State programs · Medicaid
State pharmaceutical assistance programs on the CMS list
The states and programs that CMS names as excluded from Medicaid Best Price, with the program names as the list gives them, and the federal Medicaid community engagement baseline with CMS's own sentence. The list does not say who qualifies; for help with a specific drug see the assistance guides.
Programs by state
From the CMS compilation “CMS State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price”, last updated August 2023 by CMS. The list names programs; it does not describe eligibility, income limits or current operation.
| State | Programs on the CMS list | Count |
|---|---|---|
| Arizona | Arizona Seriously Mentally Ill Program Arizona Crisis Program | 2 |
| California | Genetically Handicapped Persons Program California Children's Services | 2 |
| Connecticut | Connecticut Pharmaceutical Assistance Contract to the Elderly and Disabled (ConnPACE) General Assistance Program | 2 |
| Delaware | Non-Qualified Non Citizens Program Chronic Renal Disease Program Delaware Prescription Assistance Program Delaware Cancer Treatment Program | 4 |
| Illinois | Illinois Cares Rx Basic Health Benefits for Immigrant Seniors (HBIS) Health Benefits for Immigrant Adults (HBIA) | 3 |
| Maine | Maine Low Cost Drugs for the Elderly or Disabled (DEL) Program | 1 |
| Maryland | Maryland Pharmacy Assistance Program Maryland Kidney Disease Program Maryland Medicaid State-Only Program Maryland Breast and Cervical Cancer Diagnosis Treatment Program (BCCDTP) | 4 |
| Minnesota | Minnesota Prescription Drug Program General Assistance Medical Care Program | 2 |
| Missouri | Missouri Rx Plan | 1 |
| Montana | Mental Health Services Plan | 1 |
| Nevada | Disability Rx Program HAX Program Senior Rx Program | 3 |
| New Jersey | Pharmaceutical Assistance to the Aged and Disabled (PAAD) Senior Gold Prescription Program Work First New Jersey General Assistance Program (WFNJ/GA) Medicare Part D Wraparound Program | 4 |
| New York | Elderly Pharmaceutical Insurance Coverage (EPIC) | 1 |
| North Carolina | Senior Care Program NC HIV SPAP | 2 |
| Pennsylvania | Pharmaceutical Assistance Contract for the Elderly (PACE) General Assistance Program Chronic Renal Disease Program Special Pharmaceutical Benefits Program - Mental Health Component (SP2) | 4 |
| Rhode Island | Rhode Island Prescription Assistance for the Elderly (RIPAE) | 1 |
| Texas | Kidney Health Care Program Healthy Texas Women | 2 |
| Vermont | VPharm | 1 |
| Wisconsin | SeniorCare (Above 200% FPL) Chronic Renal and Cystic Fibrosis Program Chronic Disease Program Home Hemophilia Program | 4 |
Source: CMS list (PDF), read November 7, 2026. States not shown are not on this list; that is not a claim that they run no program.
Medicaid community engagement baseline
Federal baseline (Section 71119 of Public Law 119-21): states must condition Medicaid eligibility on community engagement from January 1, 2027, and may implement sooner. The CMS page dates the start January 1, 2027.
Source: CMS community engagement page. A statement of what the page says, not legal advice and not a reading of exemptions.
Questions
What does this list mean?
The CMS list names state pharmaceutical assistance programs that are excluded from Medicaid Best Price. It says nothing about who qualifies, income limits or whether a program operates today, so check the program with the state before relying on it.
Is my state missing because it has no program?
No. The list is the CMS compilation as of its last update, and a state may run a program that is not on it. Absence here is not a claim that a state has no program.
What is the federal baseline for the Medicaid work requirement?
Federal baseline (Section 71119 of Public Law 119-21): states must condition Medicaid eligibility on community engagement from January 1, 2027, and may implement sooner. This is what the CMS page says; it is not legal advice and the exemptions are not read here.
For developers: state assistance programs as data
One file with each state, its program names from the CMS list and a receipt for each fact. A state missing from the file is unread, not a state without a program.
Example file: https://omnirx.org/api/v1/states/spap.json
The licence page sets out what a data licence covers, and the API page documents these files.
Evaluation files with receipts; contract may change; not clinical advice.
Sources and terms. CMS State Pharmaceutical Assistance Programs Excluded from Medicaid Best Price (medicaid.gov, a federal work with no stated restriction on reuse) and the CMS community engagement page. Library edition 2026-11. Every figure is stored with its source and date in the OmniRx library: see where every figure comes from. Not medical, legal or financial advice. Licence the data.