House Bill 736 would expand the role of pharmacists in North Carolina by allowing them to use CLIA-waived tests to assist with clinical decision-making and to treat certain conditions, including influenza, COVID-19, and strep throat, under statewide protocols. The bill also directs the State Health Director, working with the Board of Pharmacy and Medical Board, to develop those protocols and to include referral criteria for patients who need primary, urgent, or emergency care.
In addition to expanding pharmacist authority, the bill would require health benefit plans to cover pharmacist-provided healthcare services when those services are within the pharmacist’s lawful scope of practice and would have been covered if performed by another provider. It also requires insurers to recognize certain credentialing arrangements for pharmacists, clarifies that pharmacy network participation does not substitute for inclusion in medical provider networks, and extends prescription drug and pharmacy service coverage rules to third-party administrators and pharmacy benefits managers. The bill includes an appropriation to the Department of Insurance and sets most insurance-related provisions to apply to contracts entered into, renewed, or amended on or after October 1, 2025.
The bill would amend Chapter 90 to broaden the statutory practice of pharmacy and Chapter 58 to add new insurance coverage and reimbursement requirements tied to pharmacist services. It would create a new framework for pharmacist testing and treatment authority, require statewide protocols for implementation, and prohibit treatment of these conditions with controlled substances in Schedules I through IV. On the insurance side, it would require parity in coverage for pharmacist-delivered services, impose credentialing and network-related obligations on insurers, and make pharmacy benefit managers and third-party administrators subject to the same prescription drug and pharmacy service coverage requirements that apply to insurers.
The available legislative record shows no committee transcript or recorded votes, so there is no documented debate or formal vote sentiment to assess. Based on the bill text, the measure appears designed to expand access to care and streamline pharmacist reimbursement, suggesting a generally pro-expansion and pro-access policy approach. However, without hearing records, the level of support or opposition cannot be determined from the provided materials.
The main points of potential contention are the expansion of pharmacist scope of practice into testing and treatment, the requirement that insurers cover pharmacist services on the same basis as comparable services by other providers, and the mandate that insurers accept certain pharmacist credentialing arrangements. Health care providers and insurers may object to the scope expansion, protocol design, network implications, or reimbursement obligations, while pharmacists and consumer-access advocates would likely support the measure as a way to improve access and reduce delays in care. The bill’s reliance on statewide protocols and referral rules also suggests concern about patient safety and appropriate limits on pharmacist treatment authority.