Weekly StateVitals Update: Volume 61 (March 23, 2026)

National

• Judge Temporarily Blocks HHS from Changing Childhood Vaccine Recommendations. Last week, a federal judge issued stays on major actions by the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) regarding childhood vaccine recommendations and advisory committees. These stays temporarily block HHS’ actions pending a full trial or decision for summary judgment. In particular, the judge issued three stays covering the following actions:

  • HHS issued a January 2026 memo reducing routine childhood vaccine recommendations from 17 to 11 and downgrading several others to “Shared Clinical Decision Making” status.

  • Secretary Kennedy reconstituted the Advisory Committee on Immunization Practices (ACIP) by appointing 13 members. 

  • ACIP took votes in June, September, and December 2025 on flu/thermisol, COVID, and hepatitis B.

  The Judge found that 1) the CDC bypassed statutory requirements for it to consult ACIP before changing immunization schedules, 2) the new ACIP members were not fairly balanced according to the Federal  Advisory Committee Act (FACA) as only six members had meaningful experience in vaccines, and it did not follow its typical appointment processes, and 3) the CDC’s vaccines recommendations were “arbitrary and capricious” as the agency did not explain why it abandoned typical practices other than to comply with a presidential memo.  As it stands, federal vaccine recommendations for children and adults before June 2025 are now in place. Yet, over the past several months, states have enacted legislation to implement new statutory and regulatory authority for vaccine recommendations. Examples of such include bills in New Jersey (S 4894), Washington (HB 2242), and Colorado (SB 32).

• HHS Launches Investigation into 13 States for Violating Weldon Amendment. This past week, the U.S. Department of Health and Human Services (HHS) announced they are launching an investigation into 13 states for violating the Weldon Amendment, a federal appropriations provision which prohibits states from receiving federal funds if they discriminate against any health care provider that refuses to cover, pay for, refer or provide an abortion. HHS intends to send letters out to each of the 13 states and provide states with 20 days to respond. HHS has indicated that the investigations are not prompted by complaints from each state but instead due to the prior Administration opting to close some complaints affiliated with those states. The states involved in the investigations include California, Colorado, Delaware, Illinois, Maine, Maryland, Massachusetts, Minnesota, New Jersey, New York, Oregon, Vermont and Washington. 

Alabama

• Alabama Becomes the 24th State to Join PA Licensure Compact. This past Tuesday, Governor Kay Ivey (R) signed HB 156 into law, authorizing Alabama to join 23 other states in the Physician Assistant (PA) Licensure Compact. The initiative came as part of Alabama’s Rural Health Transformation application, which recognizes the PA licensure compact as a strategy to strengthen the rural healthcare workforce. Under the compact, physician assistants and physician associates will not need to obtain individual licenses in each participating state where they practice. Alabama is not the only state to have joined the compact this year; Arizona, New Jersey, North Dakota, and South Dakota have enacted compact legislation as well. Moreover, 9 other states are considering bills to join the PA Licensure Compact this session, which, once signed, typically take 18-24 months to become fully operational.

Florida

• Trump Administration Requests Information on Medicaid Fraud. Last Wednesday, the Trump Administration sent a letter to state officials, including Governor Ron DeSantis (R), requesting information on Medicaid fraud oversight. The administration has sent similar requests to New York, Minnesota, Maine, and California this year. Florida is notably the first Republican state to be subject to such federal investigation initiated by the Administration. The U.S. House Committee on Energy and Commerce had previously issued a letter to Nebraska, another Republican-controlled state, requesting information related to its state Medicaid program integrity and fraud, waste and abuse efforts. In announcing the effort on social media, Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz stated that the state “has been a hotspot for health care fraud,” detailed fraud cases from the past year, and called on state officials to step up and work with the administration to stop fraud. 

Idaho

• Legislature Weighs Competing Bills to Direct Rural Health Transformation Grant Funds. Recently, Idaho legislators have been considering two competing bills that would create task forces and establish scoring metrics to direct $186 million in grants under the Rural Health Transformation Program (RHTP). In the Senate, SB 1264 would create a seven-person committee, requiring 3 legislators to represent rural districts. However, the house bill, HB 862, has no provisions requiring legislators to come from rural districts and instead creates a committee of 9. Both bills would direct the committees to make recommendations on appropriating funds in alignment with the initiatives in the state’s RHTP application: 

  • Improving rural access to care through technology.

  • Ensuring accessible, quality care through innovative models.

  • Sustaining the rural workforce with training, recruitment, and retention.

  • Implementing population-specific, evidence-based projects to make rural America healthy again.

  • Investing in rural health infrastructure and partnerships.

SB 1264 has been retained on the Senate’s calendar since February 23, delaying the vote. HB 862 is headed to general orders to be amended. The Co-Chair of the Joint Finance-Appropriation Committee, Representative Josh Tanner, has indicated that committee members have been waiting for developments with other policy bills that direct the funding before granting spending authority. Looking ahead, the bills face a two-week deadline as the legislature is set to adjourn on March 27th. 

Iowa

• House Appropriations Committee Approves Bill to Address Medicaid Shortfall. This past week, the House Appropriations Committee passed HF 2739 to increase premium taxes on health maintenance organizations (HMOs) and make a supplemental appropriation of $70.3 million from the general fund to the Department of Health and Human Services for Medicaid. The bill provides for a temporary retroactive increase in premium taxes on HMOs from 0.925 percent to 3.5 percent from January 1 to September 30, 2026, and then establishes the rate at 0.95 percent afterwards. Lawmakers noted that the bill is needed to address an estimated $91 million Medicaid shortfall this fiscal year and a $168 million shortfall in the next, though insurers contend that the tax could increase health insurance costs for consumers. The Senate Appropriations Committee approved a similar measure (SF 2464) last week, though it differs from the House version in provisions related to the Taxpayer Relief Fund. 

Kansas

• Governor Kelly Enacts Bill Expanding Optometrist Scope of Practice. Recently, Governor Laura Kelly signed HB 2223, authorizing optometrists to perform procedures that were previously only permitted to be performed by ophthalmologists. Under this expanded scope of practice are laser procedures, including laser capsulotomies and laser trabeculoplasties, as well as other medical procedures such as the incision and curettage of a chalazion, and the removal and biopsy of skin lesions. Critically, optometrists will need to complete additional credentialing to perform this procedure, either through a 32-hour certification program or a separate process, depending on their graduation year. Moreover, credentialed optometrists will need to meet professional liability insurance coverage thresholds and be included in the Health Care Stabilization fund. In addition to Kansas, several other states have introduced bills this session to allow optometrists to perform laser procedures, including legislation in New Hampshire, New Mexico, and Tennessee.

Maryland

• PDAB Publishes Draft UPL Regulations for Public Comment. Last week, the state’s Prescription Drug Affordability Board (PDAB) published draft regulations to establish upper payment limits (UPLs) on two drugs, Farxiga and Jardiance. One of the proposed regulations sets the UPLs at the Medicare maximum fair price (MFP), and the other creates implementation and monitoring requirements. Of note, Maryland’s PDAB currently has limited UPL authority, and the regulations apply to drug products purchased by or paid for on behalf of a unit of state or local government. However, once two UPLs have been in effect for one year, their authority will expand to all purchasers and payers. The PDAB is expected to discuss the proposed regulations as well as draft cost review study reports for the two drugs during their upcoming meeting, and is accepting public comments on the documents until March 30th. 

North Carolina

• Healthcare Committee Chair Indicates Focus on Hospital Price Transparency, Medicaid, and CON in Upcoming Short Session. This past week, Senator Benton Sawrey (R), Chair of the Appropriations on Health and Human Services and Healthcare Committees, indicated several health reform areas that the Senate plans to address in April’s short session. Specifically, Sen. Sawrey spoke of making changes to the state’s hospital price transparency, Medicaid, and certificate of need (CON) laws, referencing both SB 316 and SB 315 from the previous session. He brought up banning hospital fees, providing patient-friendly prior authorization, managing Medicaid service utilization, and eliminating CON requirements. Legislators will begin the 2026 session on April 21st, which is expected to adjourn on August 31st.

Oklahoma

• Rural Health Transformation Program Releases Public Grant Application. On Monday, the Oklahoma Rural Health Transformation Program announced its first public grant application through a Notice of Funding Opportunity (NOFO) for the Community-Led Wellness Hubs: Microgrants program. The funding will be used to support one-time purchases of equipment and other assets to help improve health care access, outcomes, and community wellness in rural communities. To be eligible, organizations must operate in a rural county or maintain a branch serving a rural county, serve communities with populations of 55,000 or fewer residents, and maintain required federal registration and insurance documentation. Interested applicants can submit questions via a submission form through Friday, March 27. Applications for the Microgrants program are due by 11:59 pm CT on April 13, 2026.

Tennessee

• CON Measure Continues Movement in Legislature. Last week, the Senate Health and Welfare Committee voted 8-1 to recommend SB 1369 for passage. The measure is part of a larger overhaul to the state’s efforts to reform certificate of need (CON) laws in the state and would remove any requirement that an acute care hospital must obtain a certificate of need to either establish or operate. However, the move also comes after agreement was seemingly reached between Senate Finance Committee Chair and bill sponsor Bo Watson and the Tennessee Hospital Association on CON reform holistically, which would delay key effective dates of CON removal until 2030 so that acute care hospitals, satellite emergency departments and cardiac catheterization services have time to adjust prior to implementation. There remains possible disagreement in the House with some members seeking a CON repeal effective date of 2028.  

Utah

• Governor Signs Various Healthcare Measures into Law. Last week, Governor Spencer Cox (R) signed several pieces of health policy legislation into law. The bills cover a range of healthcare topics from prior authorization, Medicaid, and scope of practice. Notable signed bills include:

  • HB 15: Modifies the automatic sunset trigger for Medicaid expansion and reduces the eligibility for Medicaid expansion from 12 to 6 months.

  • HB 527: Requires PBMs to make maximum allowable costs lists available to network pharmacies upon request, requires PBMs to provide network pharmacies with dedicated phone numbers and email addresses to contact for the purpose of submitting appeals, and mandates that PBMs provide pharmacies with the specific basis upon which the PBM can show the drug is available below MAC if that the reason for denying the pharmacy's appeal.

  • SB 288: Requires the Department of Health and Human Services to establish quality measures for evaluating Medicaid providers' performance and evaluate Medicaid providers on performance as measured by the quality measures, requires the department to implement a closed loop referral system for referrals for the delivery of health-related social needs care to Medicaid-eligible individuals, and requires the Division of Services for People with Disabilities to notify a provider of amendments to the provider's contract with the division.

  • SB 319: Requires an insurer to disclose if it uses artificial intelligence in preauthorization review, establishes timelines for preauthorization decisions, sets minimum preauthorization validity periods for chronic or long-term care conditions and outpatient services, requires insurers to publish preauthorization statistics on its website, and expands insurer preauthorization data reporting requirements.   

  • SB 31: Expands the scope of practice for several health professions, including authorizing physical therapists to prescribe durable medical equipment and order medical imaging, granting limited prescriptive authority to certified registered nurse anesthetists, permitting physician assistants and APRNs to perform minor surgical procedures, and reducing the number of clinical practice hours a physician assistant must complete to practice without a collaborative agreement.

Wisconsin

• Governor Signs Bill to Extend Postpartum Medicaid Coverage. On Wednesday, Governor Tony Evers (D) signed SB 23 to extend postpartum Medicaid coverage from 60 days to one year. Wisconsin was one of two states that had not extended such coverage to one year. In a press release, Gov. Evers noted that he has proposed expanding postpartum Medicaid in every one of his Executive Budget proposals during his seven years as governor. The expanded coverage will begin July 1, 2026, following a standard review period and approval of a state plan amendment by the Centers for Medicare & Medicaid Services. 

For additional information and updates on state activity this past week relative to state COVID-19 vaccine guidance, StateVitals Subscribers can check out our guidance tracker.