Pharmacists/Test and Treat
Senate Bill 414 would expand the role of pharmacists in North Carolina by expressly allowing them to use certain CLIA-waived tests to assist with clinical decision-making and to test and treat specified 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 protocols that include when patients must be referred to primary, urgent, or emergency care. Pharmacists would not be authorized under this bill to treat those conditions with controlled substances in Schedules I through IV.
The measure also revises insurance law to require health benefit plans to cover pharmacist-provided healthcare services when the service is within the pharmacist’s lawful scope of practice and would otherwise be covered if performed by another healthcare provider. It further requires insurers to treat pharmacy network participation separately from medical provider network participation, and it extends similar coverage requirements to third-party administrators and pharmacy benefits managers. The bill is effective in stages, with the pharmacist practice changes and insurance provisions generally taking effect October 1, 2025, and the insurance provisions applying to contracts entered into, renewed, or amended on or after that date.
The bill would amend Chapter 90 to broaden the statutory definition of pharmacy practice and authorize pharmacists to order and perform certain point-of-care tests and provide limited treatment for specific illnesses under statewide protocols. It would also amend Chapter 58 to create new insurance coverage and credentialing rules for pharmacist-delivered healthcare services, requiring parity in coverage when pharmacists provide services within scope that would be covered if delivered by other licensed providers. These changes would affect insurers, health benefit plans, pharmacy benefits managers, third-party administrators, pharmacies, and pharmacists, while also creating a statewide protocol framework for referral and treatment safeguards.
Based on the bill text and available context, the overall sentiment appears supportive of expanding pharmacist authority and improving access to care, with the bill framed as a public-facing healthcare access and reimbursement measure. The sponsors are listed as Senators Jones, Ford, and Moffitt, and there is no recorded committee transcript or vote history in the provided materials showing opposition or amendment debate. The absence of recorded controversy in the available context suggests the bill was introduced as a policy expansion rather than a contested measure, though the insurance and scope-of-practice provisions are the kinds of issues that often draw scrutiny from insurers and medical professional groups.
The most likely points of contention are the scope of pharmacist authority to test and treat patients, the requirement that insurers reimburse pharmacist services on the same basis as comparable services from other providers, and the mandate that pharmacy network participation not substitute for inclusion in medical networks. Potential critics may argue that these provisions could increase costs, complicate network credentialing, or blur lines between pharmacy and medical practice, while supporters would emphasize access, convenience, and use of pharmacists for low-acuity conditions. Another possible issue is the reliance on statewide protocols and referral criteria, which may raise questions about implementation, oversight, and patient safety.