Advocacy

NCPA’s 2026 state advocacy priorities

From comprehensive state-level PBM regulation to Medicaid managed care reform, NCPA is changing the pharmacy payment model. We are ready to assist our state partners with 2026 legislation and regulation that bring transparency, accountability, and fairness to community pharmacies.

NCPA State Panel of Experts

NCPA has assembled a diverse array of experts in different areas to assist states, based on certain criteria, in their legislative and regulatory initiatives.

Comprehensive PBM regulation

Over time, PBMs have been allowed to operate virtually unchecked. A lack of transparency in PBM practices is increasingly leading states — with NCPA’s support — to implement licensure/registration, fair pharmacy audit, or generic drug pricing legislation to try to level the playing field for pharmacies and patients.

Is Your State Enforcing PBM Regulations?

Virtually every single state has passed some form of PBM regulations over the last several years. Although there have been great strides forward with comprehensive state PBM regulations and court victories, this is all irrelevant if the state departments of insurance are not enforcing these laws.

Medicaid managed care pharmacy payment reforms

State audits and studies are showing that Medicaid drug costs are increasing, and pharmacy reimbursements are decreasing. Something isn’t adding up. NCPA supports efforts to increase transparency and accountability and to ensure state oversight of Medicaid managed care programs.

Medicaid Cost of Dispensing Surveys

Medicaid cost of dispensing (COD) surveys directly determine the professional Medicaid dispensing fee paid to pharmacies. While almost all states use these data to set fees for their Medicaid fee-for-service programs, an increasing number are using these data to set fees in their Medicaid managed care programs.

Scope of Practice and Compensation for Services

Community pharmacists are the most accessible health care providers in the country. Expanding pharmacists' scope of practice allows patients to receive timely care for common conditions, preventive services, chronic disease management, and medication-related needs without unnecessary delays. NCPA works with state pharmacy associations and policymakers to remove barriers that prevent pharmacists from practicing to the full extent of their education and training while ensuring patients receive safe, high-quality care.

State Wins for Community Pharmacy

Annual report of state legislative and regulatory wins for community pharmacy.

State-Specific Community Pharmacy Impact Fact Sheets

These fact sheets report the economic impact of independent pharmacy by state. In presentations to policymakers, employers, and other groups, you'll find them useful in demonstrating the profound economic benefit of community pharmacy to your state's economy.

State Legislative Tracking

Click on the states to learn what community pharmacy-priority bills are active in legislatures throughout the country.