2021 State Provider Status Mid-Year Legislative Update

213 state provider status-related bills have been introduced in 43 states so far in the 2021 state legislative sessions. NASPA identifies “state provider status-related bills” as those that pertain to pharmacist scope of practice, payment for pharmacist-provided patient care services, and/or the designation of pharmacists as providers.

Several bills introduced related to scope expansion are attempts to codify federal and state emergency authority granted during the current COVID-19 pandemic, including 66 bills related to immunization authority, 31 bills related to testing authority, and 11 bills related to medication administration.

So far, 32 bills in 18 states have passed their respective legislatures and been signed into law, and 16 bills in 10 states are awaiting a governor’s signature. Below are highlights of laws that have been enacted.

Pharmacist Immunization Authority:

  • Arkansas: Allows pharmacists to prescribe, administer, deliver, distribute, or dispense vaccines and medications to treat adverse reactions to administered vaccines to persons 3 years of age and older
  • Georgia: Authorizes pharmacists to administer all vaccines on the ACIP adult immunization schedules to individuals 18 and older
  • Indiana: Allows pharmacists and technicians to administer immunizations for coronavirus and allows RNs to supervise pharmacist interns or student pharmacists when administering immunizations.
  • Ohio: Authorizes pharmacists to administer any vaccine to individuals 13 and older and both influenza and COVID-19 vaccines to individuals ages 7-13 without a prescription
  • Oklahoma: Authorizes pharmacists to administer any FDA approved or authorized vaccine without a prescription, standing order, or similar arrangement
  • Virginia: Authorizes pharmacists to independently prescribe and administer (via statewide protocol) vaccines included on a CDC Immunization Schedule or that have an FDA emergency use authorization to persons 18 years of age or older

Pharmacy Technician Immunization Administration Authority: Arkansas, Indiana, Iowa, North Dakota, Wisconsin

Expanded Testing Authority:

  • Arkansas: Authorizes pharmacists to test for and treat influenza, pharyngitis caused by Streptococcus A, and other conditions that can be screened using a CLIA-waived test via a statewide protocol
  • Georgia: Authorizes pharmacists to order and administer tests that have been cleared or approved for home use by the FDA and interpret the results as a means to screen for or monitor disease, disease risk factors, or drug use and to facilitate patient education; and order and administer viral and serology COVID-19 tests
  • Iowa: Authorizes pharmacists to order and administer point-of-care testing and treatment for influenza, streptococcus A, and COVID-19 to patients 6 and older; as well as point-of-care testing in response to a public health emergency for patients 6 and older
  • New Jersey: Authorizes pharmacists to order and administer to any person any test for SARS-CoV-2 or COVID-19 antibodies that is granted emergency use authorization or approval by the FDA
  • North Dakota: Authorizes pharmacists to administer SARS-CoV-2 tests
  • Virginia: Authorizes pharmacists to initiate treatment with, dispense, or administer tuberculin purified protein derivative for tuberculosis testing

Broad Prescriptive Authority: Utah

Payment for Services: Iowa, Kentucky, Oklahoma

HIV PrEP/PEP Prescribing Authority: Utah, Virginia

Contraceptive Prescribing Authority: Arkansas, Utah

Long-Acting Injectable Administration: Maryland, North Carolina

Expanded CPA Authority: Mississippi, Nevada

Therapeutic Interchange: Indiana, Oklahoma


States with Bills Awaiting Governor Signature: Colorado (broad prescriptive authority); Connecticut (expanded CPA provisions); Florida (vaccine authority); Illinois (contraceptive prescribing authority); Missouri (HIV PEP prescribing authority); Nevada (HIV PrEP/PEP and contraceptive prescribing authority); New Hampshire (payment for services and technician vaccine administration authority); New York (vaccination authority)