NCPA's state government affairs team tirelessly tracks and engages with state legislation and regulation across the country, with our priorities including comprehensive PBM reform, PBM regulation enforcement, and Medicaid managed care reform. Here's a breakdown of our recent state government affairs activity relating to pharmacy reimbursement.
- NCPA continues to support the Pharmacists Society of the State of New York’s end-of-session push for A 5882/S 5939, legislation to create a reimbursement floor in the commercial market with NADAC plus the state Medicaid professional dispensing fee. NCPA has issued two grassroots calls to action while NCPA staff communicated with the 35 members of the Assembly Ways and Means Committee urging support.
- NCPA also called its members to action in conjunction with pharmacy stakeholders in New Jersey to push back against opposition to A 1502, sweeping reimbursement legislation that would create reimbursement floors in the commercial, state employee and teacher health plans, and the managed Medicaid program. A 1502 successfully passed through the Assembly and awaits action in the Senate Commerce Committee.
- NCPA’s eyes are on Louisiana HB 1236 and SB 387 as the bills were agreed upon by their respective conference committees and await transmission to the governor. HB 1236 creates a reimbursement floor in the commercial market of NADAC plus at least the Medicaid professional dispensing fee, which is currently $11.81. For claims dating back to Jan. 1, 2026, the bill calls for retroactive reimbursement of NADAC + $9. Among its provisions, SB 387 strengthens appeals procedures and audit protections, assigns fiduciary responsibility to PBMs, requires PBMs to pass rebates through to insurers, and delinks PBM income from fees.
Please check out the NCPA state legislative tracking webpage, where you can see all the bills we are following and connect to our Advocacy page.
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