2022 Provider Status Midyear Legislative Update

167 bills pertaining to pharmacist scope of practice, payment for pharmacist-provided patient care services, and/or the designation of pharmacists as providers have been introduced in 38 states in the 2022 state legislative sessions. Several of the bills are focused on addressing public health concerns, including 40 bills related to immunization authority, 38 bills related to contraceptive prescribing authority, and 13 bills related to HIV PrEP and PEP prescribing authority.

As of August 1, 41 bills in 24 states have passed their respective legislatures and been signed into law, and 7 bills in 6 states are awaiting a governor’s signature. Below are highlights of laws that have been enacted.

Vaccine Authority

Alaska HB 145

  • Authorizes pharmacists to independently prescribe and administer a vaccine and related emergency medication and an opioid overdose drug after approved training requirements are met.
  • Authorizes pharmacy technicians to administer vaccines or related emergency medication under immediate supervision of a pharmacist.

Arizona SB 1374

  • Authorizes pharmacists to order and administer ACIP recommended vaccines to a person who is at least 6 years of age; for international travel to a person who is at least 18 years of age; and for influenza to a person who is at least 3 years of age.
  • Authorizes pharmacists to order and administer emergency medication to manage an acute allergic reaction to an immunization, vaccine or medication in accordance with ACIP guidelines.
  • Updates reporting requirements of immunizations for pharmacists.

Connecticut HB 5485

  • Authorizes pharmacists to administer the influenza vaccine to any person between the ages of 12-17, with the consent of a parent or guardian.

Florida HB 1209

  • Authorizes registered pharmacy technicians to administer vaccines under supervision of a certified pharmacist and after board certified immunization-related training/continuing education.
  • Revises reference for immunizations or vaccines that certified pharmacists, interns, and registered pharmacy technicians may administer.

Iowa HF 2169

  • Authorizes registered nurses to practice under the order of a pharmacist to assist in the administration of vaccines and immunizations and the utilization of statewide protocols without obtaining registration from the board

Illinois SB 2017

  • Updates eligible vaccines and coverage/reimbursement for pharmacists.

Indiana HB 1169

  • Authorizes a qualified pharmacy technician to administer immunizations (beyond influenza and COVID-19) that are delegated by the pharmacist.

Pennsylvania HB 2679

  • Authorizes pharmacists to administer injectable medications, biologicals and immunizations to persons who are more than eighteen years of age and influenza and COVID-19 immunizations by injectable or needle-free delivery methods to persons five years of age and older.

Tennessee HB 2131

  • Authorizes a pharmacy technician to perform tasks delegated by the pharmacist, including participation in drug, dietary supplement and device selection, storage, distribution, and administration, if the delegated tasks are consistent with the pharmacy technician’s education, training, and experience.

Virginia SB 672 / HB 1323

  • Authorizes pharmacists and pharmacy technicians under supervision of a pharmacist to initiate treatment with and dispense/administer vaccines for COVID-19, nicotine replacement and other tobacco cessation therapies, and tests for COVID-19.
  • Authorizes pharmacists and pharmacy technicians under supervision of a pharmacist to initiate treatment with and dispense/administer certain drugs, devices and tests in accordance with a statewide protocol.

Virginia SB 647

  • Allows the Commissioner of Health to authorize persons who are not authorized by law to administer or dispense drugs or devices to do so in accordance with established protocols when the board has made an emergency order for the limited purpose of administering vaccines.

Wyoming SF 24

  • Authorizes pharmacy technicians and pharmacy interns to administer immunizations to individuals 13 and older and repeals the requirements for direct supervision (supervision is still required) of a pharmacy technician or intern by a licensed pharmacist.

Collaborative Practice Authority

Alaska HB 145

  • Expands pharmacist practice authority under collaborative practice agreements

Arizona HB 2490

  • Updates definitions of “practice of pharmacy”, “prescription order”, and “collaborative practice agreement”
  • Authorizes pharmacists to enter into a CPA with a provider to initiate, monitor, and modify drug therapy or provide disease management assistance under specific requirements

Connecticut HB 5506

  • Defines collaborative drug therapy care plan, collaborative drug therapy management agreement, and management policy
  • Expands authority for pharmacists to initiate therapy for drug therapy and initiate, continue or discontinue use of, or deprescribe, a device under an agreement or policy
  • Allows agreements and policies to cover patient populations in addition to individual patients

Idaho S 1245

  • Revises definitions for “collaborative pharmacy practice” and “practice of pharmacy”

New Hampshire SB 335

  • Revises definition of collaborative pharmacy practice agreement.

New York A 9007

  • Authorizes pharmacist to perform collaborative drug therapy management with physicians in certain settings.

West Virginia HB 4324

  • Revises definition for collaborative pharmacy practice agreements and the requirements/prohibitions related to them.

Point-of-Care Testing and Treatment Authority

Alaska HB 145

  • Authorizes pharmacists to independently provide patient care services related to a condition that has a CLIA-waived test that is used to guide diagnosis or clinical decision-making
  • Defines patient care services as “medical care services given in exchange for compensation intended to achieve outcomes related to the cure or prevention of a disease, elimination or reduction of a patient’s symptoms, or arresting or slowing of a disease process”

Kansas SB 200

  • Authorizes pharmacists to initiate therapy within the framework of new statewide protocols for the following health conditions: influenza, streptococcal pharyngitis, or urinary tract infection.

New York A 9007

  • Authorizes pharmacists to direct limited service labs and order/administer COVID-19 and influenza tests.

Contraceptive Prescribing Authority

Massachusetts H 5090

  • Authorizes the issuance of a statewide standing order to authorize the dispensing of emergency contraception by a licensed pharmacist

South Carolina S 628

  • Authorizes pharmacies to administer and dispense certain hormonal contraception to patients pursuant to a standing order and in accordance with a written joint protocol issued by the board.

Opioid Antagonist and OUD Authority

Florida SB 544

  • Authorizes pharmacists to order and dispense an emergency opioid antagonist pursuant to a pharmacist’s order or to a nonpatient-specific standing order.

Missouri HB 2162

  • Added “addiction mitigation medication” terminology to sections relating to opioid addiction treatment.

Additional Authorities to Address Public Health Issues

Alaska HB 145

  • Authorizes pharmacists to independently provide patient care services for general health and wellness, disease prevention, or conditions meeting certain criteria

Idaho S 1245

  • Revises definitions for “collaborative pharmacy practice” and “practice of pharmacy”

Illinois HB 4430

  • Authorizes pharmacists to provide patient care services for HIV PrEP/PEP to a patient after satisfying specified requirements.

Maryland SB 19 / HB 229

  • Authorizes pharmacists to administer a maintenance injectable medication or an injectable medication for treatment of a sexually transmitted infection that is not a biological product to a patient, if not the initial dose.

Maryland HB 28 / SB 62

  • Authorizes pharmacists to prescribe and dispense nicotine replacement therapy medications for the purpose of aiding in tobacco cessation of smoking cessation.

Wyoming SF 101

  • Changed the Emergency Administration of Opiate Antagonist Act to Emergency Administration of Medical Treatment Act, so it could include epinephrine auto injector for treatment of anaphylaxis.

Provider Designation and Payment for Services

Alaska HB 145

  • Adds pharmacists to the list of providers in the insurance statutes.

Illinois SB 2017

  • Updates coverage/reimbursement for pharmacists related to eligible vaccines.

Maryland HB 1219 / SB 661

  • Revised the definition of “health care provider” to include pharmacists.

Maryland SB 19 / HB 229

  • Requires payment/coverage for the administration of a maintenance injectable medication or an injectable medication for treatment of a sexually transmitted infection by the pharmacist.