Pharmacy’s Role in the Rural Health Transformation Program
In 2025, state pharmacy associations across the country leaned in and spent countless hours working with and advocating to state officials to ensure pharmacy’s place in the Rural Health Transformation Program. It was an unexpected and time-consuming task that the state pharmacy associations took on and led in their respective states. In many states, pharmacists and pharmacy services have been incorporated into the awards. Below is a compilation of activities identified so far.
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This page will continue to be updated as we learn more about this massive program.
Supports pharmacist training and licensure to implement test and treat programs.
Creates and tests alternative payment models that reimburse pharmacists for clinical services.
Pilots remote prescription dispensing machines, portable prescription boxes, and unmanned aerial vehicles.
*Log in to learn more about how the Alaska Pharmacy Association is working with their state on behalf of the profession!
Florida
Names “retail pharmacy clinics” among access-expansion strategies alongside mobile health, community paramedicine, tele-specialties, and remote monitoring, and states that “increased access via retail clinics in rural pharmacies will also be prioritized.”
Supports telepharmacy models in additional communities, “including remote dispensing by pharmacy technicians.”
Sets a milestone to place pharmacy lockers or kiosks in one pharmacy site in each of seven rural counties by December 2030, and to enhance mail-order pharmacy services.
Funds pharmacy facility upgrades and clinical pharmacist space. Initiative 5 explicitly includes “pharmacy solutions,” and the state describes pharmacists as having full scope of practice.
Focuses on post-discharge medication access under Initiative 6, “Growing Access to Hospital Post-Discharge Medications,” also called Meds-To-Beds: “By charging outpatient prices and providing bedside counseling, the program improves recovery readiness and reduces readmissions.”
Funds allied health training scholarships for 300 students, explicitly including pharmacy, in exchange for a five-year service commitment in rural Kansas.
Includes “supportive services from local pharmacists” and pharmacist consultations in its Diabetes Prevention Program workflow.
Reports its own CMS pharmacist scope score as 3, earning zero points.
Funds “startup costs for shared specialty, behavioral health, dental, pharmacy, and care coordination services,” and names “regional pharmacy support models” among priority areas.
Names independent rural pharmacies as eligible applicants. Budget Year 1 is $4,750,000; awards range $10,000 to $500,000; applications are due August 5, 2026. A 10% cost share is required, and capital equipment, telehealth infrastructure, EHR modernization, and recruitment bonuses are ineligible.
Commits to helping rural providers “practice at the top of their license” and names pharmacy technicians among rural training cohorts.
On pharmacist scope, Maine disputes CMS’s zero-point score for the state and commits to continued review of whether additional prescriptive authority is necessary.
“Pharmacies, another key access point, are limited in rural areas with only 25 pharmacies serving 160 rural communities.”
Tele-pharmacy investments “will support remote pharmacist dispensing and counseling in rural areas, pharmacy robots to enable prescription pickup, automated medication dispensing systems, and existing pharmacies to expand coverage.” This is one activity within Initiative II, a five-year, $114,502,232 initiative.
Disputes its CMS pharmacist score of 2 out of 10, noting Massachusetts pharmacists hold formula-based authority and participate in the collaborative drug therapy model.
Includes community pharmacy data sharing under its data initiative, and counts pharmacy access in its 30-minute drive-time goal.
A now-closed Notice of Grant Opportunity for Rural Hospitals funded increased “referrals to and delivery of Medication Therapy Management services by pharmacists,” plus technology upgrades connecting clinic referral systems to pharmacies. Pharmacies were named an eligible clinical setting under “Expand Rural Access to Medications for Opioid Use Disorder,” with “Pharmacy Coordination and Medication Access” an eligible project.
Minnesota’s budget period 1 award is $193,090,618.14. Additional opportunities open and close on a rolling basis — check the grants page for current notices.
Missouri *Log in to learn more about how the Missouri Pharmacy Association is working with their state on behalf of the profession!
Montana
Sub-initiative 3.3, “Extending access to lower-cost care through pharmacist point-of-care testing sites,” funds rapid near-patient diagnostic tests across selected rural pharmacies and supports prescription management for previously diagnosed conditions.
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Nebraska
Initiative 4 will “implement remote care through mobile clinical units, oral health teams, technology-enhanced pharmacy services, and consumer-facing remote patient monitoring,” with Nebraska Enhanced Services Pharmacies named among subrecipients.
Expands the use of automated prescription pickup kiosks.
Funding opportunity “Self-Serve Dispensing Kiosks in Pharmacies,” $600,000 with one expected award, applications due July 30, 2026 at 5 p.m. CT. Eligibility is limited to retail pharmacies serving rural populations and pharmacies located in rural critical access hospitals; awards are contingent on written approval from the North Dakota Board of Pharmacy.
Senate Bill 2402, giving pharmacists authority to prescribe certain medications, advanced with an amendment from Sen. Kristin Roers supported by the Boards of Pharmacy and Medicine, and was signed January 23, 2026 as part of a four-bill RHTP package.
CMS announced two Rural Health Transformation Program investments totaling $3.15 million to strengthen pharmacy connectivity and prescription information exchange across Ohio’s 73 rural counties, better integrating pharmacies with other rural providers and strengthening medication management and care coordination.
*Log in to learn more about how the Ohio Pharmacists Association is working with their state on behalf of the profession!
Oklahoma
Under Initiative 6, “Building Health Data Utility,” expands the state health information exchange to ingest data “including imaging, pharmacy, public health, and mortality feeds.” The narrative notes the PDMP remains a federal database with limited two-way access.
Commits to pharmacist scope of practice expansion.
*Log in to learn more about how the Oregon State Pharmacy Association is working with their state on behalf of the profession!
Pennsylvania
Commits to “expanding the full spectrum of the rural health care workforce including allied health, EMS, nursing, nurse practitioners, physician assistants, dentists, pharmacists, and physicians through rural focused training programs,” supported by upfront scholarships, mentoring, housing, and stipends with five-year rural service commitments.
Funds rural clinical rotations and fellowships for pharmacy students, and tuition and living support for which pharmacists are eligible.
Funds self-service diagnostic kiosks in pharmacies, noting that “pharmacies offer a unique opportunity to create new access points in co-located spaces with pharmacists.”
Names pharmacies and pharmacists as stakeholders in its digital access, maternal health, and substance use disorder initiatives, and includes pharmacists in psychiatric consultation access.
Commits that “by December 2027, we will expand scope of practice for Pharmacists and Dental Hygienists,” a legislative commitment tied to a CMS scoring factor rather than a funded pharmacy program.
*Log in to learn more about how the Rhode Island Pharmacists Association is working with their state on behalf of the profession!
South Carolina
References pharmacy in two of five initiatives. Under “Wellness Within Reach,” pharmacies are named key stakeholders and community health kiosk funding includes “equipment and supplies costs to establish a 24-hour pharmacy kiosk.”
Under “Shoring Up to Sustainability,” community health worker training programs focus on “training current healthcare professionals such as pharmacy technicians.”
Names community pharmacies among key stakeholders, and states that “rural hospitals, clinics, pharmacies, and schools will receive funding.”
Funds “interface development connecting EHRs to labs, pharmacies, imaging, and other systems.”
Asks CMS to reconsider the state’s pharmacist scope of practice score, arguing South Dakota deserves at least a 6, and faulting the underlying Cicero report for awarding no points for collaborative practice agreements and for overlooking “the telepharmacy innovation in place in South Dakota since 2007.”
Tennessee *Log in to learn more about how the Tennessee Pharmacists Association is working with their state on behalf of the profession!
Texas
Rural Texas Strong includes Initiative 4, “The Next Generation of The Small Town Doctor and Team,” a rural workforce initiative for which rural pharmacies are among the provider types in scope.
Funds expansion of pharmacists’ scope “to include test-to-treat in more scenarios (i.e., COVID-19, flu, strep throat)” through “enhanced utilization of pharmacists operating at the top of their license,” and pursues “policy and regulatory changes to enable expansion of pharmacists’ scope.”
Names community pharmacies as telehealth kiosk sites and pharmacy technicians as a rural career and technical education credential target. Pharmacist scope is classified as semi-restrictive.
Virginia’s plan is named VA Rural Vitality; the state received $189,544,888 for budget year one. The plan’s “food pharmacy” pilots offer produce, nutrition counseling, and medically tailored meals through health systems, FQHCs, food banks, and dietitians; they do not involve pharmacies or pharmacists.
Proposes “using $11–12 million per year of RHT Program funds to establish a fund for innovative, grow-your-own training programs,” expanding rural programs “including: hybrid dental hygiene, pharmacy, Advanced Practice Nurse, community paramedicine, and midwifery.”
Names pharmacists among providers eligible for opioid treatment program workforce incentives, and proposes recruiting pharmacy technicians to receive community health worker training.
Names pharmacies among telehealth sites to be “placed in locations such as libraries, schools, pharmacies, and community centers,” and among access points for nutrition and glucose monitoring supplies.
Notes that “earlier this year, WV expanded pharmacist scope of practice to include test and treat for numerous conditions.” Pharmacy is also included as a workforce and residency discipline, and pharmacies are eligible applicants.
Names pharmacies among health care provider types eligible to partner in the state’s plan, alongside rural hospitals, community health centers, dental providers, behavioral health clinics, long-term care providers, and EMS agencies.
In 2025, state pharmacy associations across the country leaned in and spent countless hours working with and advocating to state officials to ensure pharmacy’s place in the Rural Health Transformation Program. It was an unexpected and time-consuming task that the state pharmacy associations took on and led in their respective states. In many states, pharmacists and pharmacy services have been incorporated into the awards. Below is a compilation of activities identified so far.