 26.1-27-03 and 26.1-27.1-02 of the North Dakota Century Code, relating to licensing for administrators of life and health insurance and pharmacy benefit managers.

A person may not act as or hold oneself out to be an administrator of life and health insurance in North Dakota without a license issued by the commissioner. A pharmacy benefits manager must hold a license as an administrator under chapter 26.1-27. Applications require a one hundred dollar filing fee and annual renewal requires a fifty dollar fee.

HB 229: Establish licensing process, contract requirements for PBMs

Pharmacy benefit managers must obtain a license from the superintendent of insurance before providing pharmacy benefit management services in Ohio on or after July 1. Licensees must maintain written agreements with plan sponsors, retain books and records for specified periods, account annually to plan sponsors for rebates and discounts, and disclose conflicts of interest and contract terms.

SB 138: Modify alcohol, drug addiction, and mental health services laws

Boards of alcohol, drug addiction, and mental health services must establish a community-based continuum of care including prevention, assessment, residential, outpatient, inpatient, and recovery support services. Boards must contract with providers for these services, enter continuity of care agreements with state institutions, and submit proposed budgets and service lists to the director of mental health and addiction services for approval.

HB 4431: Professions and occupations; Pharmacy Act; references; prescribing authority for certain persons; repealers; effective date.

Amends Oklahoma Pharmacy Act definitions and prescribing authority provisions for Advanced Practice Registered Nurses and physician assistants, modifying references to independent prescriptive authority under Section 567.4c of Title 59, and repeals duplicate sections from Chapter 343, O.S.L. 2025, effective November 1, 2026.

Took effect 1 November 2026

HB 3755: Oklahoma Juvenile Code; directing certain provision of medication and reimbursement; creating the Juvenile Detention Prescription Medication Fund; effective date.

The Office of Juvenile Affairs must provide all prescribed medications in its possession to juvenile detention facility operators within 48 hours of a juvenile's reception, at no charge. The Office must make reasonable efforts to coordinate medication acquisition through parents or guardians. Subject to fund availability, the Office must reimburse juvenile detention facilities for necessary prescription medications for detained juveniles.

Took effect 1 November 2026

SB 1344: Prescription drugs; creating the Insulin Access and Affordability Program; requiring certain financial support and agreement. Effective date. Emergency.

HB 2298: Practice of nursing; providing for independent prescriptive authority of Advanced Practice Registered Nurses who meet certain requirements; modifying various provisions of the Oklahoma Pharmacy Act, the Oklahoma Nursing Practice Act, and the Uniform Controlled Dangerous Substances Act; effective date.

Advanced Practice Registered Nurses who complete 6,240 clinical practice hours with supervised prescriptive authority may apply to the Oklahoma Board of Nursing for independent prescriptive authority. APRNs must carry malpractice insurance of $1,000,000 per occurrence and $3,000,000 aggregate annually. APRNs must advertise clearly as APRNs and not imply physician status.

HB 2584: Physicians assistants; Pharmacy Act; prescriptions for controlled dangerous substances; Physician Assistant Act; Committee; members; requirements; Public Health Code; authority for physician assistants to carry out certain functions; prescribing and administering controlled substances; supervision.

Physician assistants with fewer than 6,240 postgraduate clinical practice hours must practice under a delegating physician's supervision via a practice agreement filed within 10 business days. Physician assistants may prescribe Schedule II through V controlled substances subject to restrictions in their practice agreement. Pharmacists may only dispense controlled substance prescriptions from Oklahoma-licensed physician assistants supervised by Oklahoma-licensed practitioners.

HB 1808: Health insurance; creating the Ensuring Transparency in Prescription Drugs Prior Authorization Act; determination; consultation; prior authorization; effective date.

Health insurers and pharmacy benefit managers must not require failure on the same medication more than once for step-therapy protocols and must grant exceptions under specified conditions. They must respond to urgent prior authorization requests within 24 hours and nonurgent requests within 2 business days. They must cover at least one readily available asthma controller medication per class without prior authorization.

Took effect 1 November 2025

HB 2048: Prescriptions; 340B Nondiscrimination Act; definitions; discriminatory actions; reimbursement; manufacturer; distributor; enforcement; Attorney General; Insurance Commissioner; violations; federal preemption; effective date.

Health insurance issuers, pharmacy benefits managers, and other third-party payors must not discriminate against 340B entities in reimbursement rates, terms, conditions, or network participation based on 340B drug pricing status. Manufacturers and distributors must not deny or restrict acquisition or delivery of 340B drugs to contracted pharmacies.

SB 773: Pharmacy benefit managers; modifying definitions; prohibiting certain circumstances; requiring nonpayment under providing venue for certain court proceeding; allowing Attorney General to obtain certain information. Effective date.

Pharmacy benefits managers must not conduct spread pricing, charge participation fees, retroactively deny claims except for fraud or audit errors, reimburse PBM-owned pharmacies more than independent pharmacies, or restrict pharmacies from disclosing price differentials to patients. PBMs must maintain three years of network development documentation and report quarterly to the Attorney General on rebates and payments.

SB 789: Pharmacy benefit managers; permitting use of certain records without limitations of date or source for certain purposes; establishing certain reimbursement rates for certain drugs. Effective date.

Pharmacy benefits managers must reimburse pharmacies at 106% of National Average Drug Acquisition Cost plus a $15.00 professional fee (or 110% of wholesale acquisition cost plus $15.00 for generic drugs without NADAC pricing, or 100% for brand-name drugs). PBMs must prohibit effective rate contracting. Entities conducting pharmacy audits must follow specific procedures including fourteen days' notice, limiting audits to fifty prescriptions annually, and providing preliminary findings within forty-five days.

Took effect 1 November 2025

SB 993: Pharmacy benefit managers; establishing requirements and limits for certain audit reports and findings. Emergency.

Pharmacy benefits managers must not use extrapolation audits to calculate recoupments. PBMs must toll the ability to initiate, continue, or conclude audits of pharmacies for the duration of a declared disaster and thirty additional calendar days afterward, except for audits involving suspected fraud with documented evidence or audits required by federal or state law unrelated to the PBM-pharmacy contract.

SB 906: Practice of pharmacy; establishing certain pharmacy staffing ratio. Effective date.

Licensed retail pharmacies must maintain a pharmacy technician-to-pharmacist ratio of not more than five pharmacy technicians for every one licensed pharmacist. No person may serve as a pharmacy technician without first procuring a permit from the State Board of Pharmacy.

Took effect 1 November 2025

HB 1585: Pharmacy technicians; training guidelines; training skills; on-the-job training; effective date.

Pharmacy managers must develop and implement pharmacy technician training programs with Board-approved guidelines. Pharmacy technician applicants must complete Phase I training before applying for a permit and Phase II within ninety days of permit issuance. Pharmacy managers must conduct training, document annual continuing on-the-job training, and document training within ten days of a technician's hire.

Took effect 1 November 2025

HB 4131: Relating to mobile pharmacies; and prescribing an effective date.

The State Board of Pharmacy must issue licenses to operate mobile pharmacies to qualified retail drug outlets that are critical access pharmacies, hospitals, federally qualified health centers, or county governing bodies. Licensed mobile pharmacies must maintain a pharmacist on-site during operations, keep records of drug transfers and dispensations, comply with storage requirements, and establish patient communication and local health authority coordination plans. Mobile pharmacies cannot operate in the same location for more than 10 consecutive days per board-determined period or more than 14 consecutive days within the same five-mile radius per board-determined period.

SB 1598: Relating to access to health services; and declaring an emergency.

Health benefit plans that are not grandfathered health plans must provide coverage of preventive health services prescribed by the United States Department of Health and Human Services pursuant to 42 U.S.C. 300gg-13 in rules in effect on June 30, 2025, and immunizations recommended by the Public Health Officer. Health benefit plans may not impose cost-sharing requirements on enrollees for these services except as allowed by federal law. Health benefit plans must provide coverage of recommended immunizations no later than 15 business days following publication.

HB 2929: Relating to substance use; and declaring an emergency.

Participating state agencies must meet quarterly with the Alcohol and Drug Policy Commission to review progress implementing the substance use prevention, treatment, and recovery support services plan. Agencies must report process and outcome measures and provide 45 days' notice before adopting rules relating to substance use services. The commission must review and update the plan by July 1 of each even-numbered year.

HB 3045: Relating to the State Board of Pharmacy; and prescribing an effective date.

The State Board of Pharmacy must determine fees for examinations, licenses, registrations, and renewals within 30 days prior to each state fiscal year. The board may require persons under investigation to undergo mental, physical, chemical dependency, or competency evaluations at the person's expense.

SB 598: Relating to step therapy for nonopioids.

Entities that provide health care coverage for prescription drugs must ensure their drug formulary provides coverage for at least one clinically appropriate nonopioid prescription drug as an alternative for each opioid prescription drug. Coverage for nonopioid drugs may not be more restrictive than coverage for opioid drugs regarding prior authorization, step therapy, utilization review, cost-sharing, copayments, coinsurance, and deductibles.

HB 3409: Relating to health care; and prescribing an effective date.

The Department of Revenue shall annually adjust the maximum medical care expense subtraction allowable under Oregon tax law and the qualifying federal adjusted gross income levels by multiplying specified amounts by the percentage increase in the U.S. City Average Consumer Price Index for the 12 consecutive months ending August 31 compared to the index for the 12 consecutive months ending August 31, 2024.

HB 3226: Relating to organizations that provide services related to obtaining prescription drugs; and prescribing an effective date.

A person acting as a pharmacy services administrative organization or as an organization that advises or represents pharmacies in matters related to procuring or supplying prescription drugs must obtain a third party administrator license from the Director of the Department of Consumer and Business Services before transacting business in Oregon.

HB 2013: Relating to mental health treatment providers.

Member states must license and regulate social workers at clinical, master's, or bachelor's levels and participate in the Social Work Licensure Compact. Regulated social workers holding multistate licenses must abide by laws and regulations of the member state where the client is located. Home states must issue multistate licenses to eligible applicants and report adverse actions to the Commission's data system.

HB 2942: Relating to reimbursement of pharmacy services; and prescribing an effective date.

The Oregon Health Authority must reimburse pharmacists or pharmacies for health services within the lawful scope of pharmacist practice provided to medical assistance recipients not enrolled in coordinated care organizations. Coordinated care organizations must reimburse pharmacists or pharmacies for such services provided to enrolled recipients. Both must reimburse for prescription, dispensation and administration of preexposure and post-exposure prophylactic antiretroviral therapies.

HB 3044: Relating to nursing; and prescribing an effective date.

The Oregon State Board of Nursing must establish standards for nursing education, licensure, and practice. Entities employing nonresident nurses must notify the board in writing. Long-term care facilities and in-home care agencies must train nursing assistants within eight weeks of employment or face penalties.

SB 289: Relating to prescription drugs.

Manufacturers of prescription drugs must report annually to the Department of Consumer and Business Services by March 15 regarding drugs with prices of $100 or more for one-month supply and net price increases of 10 percent or more, including detailed information on costs, sales revenue, profit, and patient assistance programs. Manufacturers must notify the department within 30 days of introducing new specialty drugs exceeding CMS thresholds.

Took effect 1 January 2026

SB 295: Relating to pharmacy.