COVID-19: Information from the States

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The chart below includes NASPA’s compilation of state actions affecting pharmacy. This is a work in progress.

The following are links to other collections of state actions:

National Resources on the COVID-19 Pandemic

Hydroxychloroquine, Chloroquine, and Azithromycin

Compounding Hand Sanitizer

State Actions Affecting Pharmacy

State Actions and authorities affecting pharmacy Source Links Last Updated by NASPA
Alabama Governor’s emergency orders/declaration:
Emergency declared. (March 13). Allows healthcare facilities to implement “alternative standards of care.” (March 13). Prohibits price gouging. (March 13).
Board of Pharmacy:
Directs institutional settings to conserve supplies for compounded medications (per CDC guidelines). (March 13). Directs pharmacists with positive coronavirus test to stay home and not perform any pharmacy functions while ill. (March 13). Encourages use of drive thru and curbside delivery. (March 14). Authorizes offsite order entry under certain conditions. Expires July 18, 2020. (March 20). Authorizes 30-day emergency refills under certain conditions NABP: Including CII’s. Expires July 21, 2020. (March 23). Board will not enforce state controlled-substance-related regulatory requirements related to good-faith use of telemedicine and phoned-in CII prescriptions. Expires April 6 but may be extended. (March 23). Telephoned CII prescriptions still must be followed up with a hard copy within 7 days. (March 24). Technicians registered on or after Jan. 1, 2020 have until Dec. 31, 2020 to complete training requirements. (March 25). Board does not intend to set policy regarding chloroquine and HCQ. (March 25).
Other State Agencies:
Department of Revenue: Several tax deadlines postponed or late penalties waived for small business, income tax, etc. Medicaid: Temporarily suspended rules requiring prescriptions be presented to Medicaid’s fiscal agent within 90 days from the date it was written. (Rule 560-X-13-.03). (March 24).
Governor’s and State Agencies’ Emergency Orders

Board of Pharmacy Homepage

BOP Emergency Orders

COVID-19 Related Emergency Actions of State Agencies

Public Health Info Page

April 1
Alaska Health Mandates from Governor/DHSS:
Emergency declared. (March 11). Public-facing businesses providing essential services are ordered to: 1) take reasonable precautions to ensure the health of their service sector and employees; 2) actively promote social distancing, including expanding delivery, drive-through services, limiting the number of people in a building, spacing lines to keep people 6ft apart, or making appointments; and 3) employees who can feasibly work from home should. (March 27)
Board of Pharmacy:
Authorized out-of-state pharmacists to practice in Alaska under certain conditions, no need to take the MPJE. (March 12). Pharmacists authorized to dispense a 30-day emergency refill under certain conditions. (March 12). Advised pharmacists to make the public aware of any changes to pharmacy hours. (March 30). Advised that pharmacists should still be administering immunizations. (March 30). Clarified that Health Mandate 5.1–which prohibits elective, routine, and non-urgent, or non-emergent in-person healthcare and personal services–includes point-of-care testing unless done in an emergency or diagnostic setting within a health care facility. (March 30). Employees who test positive for COVID-19 should not work for 14 days. (March 30). If the pharmacy must close, the pharmacy should make the public aware and notify the board. (March 30).
Medicaid:
Early refill restrictions relaxed. (March 6). Guidance available regarding DME. (March 23). Meds usually limited to 34-day supply now extended to 68-day supply. (March 26). Prior authorizations for existing patients grandfathered in for continuity of care. (March 26). Medicaid already covers shipping costs for prescriptions. See manuals.medicaidalaska.com for billing info. Third Party Liability edit rules bypassed. (March 26). Medicaid signature requirements waived. (March 26).
Emergency Declaration

State Health Mandates

Medicaid Updates

Public Health Info Page

BOP COVID-19 Resource Page

March 31
Arizona Governor’s emergency orders/declaration:
Emergency declared. (March 11). Requires insurance companies and health plans to cover out of network providers, including out of plan laboratories and telemedicine providers. (March 11) Implements consumer protections, including prohibiting price-gouging on COVID-19 of diagnosis and treatment-related services. (March 11). Identifies pharmacies and other “healthcare and public health operations” as essential functions. (March 23). License renewal and continuing education deadlines extended by six months unless they can be done online. (March 26). Directs boards to issue provisional licenses if licensing exam cannot be provided electronically. (March 26).
Emergency Statutes and Rules Activated Due to Emergency Declaration:
Pharmacists can dispense up to two emergency 30-day refills. (A.R.S. § 32-1910(C-D); A.A.C. § R4-23-412). Out-of-state licensed pharmacists, technicians, and interns may practice in Arizona. (A.R.S. § 32-1910(E); A.A.C. § R4-23-413).
Board of Pharmacy (see FAQ document on homepage):
Provides guidance on protecting pharmacy staff and patients. (March 30). Pharmacists should notify the board if a pharmacy will be closed longer than 48 hours or will have different hours of operation. (March 30). Recommends counseling via a drive-thru, over the phone or other technology, or providing written information. (March 30). Recommends measures for controlling azithromycin, chloroquine, and HCQ dispensing. (March 30). Clarifies that existing authority authorizes remote work under certain conditions. (March 30; A.A.C. § R4-23-621). Stated that the board “will take into consideration contingency plans to conserve” PPE under certain conditions. (March 30). Authorizes hand sanitizer compounding if following FDA/USP guidance. (March 30). The board will not be enforcing USP 800. (March 30).
Emergency Declaration

Board of Pharmacy Home Page

Public Health Info Page

March 31
Arkansas Governor’s emergency orders/declaration:
Emergency declared. (March 11).
Board of Pharmacy:
Linked to recommendations regarding PPE shortages and hand-sanitizer compounding and DEA guidance on controlled substances. (undated, last accessed April 1). Provided guidance regarding existing authority for emergency 30-day refills, limiting hours of operation, limiting to drive thru or delivery only, and asking sick patients to not enter the pharmacy. (undated, last accessed April 1). Recommended voluntary suspension of all non-emergency or non-urgent care or services through April 3 or longer. (undated, last accessed April 1). Suspended rule requiring an endorsement on a pharmacist or intern license to administer medications. (Rule 09-00-0002). Expires April 16, may be extended. (March 17). Suspended rule requiring current CPR certification to administer medications. (Rule 09-00-0002). Expires April 16, may be extended. (March 17). Suspended rule requiring an endorsement to provide Disease State Management via written protocols Waived ratio of one pharmacy intern working per pharmacist. (Rule 02-01-0004(h)(4)). Expires April 16, may be extended. (March 17). Authorized therapeutic substitution, without prescriber opt in, for albuterol and levalbuterol inhalers. Pharmacist must notify prescriber of the substitution. (Rule 17-92-101(18)(B)). Expires April 16, may be extended. (March 17). Board will consider, on a case-by-case basis, remote activities like order entry and verification and other offsite activities. (Rules 04‐02‐0012 and 04‐05‐0004). Expires April 16, may be extended. (March 17). NABP: April board meetings postponed
Other Agencies:
Department of Health: Recommendations regarding chloroquine and HCQ use. (March 21).
Emergency Declaration

Executive Orders
Board of Pharmacy HomepageBOP COVID-19 Resource PagePublic Health Info Page
April 1
California Governor’s emergency orders/declaration:
Emergency declared. (March 4). Allows out-of-state medical personnel to practice in the state – with approval of the Director of the Emergency Medical Services Authority. (March 4). Prohibits price gouging through Sept. 4. (March 4). Provides tax extensions for business filing a return for less than $1 million in taxes along with other tax-related relief. (March 30). Authorizes the Director of Consumer Affairs to waive CE requirements in Divisions 2 & 3 of the Business and Professions Code. (March 30).
Board of Pharmacy (waivers expire 30 days after issuance):
Waives certain requirements related to PPE and hand cleaning. (March 17). Waiver allows prescribers to dispense bronchodilators to ER patients. (March 17). Waives certain consulting pharmacist requirements regarding quarterly visits. (March 17). Waives signature requirement for drug deliveries to the pharmacy. (March 17). Waiver authorizes pharmacists to conduct remote processing and pharmacy interns and technicians to conduct nondiscretionary tasks if in compliance with specific reccomendations. (March 18). Waiver authorizes pharmacists to supervise one additional technician and one additional intern pharmacist under certain conditions. (March 19; March 20). Waiver authorizes pharmacies to recieve drugs and devices from an unlicensed pharmacy, wholesaler, or third-party logistics provider in another state to alleviate shortages under certain conditions. (March 21). Waiver allows a sterile compounding facility within a hospital to renew its license without completing renewal requirements under certain conditions. (March 21). Waiver allows the temporary use of a mobile pharmacy or clinic under certain conditions. (March 24). Waiver allows inventory reconciliation to be done every six months rather than every three months, if PIC deems the reduction necessary. (March 24). Board provided a process for pharmacies to request specific waivers. (Updated March 24).
Emergency Proclamation

Executive Orders

Board of Pharmacy Waivers

Board of Pharmacy Homepage

Public Health Info Page

April 2
Colorado Governor’s emergency orders/declaration:
Emergency declared. (March 11). Income tax payment – for individuals and businesses – extended to July 15, 2020. (March 20).
Board of Pharmacy:
Board met on March 19. Minutes not available as of April 2.
Other State Agencies:
Medicaid/CHIP Guidance for Pharmacies (March 31): All albuterol inhalers have preferred status; chloroquine and HCQ require prior authorization. (March 31). Signature requirements are temporarily waived for Member Counseling and Proof of Delivery, keep record when counseling not provided. (March 31). Early refills allowed after 50% of days supply has lapsed. See guidance for details. (March 31). Eased prior authorization requirements for prescription cough and cold medicine. See guidance for details. (March 31). Reminder that existing authority authorizes emergency refill and that maintenance meds can be dispensed with 100-day supply. (March 31).
Emergency Declaration and Executive Orders

Board of Pharmacy Homepage

Public Health Info Page

Public Health Orders

COVID-19 Info for Medicaid and CHIP Providers

April 1
Connecticut Governor’s emergency orders/declaration:
Emergency declared. (March 10). Suspends garbing requirements for non-hazardous compounding of sterile pharmaceuticals. (March 14). Waives manufacturer registration requirement for hand sanitizer. (March 14). Identifies pharmacies as essential health care operations. (March 20). Suspends prescription copays for full-benefit dual-eligible Medicare Part D beneficiaries and HUSKY B clients. (March 21). Allows for 90-day refills of maintenance and non-maintenance medications for HUSKY beneficiaries (non-controls only). (March 21). Authorizes 30-day emergency refill dispensing. (March 21). Authorizes agency leaders to extend regulatory administrative deadlines by 90 days. (March 25). Single-use bag tax suspended. (March 26). Allows healthcare providers to provide direct patient care at a healthcare facility or institution, with the permission of such facility or institution, with an identification badge displaying the name of a different healthcare facility or institution. (March 27). Authorize the Commissioner of Public Health to waive licensing, renewal, and inspection requirements pursuant to Sections 19a-131j(b), (c) and (d). (March 27). Authorizes non-traditional manufacturers to compound hand sanitizer under the implementing orders/guidance of the Commissioner of Consumer Protection. (March 27). Requires stores to take protective measures to reduce transmission. Directs Commissioner of Economic and Community Development to issue rules immediately which “shall supersede and preempt any current or future municipal order. (April 1). Waives regulatory administrative requirements to allow the Commissioner of Social Services to act quickly regarding Medicaid state plan amendments. (April 1). Establishes tax deferment and low interest rate programs to assist individuals and businesses. (April 1).
Board of Pharmacy/ Department of Consumer Protection:
Executive order 7I gave the Commissioner of the Department of Consumer Protection, rather than the Commissioner of Pharmacy, the authority to waive pharmacy regulations. (March 21). Guidance states practitioners may issues prescription refills for controls without seeing patient in-person under certain conditions. Rx should be transmitted using EPCS. (March 19). Issued rules and guidance implementing Executive Order 7B regarding hand sanitizer compounding, preserving PPE, and remote order entry/verification. (March 15).
NABP: No more than 90 Day emergency supply and Cannot Exceed Amount Authorized by Prescriber
Executive Orders (March 18)

Board of Pharmacy Home Page

Public Health Info Page

April 2
Delaware Governor’s emergency orders/declaration:
Prohibits price gouging. Pharmacists who have active licenses or certificates of good standing in any U.S. jurisdiction, or whose Delaware license expired in the last five years, are authorized to provide in-person health care services in Delaware throughout the emergency, as well as telemedicine services.
Board of Pharmacy:
No actions identified as of March 27.
Emergency Declaration (March 12)

Board of Pharmacy Home Page

Public Health Info Page

March 27
District of Columbia Mayor’s emergency orders/declaration:
Prohibits price gouging.
Board of Pharmacy:
No actions identified as of March 27.
Emergency Declaration (March 13)

Board of Pharmacy Home Page

Public Health Info Page

March 27
Florida Governor’s emergency orders/declaration:
Authorizes pharmacists to “dispense up to a 30-day emergency prescription refill of maintenance medication to persons who reside in an area or county covered under [the] Executive Order and to emergency personnel who have been activated by their state and local agency but who do not reside in an area or county covered by [the] Executive Order.” Authorizes medical professionals with valid out-of-state licenses to practice in Florida if their services are provided free of charge and under the direction of the American Red Cross or the Florida Department of Health.
Executive Orders

Board of Pharmacy Home Page

Public Health Info Page

March 30
Georgia Governor’s emergency orders/declaration:
Authorizes a process for out-of-state licensed physicians and nurses to practice in Georgia (no process for pharmacists).
Prohibits price gouging.
Board of Pharmacy:
Provided guidance that pharmacists can compound hand sanitizer.
Existing policy authorizes pharmacists to dispense 30-day refills in declared emergency. Board clarified: no controls, must be essential or continuation of therapy; RPh to make an emergency refill prescription record; inform patient; notify prescriber if possible.
Existing policy allows non-residents to apply for temporary licenses and addresses temporary pharmacy facilities.
Authorizes pharmacists currently licensed in good standing in another state to obtain a temporary license if the pharmacist is engaged in documented relief effort. Authorizes pharmacy technicians and interns registered or licensed in another state to assist in dispensing prescription drugs.
BOP Emergency Policy (March 17)

BOP Hand Sanitizer Guidance (March 16)

March 30
Hawaii Governor’s emergency orders/declaration:
Prohibits price gouging.
Authorizes out-of-state licensed physicians, physician assistants, and nurses to practice in Hawaii–pharmacists not included.
Board of Pharmacy:
Licensure exams cancelled.
Emergency Proclamations (March 16)

Board of Pharmacy Home Page

Public Health Info Page

March 19
Idaho Board of Pharmacy:
Board of Pharmacy: Implemented process for rapid licensure/registration of new support staff. Allows out-of-state licensed pharmacy staff to work in Idaho. Outlines process for closing/limiting pharmacy hours, encourages pharmacies to stay open and use drive through or delivery if possible. Allows for use of the Critical Point recommendations regarding limited re-use of PPE, with some changes to the Critical Point webinar’s information. Limits the circumstances under which chloroquine and hydroxychloroquine may be dispensed. Addresses hand sanitizer compounding, remote work, early refills on controls for hospice patients, Medicaid payment allowance for 90 day supply, other compounding. Other questions addressed. See Memo from Idaho board and note that it is frequently updated. See BOP homepage if the memo link to the right is expired. Emphasizes that counseling signatures are not required, but counseling is required and it can be accomplished via technology.
BOP Memo (revised March 18) March 27
Illinois Governor’s emergency orders/declaration:
Governor’s emergency orders/declaration: Declared state of emergency Requires all health insurers regulated by the Department of Insurance to cover telehealth services and reimburse providers at the same rate as in-person visits and are prohibited from imposing any cost-sharing for in-network providers (includes pharmacists).
Department of Healthcare and Family Services (Medicaid):
Provided override code for Refill Too Soon. Allowed 90-day supply for insulin. Waived signature requirements for receipt of prescriptions.
Board of Pharmacy:
No actions identified as of March 30.
Executive Orders (March 16)

Board of Pharmacy Home Page

Public Health Info Page

March 30
Indiana Governor’s emergency orders/declaration:
Prohibits price gouging.
Allows out-of-state licensed health care providers to practice in Indiana.
Board of Pharmacy:
No actions identified as of March 19.
Health Department:
Issued guidance regarding PPE conservation.
Executive Orders (March 19)

Public Health Info Page

Health Dept. PPE Guidance

March 27
Iowa Governor’s emergency orders/declaration:
Allows certain healthcare providers whose license is inactive or lapsed to practice in Iowa. Does NOT include pharmacists.
Board of Pharmacy:
Issued guidance on PPE conservation.
Executive Orders/ Proclamations (March 17)

Board of Pharmacy Homepage

PPE Guidance

Public Health Info Page

March 19
Kansas Governor’s emergency orders/declaration:
Declared state of emergency, no pharmacy-related orders identified to date.
Board of Pharmacy:
Recommends pharmacies encourage customers use drive-throughs, when available, separate customers in line, put more space between customers and pharmacy staff at counter.
Sets up a process for pharmacies to report temporary closures.
Provides temporary authorization for certain pharmacists and certain technicians to work remotely.
Allows PPE reuse and recommends Critical Point training video. Directs pharmacies to update policy and procedures and to train staff on changes.
Existing authority allows for emergency refills.
References FDA guidance on hand sanitizer and clarifies that the board requires all compounding documentation be maintained for sanitizer compounding.
Emergency Declaration (March 12)

Executive Orders (March 18)

Board of Pharmacy Home Page

Board of Pharmacy Memo (March 17)

Public Health Info Page

March 27
Kentucky Governor’s emergency orders/declaration:
Authorizes pharmacists to dispense a 30-day supply of non-controlled medications for residents of Kentucky.
Authorizes pharmacists to temporarily operate a pharmacy in an area not designated on the pharmacy permit.
Authorizes pharmacists to “dispense drugs as needed to treat COVID-19 pursuant to protocols established by the CDC or the NIH or determined to be appropriate by the commissioner of public health or his designee to respond to the circumstances causing the emergency.”
Board of Pharmacy:
Strongly encourages pharmacies to assess current and potential supply and implement policies that will ensure adequate supply for patients previously established on the drugs hydroxychloroquine and azithromycin.
Executive Actions (March 17)

Emergency Declaration (March 6)

Board of Pharmacy Home Page

Public Health Info Page

March 30
Louisiana Governor’s emergency orders/declaration:
Prohibits price gouging.
Authorizes out-of-state and licensed medical professionals and personnel and those from other countries to practice in Louisiana. Must submit a copy of their license and photo ID to the State Health Officer.
Board of Pharmacy:
Authorized an extension of the expiration date for certain education requirements.
Changes for hospital pharmacies to accommodate additional storage needs, PPE conservation related to centralized compounding at hospitals with multiple locations.
Waived state laws related to limits on hospitals dispensing outpatient prescriptions to certain patients not affiliated with the hospital; meant to address needs of homeless patients.
Executive Orders (March 16)

Board of Pharmacy Home Page

Additional BOP Guidance and Resources (March 18)

BOP Guidance (Updated March 18)

Public Health Info Page

March 19
Maine Governor’s emergency orders/declarations:
Prohibits price gouging.
Board of Pharmacy:
No identified actions as of March 21.
Emergency Proclamations (March 17)

Board of Pharmacy Home Page

Public Health Info Page

March 21
Maryland Governor’s emergency orders/declarations:
Extended the expiration date of all licenses.
Authorizes out-of-state licensed healthcare providers to practice in Maryland (some admin requirements).
Authorizes healthcare providers with inactive licenses to practice under certain conditions.
Authorizes health care practitioners to engage in activities beyond their scope of practice if doing so is necessary and a qualified supervisor at the health care facility deems the practitioner competent to do so and reasonably supervises. May only apply to pharmacists in institutional settings – review executive order and relevant statutes.
Board of Pharmacy:
Directs/authorizes pharmacies to :
implement emergency policies as informed by CDC guidance for employers and information for pharmacies from APhA and ASHP;
Compound hand sanitizer per FDA guidance;
Send home staff exhibiting flu-like symptoms or respiratory illness.
States the board will not enforce tech supervision requirements if techs are working remotely–including prescription and data entry, insurance processing, other administrative functions.
Authorizes 30-day emergency refills under certain conditions.
Provides guidance regarding sterile compounding and conserving PPE.
States the board will not enforce 30-day notice requirements for changes in pharmacy hours.
Emergency Declaration (March 5)

Emergency Orders (March 19)

Board of Pharmacy Home Page

BOP Guidance (March 19)

Public Health Info Page

March 21
Massachusetts Governor’s emergency orders/declarations:
Authorizes pharmacists to administer methadone and buprenorphine for opioid use disorder.
Extends the registration of certain health care professionals’ licenses.
Permits pharmacists to compound and sell hand sanitizer over the counter.
Board of Pharmacy:
Clarifies that pharmacists can work longer than 12 hours during the emergency.
States that the board will not enforce pharmacist-to-technician ratios during the emergency.
Clarifies that pharmacists can refill clozapine without labs under certain circumstances.
Pharmacies that must temporarily close can notify board via email. Must also notify patients of the continuity of care plan.
Form required to change operational hours. One time changes can be communicated via email.
Guidance coming soon regarding remote work and compounding.
Emergency Declaration (March 10) and executive orders (March 18)

Board of Pharmacy Home Page

Board of Pharmacy FAQs

Hand Sanitizer Guidance (March 17)

Public Health Info Page

Health Department Order on Hand Sanitizer

March 22
Michigan Governor’s emergency orders/declarations:
Prohibits price gouging.
Suspends provisions related to scope of practice, supervision, and delegation, to the extent necessary to permit licensed pharmacists to provide care for routine health maintenance, chronic disease states, or similar conditions, as appropriate to the professional’s education, training, and experience, without physician supervision and without criminal, civil, or administrative penalty related to a lack of such supervision. Professional certifications in BLS, ACLS, or first aid shall continue to remain in effect while the emergency declaration is in effect, even if they are due to expire during the emergency. Allows health care professionals (including pharmacists) licensed and in good standing in any state to practice in Michigan. Suspends requirements for exams, fingerprinting, and continuing education for the purposes of health care professional (including pharmacist) licensure, certification, registration, or renewal.
Emergency Declaration (March 10) and executive orders (March 18)

Board of Pharmacy Home Page

Public Health Info Page

March 30
Minnesota Governor’s emergency orders/declarations:
Prohibits price gouging.
Board of Pharmacy:
Encourages pharmacies to stay open but clarifies there is no regulatory requirement to say open.
Authorizes remote work with certain conditions.
Provides guidance if a pharmacy has to close.
Authorizes out of state pharmacies to deliver prescriptions by mail during the emergency.
Clarifies existing authority for 30-day emergency refills under certain conditions.
Authorizes  curb-side delivery and associated counseling by phone.
Pharmacies that need staffing assistance from out-of-state licensed pharmacists should contact the board (will be updated if an executive order is later authorized).
Authorizes changes to the pharmacist-to-technician ratio.
Authorizes supervision of technicians to occur remotely.
Clarifies that pharmacists can test and treat flu/strep with a protocol under existing authority.
Provides guidance on hoarding and overprescribing of medications used to treat COVID19.
Clarifies that pharmacists can convert 30 day Rx to 90 days UNLESS it is the first fill. See FAQ for details.
Includes recommendations regarding PPE shortages and compounding.
Addresses compounding commercially available products under certain conditions.
Authorizes pharmacies to compound hand sanitizer.
Addresses board operation variances.
Emergency declaration (March 13) and executive orders (March 20)

Board of Pharmacy Home Page

BOP FAQs (March 20)

Public Health Info Page

March 22
Mississippi Declared state of emergency, more details to come. BOP Emergency Refill Resolution March 23
Missouri Declared state of emergency, more details to come. BOP Statement March 23
Montana Declared state of emergency, no pharmacy-related orders identified to date.
Nebraska Governors executive orders/declarations:
Allows pharmacists and pharmacy technicians in good standing and free from disciplinary action in other states where they are licensed to practice in Nebraska. Allows pharmacists and pharmacy technicians who have lapsed or inactive credentials to temporarily reactivate their credentials in order to practice as pharmacists and pharmacy technicians without having to complete the CE requirements, and upon submission of an application with DHHS. Temporarily suspends continuing education (CE) requirements and renewal fees for pharmacists and pharmacy technicians (unclear on technician certification requirements) Allows graduating student pharmacists to be provisionally licensed to practice pharmacy without submitting test scores Allows pharmacists to compound and sell hand sanitizer without a patient-specific prescription or collaborative practice agreement
March 30
Nevada Declared state of emergency, more details to come.
Quantity limits and diagnosis requirements for dispensing chloroquine and hydroxychloroquine.
Board of Pharmacy Response and Waivers

Public Health Info Page

March 25
New Hampshire Declared state of emergency.
Authorizes pharmacists to refill prescription drugs, including controlled substances listed in Schedules III, IV and V, without the authorization of the prescribing practitioner, if certain criteria are met. Authorizes out-of-state pharmacies to act as a licensed mail-order facility within the State of New Hampshire. Authorizes out-of-state medical providers to provide medically necessary services and provide services through telehealth. Authorizes pharmacists and pharmacies to compound and sell hand sanitizer over the counter. Allows pharmacy technicians to perform non-dispensing tasks remotely.
March 25
New Jersey Allows compounding pharmacies to reuse certain PPE (ie masks, gowns) as a proactive measure to conserve existing supplies of these items. Allows pharmacies to be open for less than 40 hours per week until June 1, 2020. Waives requirement to obtain the signature of the patient or caregiver that counseling was provided or refused until June 1, 2020. Allows for early medication refills and emergency fills of prescriptions. AG Guidance for Pharmacy March 25
New Mexico Allows out-of-state licensed health care providers to practice in New Mexico.
Authorizes pharmacists to dispense emergency fills with certain stipulations.
COVID FAQs March 25
New York Authorizes unlicensed individuals to collect specimens for COVID-19 testing, after completing training deemed adequate by the Commissioner of Health. Suspends regulations regarding prior authorizations in Medicaid to allow patients to receive prescribed drugs without delay. Executive Orders March 25
North Carolina Prohibits price gouging.
Allows out-of-state licensed healthcare providers to practice in North Carolina.
Authorizes MDs, NPs, and PAs to issue standing orders for COVID-19 testing.
Directs NCDHHS and NC Dept of Insurance to work with health plans to identify burdens related to COVID-19 testing,  prescription drug, and telehealth service access.
BOP Emergency Services Waiver

BOP Guidance

North Dakota Declared state of emergency, more details to come.
Ohio Prohibits price gouging.  Quantity limits and diagnosis requirements for dispensing chloroquine and hydroxychloroquine. BOP Response Efforts (March 17)

Emergency Rule for Dispensing Chloroquine and Hydroxychloroquine

Public Health Orders

Oklahoma Declared state of emergency, no pharmacy-related orders identified to date.
Quantity limits and diagnosis requirements for dispensing chloroquine and hydroxychloroquine.
Executive Order, chloroquine and HCQ
Oregon Directs the Public Health Director to take certain steps, including deploying emergency volunteer health care professionals.
Directs state agencies to develop and impelement procedures, including waiving rules or adopting temporary rules to prevent or alleviate the public health threat.
BOP Guidance (March 13)
Pennsylvania Allows pharmacy technicians and pharmacy interns to conduct data entry via technological means if the pharmacy has documented policies and procedures and other adequate safeguards to protect againstpatient harm and privacy incidents and if the technician or intern is under the supervision of a pharmacist. Suspends registration requirement for out-of-state pharmacies and allows pharmacies to ship into Pennsylvania under certain conditions Suspends requirement for pharmacist to hold active CPR certificate to administer injectables Suspends certain licensure and administrative requirements to allow for temporary licenses for out-of-state pharmacists on an expedited basis Authorizes pharmacy to retain its permit if closing longer than 24 hours as long as board is notified Advises licensees to follow USP guidance regarding PPE reuseUrges pharmacists to confirm COVID-19 diagnosis before dispensing hydroxychloroquine if patient is not already established on therapy for other diagnoses. Encourages pharmacists to dispense hydroxychloroquine in smaller quantities when appropriate to prevent potential shortages

Emergency Declaration
Executive OrdersSuspended Licensing RegulationsPublic Health Info Page

 

March 30
Puerto Rico Declared state of emergency, more details to come.
Rhode Island Prohibits price gouging.
South Carolina Declared state of emergency, more details to come.
South Dakota Declared state of emergency, more details to come.
Tennessee Allows out-of-state licensed health care providers to practice in Tennessee.
Allows pharmacists to dispense an emergency 30-day supply of maintenance prescriptions, even if the prescription is out of refills.
Prohibits price gouging.
Texas Governor’s declarations/executive orders:
Declared state of emergency. Temporarily suspended the annual inventory notarization requirement. Temporarily suspended the requirement to have in-person contact for patient counseling in order to allow patient counseling to be performed by telephonic consultation. Temporarily suspended the requirement to obtain to obtain an inspection within the last renewal period in order to renew a Class A-S, Class B, Class C-S, and Class E-S pharmacy license. Temporarily suspended the requirement to the extent necessary to expand the pilot program for automated systems in order to allow for remote automated dispensing. Temporarily suspended the requirement to maintain documentation of current certification in American Heart Association’s Basic Cardiac Life Support for Health-Care Providers or its equivalent in order to provide immunization or vaccination under written protocol of a physician. No prescription or medication order for chloroquine, hydroxychloroquine, mefloquine, or azithromycin may be dispensed or distributed unless all the following apply (prescription is for an FDA approved use, the day supply is limited to 14 days (unless the patient was previously on it), and there are no refills. Pharmacist is able to dispense up to a 30-day supply of a prescription drug, other than a Schedule II controlled substance, without the authorization of the prescribing practitioner if certain criteria are met.
BOP Guidance on Compounding (March 13)

Office of the Governor

Emergency Fills

Medication Limitations

March 26
Utah Declared state of emergency.
Board of Pharmacy:
Allows the compounding and sale of certain alcohol-based hand sanitizer products by Utah-licensed pharmacies.
BOP Guidance March 25
Vermont Declared state of emergency.
A pharmacist may disregard individual fill quantities, up to the total prescribed quantity or ninety days, whichever first occurs. Allows compounders to produce hand sanitizer consistent with FDA policy. Prohibits BUD extenstion beyond USP <795> or <797> standards if reusing PPE.
Public Health Info Page

Emergency Guidance

March 25
Virginia Declared state of emergency.
Authorizes compounding hand sanitizer in accordance with USP <795> standards for sale to the general public at a reasonable price. Authorizes pharmacists or pharmacy technicians currently licensed in another state to practice in an affected area of the Commonwealth or to provide central/remote order processing or order verification services on behalf of an out-of-state pharmacy. If a pharmacy must close for longer than 72 hours due to emergency circumstances, it is strongly recommended that the pharmacy notify the board of the closing, the anticipated duration of the closing, and actions taken to ensure patient continuity of care and to mitigate diversion of drug. Pharmacists may exercise professional judgement regarding the dispensing of early refills for Schedule VI drugs and must document the reason for the early refill. Pharmacists may refill a Schedule VI drug without authorization from the prescriber if the pharmacist ascertains that patient’s health would be in imminent danger without the benefits of the drug. Pharmacists may dispense a one-time early refill of schedule III-V prescriptions and must document the reason for the early refill. Pharmacists may dispense a one-time early dispensing of a Schedule II prescription for a chronic condition and must document the reason for the early dispensing.
BOP Guidance and Waivers (March 13) March 25
Washington Directs health plans to allow for early refills to ensure patients can maintain an adequate supply of necessary medication.
Relaxes enforcement action against licensees for failure to comply with USP Chapters if failure to comply caused by COVID-19.
WSPA Guidance

Insurance Commissioner Emergency Orders

March 25
West Virginia Prohibits price gouging.
Board of Pharmacy:
A prescription for chloroquine or hydroxychloroquine may only be dispensed if there is a written diagnosis, quantity is limited to 30 tablets (unless patient previously established on medication), and there are no listed refills. Permits licensed pharmacy professionals (pharmacists, pharmacy interns, and pharmacy technicians/pharmacy technician trainees) to process prescriptions and medication orders from remote locations. Authorizes exceeding pharmacist:technician ratio if there is actual impact of COVID-19 virus directly on the pharmacy, facility, or staff. Authorizes a pharmacist, pharmacy intern, or pharmacy technician to work in WV with a temporary permit from BOP. Authorizes reuse of masks due to PPE shortage, referencing CDC and FDA guidance and CriticalPoint resources. Requires weekly surface sampling in ISO 5 spaces when garbing in a manner inconsistent with USP standards. Waives the requirement to submit reports of “zero” to state PDMP when the pharmacy is closed due to COVID-19. Grants leniancy for pharmacists that do not complete certain continuing education requirements for licensure renewal. Requires pharmacy to notify Board within 48 hours if closing due to illness or staff shortages. Requires staff exhibiting fever, cough, or shortness of breath to be sent home.
Department of Motor Vehicles:
Extended expiration date of driver’s licenses and instructional permits expiring in March or April 2020 by three months from date of expiration on the face of the document (valid for controlled substances).
BOP Home Page

Public Health Info Page

March 25
Wisconsin Governor’s declarations/executive orders:
Declared state of emergency. Authorizes pharmacists who are licensed in good standing in another state to practice in Wisconsin, provided they apply for a temporary license within 10 days of beginning work in Wisconsin. Allows pharmacists who have recently retired or let their license lapse to reapply without needing to pay a late renewal fee or certify completion of 30 hours of continuing education
Board of Pharmacy
Approves the reuse of certain PPE for sterile compounding, including coveralls, shoe covers, hair and facial covers, face masks, eye shields, and gloves. Existing policy allows for remotely completing DURs or prescription verification. Pharmacy technicians are able to complete order entry and other tasks remotely if the supervising pharmacist is regularly available to coordinate, direct, and inspect the work of the technician. Existing policy allows pharmacists to dispense a 7-day supply of a prescription without refill authorization under certain conditions. Allows pharmacists to dispense prescription medications and devices in locations that are not licensed as pharmacies
Medicaid
Allows override of overuse precaution (early refill) alert, except for certain controlled substances. Encourages dispensing three-month supply, when possible. Allows for dispensing of 14-day emergency supply of drugs with prior authorization restrictions. Permits and encourages pharmacies to deliver prescription and OTC by mail service.
COVID19 Compiled Resources for Pharmacists

Department of Health Services Resource Page

March 30
Wyoming Declared state of emergency.
Department of Public Health:
Exempts pharmacies from mandatory closure order. Identifies pharmacy staff as essential personnel, allowing pharmacy staff continued access to child care centers and home daycares.
Board of Pharmacy:
References FDA, WHO, and USP guidance for compounding hand sanitizer. References FDA, USP, and Critical Point guidance for reusing PPE due to shortage. Existing policy requires a pharmacy to be locked and a sign stating “Prescription Department Closed – No Registered Pharmacist on Duty” to be conspicuously posted if the pharmacy decides to temporarily close. Board remains open and fully operational with no changes to services, processing applications, renewals, or license/registration timelines. Virtual support group available to help healthcare professionals cope with the stress, anxiety, and trauma of working in the healthcare field during COVID-19.
Board of Pharmacy COVID-19 Guidance March 25

***The information on this page is for informational purposes ONLY. Please read and only rely on the most up to date information on the state website.***

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