LTC Pharmacy News

State Update Fall 2026

While we spend a lot of time covering the federal news, it's the states that dictate how your pharmacy operates and how pharmacists practice pharmacy. So, it's worth spending some time keeping track of what's going on in state capitals around the country. If you already subscribe to LTC Pharmacy News, you need to subscribe separately to LTC Pharmacy State News to keep up to date on state issues.

By maintaining a separate subscription to each newsletter you can unsubscribe to one without canceling both.

While most state legislatures are not in session now, the all-important legislative elections will be coming in November. Keeping track of who's in and who's out will help you keep track of what happens with pharmacy laws and regulations over the next two years.

See you again soon.

Paul

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Headlines

What's at Stake for States in the '26 Election

There are 28 states where Republicans control both houses of the legislature, while Democrats have full control in 18 states. Four states have split control, where Republicans control one house and Democrats control the other. 46 states will hold legislative elections this fall. So how close will it be this time? More

The Rural Health Initiative Criticized for Lack of Transparency

Last year the Trump Administration launched the $50 billion Rural Health Initiative, providing grants to the states to devise and implement plans to transform rural healthcare. A year later, critics argue that a lack of transparency is slowing progress. More

HHS OIG Wants $46.9 Million Back from United Healthcare

Claiming the health insurer billed Medicare for services that weren't documented, The HHS Inspector General 'recommends' the company pay back the federal government. More

State Highlights

Oregon Board for Universal Healthcare Design Delays Release of Report: Can't Find a Way to Pay

Single-payer healthcare is a popular idea, but paying for it is hard. So finds the Oregon Universal Health Plan Governance Board. So difficult, in fact, the Board, charged with developing such a plan has asked for an extension on the release of its report. More

Republican Group Petitions Maine for Improved Medicaid Oversight

The Maine Dept. of Health has begun the process for examining the state's oversight of the Medicaid program, in response to a GOP-led petition. The petition wants stricter enforcement of providers under investigation and more in-person investigations. More

Employers Sue NJ over Fines for Employees on Medicaid

New Jersey passed legislation fining large employers whose employees were enrolled in Medicaid, believing that the government was unnecessarily subsidizing big companies for their failures to provide health insurance. Employers are fighting back with, what else, a lawsuit. More

Rhode Island Governor Loses Primary to Former CVS Executive

Rhode Island Governor Dan McKee has lost the Democratic primary election to former CVS executive Helena Foulkes. Governor McKee attacked Foulkes for CVS' role in the opioid crisis, but the Governor's popularity suffered from other issues related to state infrastructure. Washington Post (subscription required)

Maryland Wants Courts to Mandate Mental Health Treatment

The Maryland Dept. of Health is rolling out The Assisted Outpatient Treatment program, which will allow healthcare professionals to petition the court to impose mandatory treatment for mental health conditions. The Dept. notes that some mental health conditions interfere with a patient's ability to discern the need for treatment, and must be legally compelled in order to prevent harm. More

Florida Investigates CVS over Alleged Pharmacy Steering

The Florida Attorney General has initiated an investigation of CVS and its related PBM, Caremark, over allegations that it steers patients to CVS pharmacies, handicaps independent pharmacies, and engages in abusive audit practices designed to hobble competitors. More

California Legislatures Passes Bill to Require Mandatory Substitution of Biologics

A bill to require substitution of biologic medications with biosimilars awaits the signature of Governor Newsom. The legislation is supported by the insurance industry and some labor unions as a partial solution to the rising cost of healthcare. The bill requires substitution unless the prescriber objects. More

Arkansas Pharmacies Sue PBM for Under-reimbursement

Twelve Arkansas pharmacies filed a lawsuit against Express Scripts claiming a violation of an Arkansas law requiring PBMs to pay pharmacies, at a minimum, the same price as drugstores pay wholesalers. More

Minnesota's Medicaid Spending Outruns Tax Revenue

The state's spending on Medicaid is projected to reach $29 billion in 2029, a 40 percent jump from 2025, while state tax growth is likely to grow by 10 percent during the same time frame. Seniors comprise 25 percent of the state's Medicaid population, but consume 60 percent of its Medicaid spending. More

Trump Administration announces $11.7 million grant to Vermont

The grant is targeted at improvements in rural nursing home care by improving facilities and increasing workforce capacity in the LTC sector. See CMS Announcement

Mississippi to Receive $107 Million Healthcare Transformation Grant

Part of the Rural Health Transformation project, Mississippi will invest in projects to update technology and move healthcare closer to home. CMS Announcement