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A number of states regulate the use of drug formularies by requiring MCOs and HMOs to disclose drugs listed on the plan formulary or to disclose procedures to obtain drugs that are not listed on the formulary.

During the late 1990s, the Internet became a popular place to purchase merchandise, and states faced a new challenge in dealing with a type of business that is not the traditional "brick and mortar." As online pharmacies became part of the spectrum of stores on the Internet, states grappled with how to ensure the safety of their residents while balancing the convenience and potential cost saving from using the Internet to purchase prescription drugs.

During the last few years, the debate over the use of marijuana for medical purposes has moved from the legislative arena into the public forum. Since 1996, eight states have passed ballot initiatives that allow people with certain medical conditions to use marijuana, and now most of those states are wrestling with ways to implement the laws. During the past 24 years, 35 states have enacted laws on medical marijuana; however, several states have either repealed their laws or allowed them to sunset.