Prescription Drug Law by State (2026)
A 50-state reference for the prescription-drug-law questions that decide whether and how you can fill a script cheaply: generic substitution mandates, Medicaid Preferred Drug List access, State Pharmaceutical Assistance Programs, dispensing rules for 90-day fills and mail order, Prescription Monitoring Programs, and 340B clinic locators. Each state page carries a last-verified date and primary-source citations.
State comparison
Quick scan across the axes covered on every state page. Click a state for the full reference with citations.
| State | Generic substitution | SPAP | 90-day fills | PMP query |
|---|---|---|---|---|
| California | Permissive | No | Allowed | Required |
| Texas | Mandatory | No | Allowed | Required |
| New York | Mandatory | EPIC (Elderly Pharmaceutical Insurance Coverage) | Allowed | Required |
| Florida | Mandatory | No | Allowed | Required |
| Pennsylvania | Permissive | PACE / PACENET | Allowed | Required |
| Alabama | Permissive | No | Allowed | Required |
| Alaska | Permissive | No | Allowed | Required |
| Arizona | Permissive | No | Allowed | Required |
| Arkansas | Mandatory | No | Allowed | Required |
| Colorado | Permissive | No | Allowed | Required |
| Connecticut | Mandatory | ConnPACE | Allowed | Required |
| Delaware | Permissive | Delaware Prescription Assistance Program (DPAP) | Allowed | Required |
| Georgia | Permissive | No | Allowed | Required |
| Hawaii | Permissive | No | Allowed | Required |
| Idaho | Permissive | No | Allowed | Required |
| Illinois | Mandatory | No | Allowed | Required |
| Indiana | Mandatory | HoosierRx | Allowed | Required |
| Iowa | Mandatory | No | Allowed | Required |
| Kansas | Permissive | No | Allowed | Voluntary |
| Kentucky | Permissive | No | Allowed | Required |
| Louisiana | Permissive | No | Allowed | Required |
| Maine | Mandatory | Maine Low Cost Drugs for the Elderly or Disabled (DEL) | Allowed | Required |
| Maryland | Mandatory | Maryland Senior Prescription Drug Assistance Program (SPDAP) | Allowed | Required |
| Massachusetts | Permissive | Prescription Advantage | Allowed | Required |
| Michigan | Permissive | No | Allowed | Required |
| Minnesota | Permissive | No | Allowed | Required |
| Mississippi | Permissive | No | Allowed | Required |
| Missouri | Permissive | Missouri Rx Plan (MORx) | Allowed | Voluntary |
| Montana | Permissive | No | Allowed | Required |
| Nebraska | Permissive | No | Allowed | Voluntary |
| Nevada | Permissive | No | Allowed | Required |
| New Hampshire | Mandatory | No | Allowed | Required |
| New Jersey | Mandatory | PAAD / Senior Gold | Allowed | Required |
| New Mexico | Permissive | No | Allowed | Required |
| North Carolina | Mandatory | No | Allowed | Required |
| North Dakota | Permissive | No | Allowed | Required |
| Ohio | Permissive | No | Allowed | Required |
| Oklahoma | Permissive | No | Allowed | Required |
| Oregon | Permissive | No | Allowed | Voluntary |
| Rhode Island | Permissive | Rhode Island Pharmaceutical Assistance to the Elderly (RIPAE) | Allowed | Required |
| South Carolina | Permissive | No | Allowed | Required |
| South Dakota | Permissive | No | Allowed | Voluntary |
| Tennessee | Permissive | No | Allowed | Required |
| Utah | Permissive | No | Allowed | Required |
| Vermont | Permissive | VPharm | Allowed | Required |
| Virginia | Mandatory | No | Allowed | Required |
| Washington | Permissive | No | Allowed | Voluntary |
| West Virginia | Mandatory | No | Allowed | Required |
| Wisconsin | Permissive | SeniorCare | Allowed | Required |
| Wyoming | Permissive | No | Allowed | Required |
All 50 states
Federal-side patient assistance
State law is only half of the cheapest-legal-fill question. For federal-side patient assistance programs (manufacturer PAPs, foundation copay assistance, GoodRx-style discount cards), see our sister site OmniRx's assistance directory →
About this reference
Each state page covers six axes: generic substitution law (mandatory vs permissive, DAW handling), Medicaid Preferred Drug List access and prior authorization, State Pharmaceutical Assistance Program eligibility (where one exists), dispensing rules covering 90-day fills and mail-order eligibility, the state's Prescription Monitoring Program and mandatory-query rules, and 340B drug pricing program clinic locator. Where a state has no statewide law on a given axis we say so explicitly and link to the federal floor. Primary sources include the National Conference of State Legislatures (NCSL), state Boards of Pharmacy, state Medicaid agencies, CMS, HRSA Office of Pharmacy Affairs, and the Medicare.gov SPAP directory.
Maintained by Vincent Couey, RxGrab editor. Annual reverification is on the operator queue; each page's "Verified" badge shows the date of last primary-source review.