HB 1520
In CommitteeHouse
Pharmacist scope of practice
Expanding pharmacists' scope of practice to improve access to health care and the management of chronic diseases.
This status may be delayed. See Action History below for the latest updates.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill expands pharmacists’ authority to prescribe certain medications and devices directly to patients without a prior diagnosis or provider referral, especially for preventive, chronic, or minor conditions. The goal is to improve access to care—particularly in rural and underserved areas—by using pharmacists’ clinical training to manage common health needs more efficiently.
- Starting December 1, 2026, pharmacists may prescribe a range of medications—including immunizations, opioid addiction treatments (e.g., naloxone), epinephrine autoinjectors, hormonal contraception, tobacco cessation products, and HIV prevention drugs—without requiring a new diagnosis or provider referral.
- Pharmacists may also prescribe medications or devices for minor, self-limiting conditions (e.g., minor skin infections, allergies, conjunctivitis) that have an FDA-approved test to guide diagnosis (e.g., rapid strep or flu tests) and are waived under federal lab rules.
- Pharmacists can prescribe in team-based practices with shared medical records, allowing collaborative care with other providers.
- The law includes a sunset clause: the expanded prescribing authority expires on January 1, 2030, unless renewed by the legislature.
- The pharmacy quality assurance commission is authorized to adopt rules to implement the law, including defining protocols, training requirements, and oversight standards.
Who is affected
- Pharmacists — Pharmacists gain new authority to prescribe specific medications and devices without requiring a prior diagnosis or provider referral for certain conditions, allowing them to provide more direct care.
- Patients — Patients—especially in rural, underserved, or high-need communities—gain improved access to medications like immunizations, addiction treatments, hormonal contraception, and tobacco cessation aids without needing a separate provider visit.
- Pharmacies — Pharmacies and pharmacy chains may need to adjust operations, train staff, and potentially hire or reassign staff to support expanded prescribing services, including point-of-care testing and patient counseling.
- Health care providers and clinics — Health systems and clinics may see shifts in patient flow, with some routine care moving to community pharmacies, potentially reducing demand for primary care visits for minor or preventive conditions.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Expanding pharmacist prescribing for immunizations, HIV PrEP, opioid antagonists, and hormonal contraception directly improves access for low-income, rural, and underserved patients who face transportation, time, or provider availability barriers—especially women, LGBTQ+ individuals, and people with substance use disorders.
HealthcarePeopleRef: Sec. 3(1)(a)-(h)Allowing pharmacists to prescribe for minor, self-limiting conditions using FDA-approved point-of-care tests reduces unnecessary emergency department and urgent care visits—freeing higher-acuity resources for true emergencies and lowering out-of-pocket costs for patients.
Public SafetyPeopleRef: Sec. 3(1)(j)(ii)-(v)Direct pharmacist prescribing of naloxone and HIV PrEP removes a critical access barrier to life-saving preventive care—especially for people experiencing homelessness, unstably housed, or stigmatized populations who avoid traditional clinical settings.
HealthcarePeopleRef: Sec. 3(1)(b), (f)Team-based prescribing with shared medical records supports continuity of care for patients with complex needs (e.g., diabetes, hypertension) by enabling pharmacists to adjust medications within protocols—potentially improving adherence and clinical outcomes while reducing provider burnout.
HealthcarePeopleRef: Sec. 3(1)(j)(v)The bill delegates implementation to the Pharmacy Quality Assurance Commission, allowing flexible, stakeholder-informed rulemaking—including defining protocols, training standards, and quality metrics—while ensuring accountability through existing oversight structures.
Local GovernmentPeopleRef: Sec. 5 (rulemaking authority)
Potential Concerns (5)
Expanding pharmacist prescribing authority in team-based practices with shared medical records may increase fragmentation of care if coordination protocols are not rigorously enforced, potentially leading to medication errors or miscommunication between pharmacists and primary care providers—especially in complex chronic disease management.
HealthcarePeopleRef: Sec. 3(1)(j)(v)The 2030 sunset clause creates regulatory uncertainty for pharmacists, health systems, and patients, potentially discouraging long-term investment in infrastructure (e.g., point-of-care testing, EHR integration) and undermining program sustainability—particularly in rural areas where startup costs are highest.
HealthcarePeopleRef: Sec. 3(2) (sunset clause)Allowing pharmacists to prescribe for minor, self-limiting conditions using only waived point-of-care tests (e.g., rapid flu/strep) may lead to misdiagnosis or delayed care for patients with atypical or overlapping symptoms (e.g., strep throat vs. mono, flu vs. RSV), especially where test sensitivity is limited or pharmacists lack training in differential diagnosis.
Public SafetyLean peopleRef: Sec. 3(1)(j)(i)-(v)Pharmacies—especially small, independent ones—may face significant upfront costs to implement EHR interoperability, train staff, and purchase point-of-care testing equipment, potentially accelerating consolidation in the pharmacy sector and reducing local ownership.
Business & EmploymentLean peopleRef: Sec. 3(1)(j)(v)The bill does not mandate compensation parity for pharmacist-prescribed services (e.g., via Medicaid/Medicare or private payers), which may disincentivize participation—especially for pharmacists in safety-net settings—limiting real-world access gains for vulnerable populations.
HealthcareLean peopleRef: Sec. 3(1)(j)(v)
Who Is Most Affected
Low-income, rural, and underserved patients—especially women, LGBTQ+ individuals, and people with substance use disorders—gain direct, timely access to preventive and chronic care services without needing appointments or referrals. This reduces out-of-pocket costs and travel burdens, improving health equity.
Pharmacists gain expanded clinical autonomy and professional recognition, enabling them to practice at the top of their training. However, this requires new training, liability considerations, and potential role redefinition—especially in team-based settings where scope boundaries may be unclear.
Pharmacies—particularly large chains—can generate new revenue streams and strengthen community health roles, but small, independent pharmacies may struggle with startup costs (e.g., testing equipment, EHR integration), potentially accelerating industry consolidation.
Primary care providers may see reduced demand for routine preventive or minor-condition visits, potentially easing appointment access for complex cases—but also face concerns about care fragmentation, lack of continuity, and unclear liability boundaries when pharmacists prescribe independently.