SF4486 (Legislative Session 94 (2025-2026))
Pharmacists authorization to initiate, prescribe, administer, and dispense certain drugs for the treatment of opioid use disorder
AI Generated Summary
Purpose
- Expand pharmacists’ role in health care by authorizing them to initiate, prescribe, administer, and dispense certain medications, especially for opioid use disorder (OUD).
- Update requirements for pharmacist conduct and disciplinary action to reflect broader practice.
- Allow pharmacists to participate more fully in preventive care (vaccinations) and other medication-related services, within defined protocols and supervision.
Key scope and definitions
- Pharmacists can be treated as "practitioners" for more purposes, including prescribing self-administered hormonal contraception, nicotine replacement medications, opiate antagonists, and drugs to prevent HIV acquisition, under specified sections.
- The bill maintains that pharmacists work under protocols or collaborative practice agreements with other health professionals, and must document changes in the patient’s medical record.
Expanded duties and clinical activities for pharmacists
- Drug testing and interpretation: Pharmacists may collect specimens, interpret results, notify patients, and refer for follow-up care under protocol, with supervision rules for technicians/interns.
- Administration of medications and first-dose treatment: Pharmacists may initiate and administer initial doses for certain drugs and manage first dosages under protocols.
- Protocol-driven therapy changes: Pharmacists can initiate, modify, and discontinue drug therapy when guided by a written protocol or collaborative practice agreement with other licensed prescribers (e.g., dentists, optometrists, physicians, podiatrists, veterinarians, or advanced practice nurses).
- Documentation: Any changes to therapy must be recorded in the patient’s medical record or reported to the responsible practitioner.
- Vaccination authority: Pharmacists may initiate, order, and administer influenza and COVID-19 vaccines (and other FDA-approved vaccines) to eligible individuals per ACIP guidance; the program includes training, MIIC (Minnesota Immunization Information Connection) use, reporting of administration, and specific supervision and training requirements for pharmacy technicians or interns administering vaccines.
- Training and supervision: Vaccine administration training must be ACPE-approved (or board-approved), with in-person supervision of technicians, CPR certification, continuing education, and verified training programs.
Treatment of opioid use disorder (OUD)
- New authority: Pharmacists may prescribe, administer, and dispense legend drugs and controlled substances in Schedules III–V to treat OUD, if:
- There is a medically indicated treatment plan, and
- The pharmacist documents the assessment, treatment, response, and monitoring in the patient’s health record.
- Training and credentials: Pharmacists must complete a training program specifically developed for substance use disorder treatment (per federal standards, 21 U.S.C. § 823m) and obtain the proper DEA registration for the prescribed schedules.
- Intern involvement: Pharmacist interns may prepare prescriptions, but a pharmacist authorized to prescribe must review, approve, and sign before processing/dispensing.
- Collaboration: Pharmacists can participate in treatment under existing protocols or collaborative practice agreements, similar to other drug-therapy management activities.
- Counseling and documentation: The pharmacist must provide counseling on proper drug use, follow-up, and other information required by rules; documentation must be in the patient’s health record.
- Fees: Pharmacists may charge for these services.
Controlled substances and prescription rules
- Schedule III–IV prescriptions: The bill tightens prescription requirements for Schedule III–IV drugs, including limits on refills and timeframes (with some carve-outs for cannabis products under state law).
- Pharmacist authority to prescribe/administer: The bill adds a subdivision allowing pharmacists to prescribe, administer, and dispense Schedule III–V controlled substances under the expanded authority described above, including allowance for interns to participate under supervision.
Disciplinary actions and professional conduct
- Expanded grounds for discipline: The bill broadens and clarifies grounds for disciplinary action for pharmacists, interns, and related licensees, including:
- Fraud in licensing or license maintenance, criminal convictions related to practice, misconduct, violations of board orders, failure to report or cooperate with investigations, and unethical or incompetent practice.
- Conduct that endangers public health or patient safety, impairment from illness or substances, and improper management of patient records.
- Aiding or abetting unlicensed practice, or involvement in deceptive billing or referral schemes.
- Failures related to licensing status (lapsed/nonrenewed licenses) or disciplinary actions in other states.
- Potential consequences: The board may delay or withhold licenses or registrations pending adjudication or resolution of other disciplinary proceedings.
Implementation considerations and public health context
- Training and quality assurance: The expanded authority relies on approved training programs (ACPE or board-approved), ongoing continuing education, and documentation in patient records to ensure safe practice.
- Coordination with other health professionals: Because many duties occur under protocols or collaborative practice agreements, pharmacists will need effective collaboration with physicians, dentists, optometrists, PAs, NPs, veterinarians, and others.
- Privacy and patient records: All therapy changes and treatments must be documented in the patient’s medical record to ensure continuity of care.
- Immunization data sharing: Use of MIIC and reporting requirements will help track vaccination status and improve public health reporting.
Relevant terms - opioid use disorder (OUD) - Schedule III–V controlled substances - prescribe, administer, dispense - legend drugs - protocols and collaborative practice agreements - vaccines (influenza, COVID-19/SARS-CoV-2, ACIP recommendations) - Minnesota Immunization Information Connection (MIIC) - ACPE (Accreditation Council for Pharmacy Education) - DEA registration (Drug Enforcement Administration) - self-administered hormonal contraceptives - nicotine replacement medications - opiate antagonists - HIV prevention drug therapy - clinical protocol-based care - pharmacist intern, pharmacy technician - patient counseling and medical record documentation - disciplinary grounds and board actions - lapsed/nonrenewed license provisions
Bill text versions
- Introduction PDF PDF file
Actions
| Date | Chamber | Where | Type | Name | Committee Name |
|---|---|---|---|---|---|
| March 17, 2026 | Senate | Action | Introduction and first reading | ||
| March 17, 2026 | Senate | Action | Referred to | Health and Human Services |
Citations
[
{
"analysis": {
"added": [
"Authorization for initiating, modifying, or discontinuing drug therapy pursuant to a protocol or collaborative practice agreement.",
"Inclusion of laboratory testing and related clinical interpretation under pharmacist scope in accordance with CLIA-related allowances."
],
"removed": [],
"summary": "Amends Subdivision 27 (Practice of pharmacy) to broaden pharmacist responsibilities and clarify authority related to drug therapy, testing, and collaborative practice.",
"modified": [
"Expands the scope of practice to include broader clinical activities within the pharmacist role."
]
},
"citation": "151.01",
"subdivision": "27"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Relates to grounds for disciplinary action for pharmacists, pharmacist interns, and related licensees.",
"modified": [
" clarifies and potentially broadens grounds for disciplinary action to accommodate expanded pharmacist roles and protocol-based practice."
]
},
"citation": "151.071",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Subd.18 Treatment of opioid use disorder authorizing pharmacists to prescribe, administer, and dispense certain legend drugs and Schedule III–V medications for OUD under specified conditions.",
"Training, DEA registration, patient counseling, and protocol-driven practice requirements associated with OUD treatment."
],
"removed": [],
"summary": "Adds a new subdivision to 151.37 to enable treatment of opioid use disorder (OUD) by pharmacists with defined requirements and safeguards.",
"modified": [
"Expands pharmacist authority to participate in OUD treatment through prescribed protocols."
]
},
"citation": "151.37",
"subdivision": ""
},
{
"analysis": {
"added": [
"Prescription issuance by eligible prescribers (including pharmacists under authorized scope) for Schedule III or IV substances.",
"Limitations on duration (six months) and number of refills (no more than five)."
],
"removed": [],
"summary": "Prescribing requirements for Schedule III or IV controlled substances; defines prescription validity and refill limits.",
"modified": [
"Sets or clarifies restrictions on prescribing and refilling Schedule III–IV substances."
]
},
"citation": "152.11",
"subdivision": "2"
},
{
"analysis": {
"added": [
"Subd.2a Pharmacist may prescribe, administer, and dispense a controlled substance included in Schedules III–V under authorized authority (e.g., 151.37(18)); pharmacist intern may administer under pharmacist supervision."
],
"removed": [],
"summary": "Adds a subdivision authorizing pharmacist prescribing, administering, and dispensing certain controlled substances; permits intern involvement under supervision.",
"modified": [
"Expands pharmacist scope to include more controlled substances and allows intern participation under supervision."
]
},
"citation": "152.12",
"subdivision": "2a"
},
{
"analysis": {
"added": [
"Practitioner also means a pharmacist authorized to prescribe self-administered hormonal contraceptives, nicotine replacement medications, or opiate antagonists under section 151.37(14–16) or to prescribe HIV-related drugs under section 151.37(17) or subdivision 27."
],
"removed": [],
"summary": "Minnesota Statutes 2025 Supplement: expands practitioner definition to include pharmacists under certain prescribing authorities.",
"modified": [
"Broadens the definition of practitioner to explicitly include pharmacists with prescribing authority for specified therapies."
]
},
"citation": "151.01",
"subdivision": "23"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference within practitioner scope provisions; supports integration of expanded pharmacist activities.",
"modified": [
"Incorporates cross-references to related sections governing expanded pharmacist practice."
]
},
"citation": "151.15",
"subdivision": "4"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference related to expanded practitioner definitions and authority.",
"modified": [
"Aligns cross-references with expanded scope provisions for pharmacist practice."
]
},
"citation": "151.211",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference related to practitioner definitions and scope in connection with 151.461 and related sections.",
"modified": [
"Links to other sections governing pharmacist practice and collaboration across professions."
]
},
"citation": "151.252",
"subdivision": "1"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference to 151.252(3) and 151.37(14–17) concerning prescribing and therapeutic management by pharmacists.",
"modified": [
"Supports expanded prescribing and management authority for pharmacists under protocol-based practice."
]
},
"citation": "151.252",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Clarifies protocol-based initiation, management, modification, and discontinuation of drug therapy by pharmacists with other providers.",
"modified": [
"Reiterates protocol-based approach to pharmacotherapy decisions and documentation requirements."
]
},
"citation": "151.37",
"subdivision": "2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference related to supervision and collaborative practice agreements among pharmacists and other providers.",
"modified": [
"Ensures alignment of supervisory relationships and interprofessional collaboration provisions."
]
},
"citation": "151.37",
"subdivision": "13"
},
{
"analysis": {
"added": [
"Pharmacists may prescribe self-administered hormonal contraceptives under defined conditions."
],
"removed": [],
"summary": "Authorizes prescribing self-administered hormonal contraceptives under pharmacist authority when appropriately trained.",
"modified": [
"Broadens pharmacologic authority to include contraceptive prescribing."
]
},
"citation": "151.37",
"subdivision": "14"
},
{
"analysis": {
"added": [
"Pharmacists may prescribe nicotine replacement therapies under defined protocols."
],
"removed": [],
"summary": "Authorizes prescribing nicotine replacement medications under pharmacist authority where appropriate.",
"modified": [
"Expands pharmacist prescribing capabilities in tobacco cessation therapy."
]
},
"citation": "151.37",
"subdivision": "15"
},
{
"analysis": {
"added": [
"Pharmacists may prescribe opiate antagonists under specified conditions."
],
"removed": [],
"summary": "Authorizes prescribing opiate antagonists for treatment of overdose or related indications under pharmacist authority.",
"modified": [
"Extends pharmacist-driven interventions for overdose management."
]
},
"citation": "151.37",
"subdivision": "16"
},
{
"analysis": {
"added": [
"Pharmacists may prescribe pre-exposure or preventive HIV therapies under defined criteria."
],
"removed": [],
"summary": "Authorizes prescribing drugs to prevent HIV acquisition under drug therapy when certain prerequisites are met.",
"modified": [
"Expands pharmacist access to preventive HIV therapeutics."
]
},
"citation": "151.37",
"subdivision": "17"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Treatment of opioid use disorder; detailed in Sec.4; outlines required training, DEA registration, and protocols.",
"modified": [
"Explicitly authorizes and regulates pharmacist-led OUD treatment under a defined treatment protocol."
]
},
"citation": "151.37",
"subdivision": "18"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference defining practitioner scope to include pharmacists under related chapters.",
"modified": [
"Ensures pharmacist authority is harmonized with the broader practitioner definitions."
]
},
"citation": "151.461",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Grounds for disciplinary action include failure to comply with orders or regulations related to health professionals; cross-references to rehabilitative programs.",
"modified": [
"Links disciplinary actions to standards applicable to health professionals, including pharmacists."
]
},
"citation": "604A.04",
"subdivision": "1"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Related to professional discipline or sanctions (conforming with board actions) in the context of pharmacy practice.",
"modified": [
"Cites core disciplinary frameworks applicable to pharmacies and health professionals."
]
},
"citation": "62J.842",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Related to disciplinary action frameworks and reporting requirements in health licensing programs.",
"modified": [
"Maintains alignment with disciplinary processes across health licensing bodies."
]
},
"citation": "62J.845",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "References to sections 144.291–144.298 (patient records, access, and health information handling).",
"modified": [
"Cross-references to patient records and privacy provisions related to health care."
]
},
"citation": "144.291",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "See 144.291–144.298; health information handling provisions.",
"modified": [
"Continues integration of health information privacy and access provisions."
]
},
"citation": "144.292",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "See 144.291–144.298; patient records and related duties.",
"modified": [
"Ensures consistency with privacy and records requirements in pharmacy practice."
]
},
"citation": "144.298",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Reference to financial interests and disclosures under section 144.6521(3) in relation to health care referrals and billing.",
"modified": [
"Connects with anti-kickback and disclosure provisions applicable to health care arrangements."
]
},
"citation": "144.6521",
"subdivision": "3"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Aiding or abetting suicide provisions; cross-referenced in disciplinary provisions for health professionals.",
"modified": [
"Reinforces alignment with criminal provisions governing assisting suicide and related conduct."
]
},
"citation": "609.215",
"subdivision": "1"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Aiding or abetting suicide provisions; cross-referenced in disciplinary provisions for health professionals.",
"modified": [
"Reinforces alignment with criminal provisions governing assisting suicide and related conduct."
]
},
"citation": "609.215",
"subdivision": "2"
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Reference to chapter 150A (Dental therapy-related provisions) used in cross-referencing scope for practitioner definitions.",
"modified": [
"Cross-reference to related professional practice chapters, including 150A."
]
},
"citation": "150A",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Federal CLIA-related reference governing laboratory testing and related activities.",
"modified": [
"Frames pharmacist testing and related activities under the federal CLIA framework."
]
},
"citation": "42 U.S.C. § 263a",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Requires training for practitioners in treatment of substance use disorders; DEA registration where applicable.",
"modified": [
"Connects pharmacist training requirements to federal statute for substance use disorder treatment."
]
},
"citation": "21 U.S.C. § 823(m)",
"subdivision": ""
},
{
"analysis": {
"added": [],
"removed": [],
"summary": "Cross-reference to schedules of controlled substances kept in 152.02; used to determine what may be prescribed under pharmacist authority.",
"modified": [
"Ensures alignment with state-scheduled controlled substances framework when expanding pharmacist prescribing."
]
},
"citation": "152.02",
"subdivision": ""
}
]Progress through the legislative process
In Committee