Collaborative Practice Agreements
S0449 would authorize pharmacists and physicians in South Carolina to enter into written collaborative practice agreements. The bill adds matching definitions to the Pharmacy Practice Act and the physician licensing chapter, and it specifies that these agreements are for evidence-based medication management and related patient care services delegated by a physician for identified patients. The agreements must include coordinated communication between the pharmacist and physician, with access to the same electronic medical records system or another HIPAA-compliant method for sharing records.
The bill also expands the statutory description of the “practice of pharmacy” to include certain testing and treatment activities. It expressly allows pharmacists to initiate, order, and administer CLIA-waived flu and COVID-related tests, including tests for influenza, SARS-CoV-2, streptococcal pharyngitis, and other conditions approved by the relevant boards, and permits pharmacists to delegate test administration to trained technicians or interns while retaining responsibility for interpretation. It further contemplates treatment of conditions identified through those tests under a joint written protocol issued by the Board of Medical Examiners and the Board of Pharmacy.
The bill’s impact on state law is to create a new legal framework for pharmacist-physician collaborative care and to require both the State Board of Pharmacy and the State Board of Medical Examiners to promulgate regulations governing these agreements. Collaborative practice agreements cannot be implemented until those regulations take effect, making agency rulemaking a condition precedent to implementation. The bill would therefore affect pharmacists, physicians, boards of licensure, and patients receiving medication management or point-of-care testing services.
The available voting history suggests broad bipartisan support and little visible opposition. The Senate passed the bill on second reading 44-0, and the House later passed it 104-0. No committee transcripts were provided, so there is no recorded floor or committee debate in the supplied materials, but the unanimous votes indicate the measure was generally viewed favorably.
The main point of potential contention is not whether collaborative practice agreements should be allowed, but how they will be regulated and implemented. The bill leaves important operational details to the two professional boards, including the rules governing scope, communication, and use of the agreements. Any concerns would likely center on patient safety, professional oversight, and the boundaries of pharmacist authority, but those concerns are not reflected in the voting record provided.
S0449 amends the South Carolina Code in Titles 40-43 and 40-47 to define and authorize collaborative practice agreements between pharmacists and physicians, and to expand the statutory scope of pharmacy practice to include certain testing, reporting, and protocol-based treatment activities. It also directs the State Board of Pharmacy and the State Board of Medical Examiners to adopt regulations before any collaborative practice agreement may be implemented, making the bill dependent on future administrative rulemaking.
The bill appears to have been received positively and with strong consensus. The Senate passed it 44-0 on second reading, and the House passed it 104-0, indicating no recorded opposition in the voting history provided. With no committee transcripts available, the record suggests a broadly supportive view of pharmacist-physician collaboration and expanded access to medication management services.
No explicit contention is shown in the provided materials, but the likely issues are the scope of pharmacist authority, the requirement for physician delegation, and the regulatory details left to the State Board of Pharmacy and the State Board of Medical Examiners. The bill requires shared records or HIPAA-compliant communication and delays implementation until regulations are effective, which suggests that any disagreement would likely focus on implementation standards, patient safety safeguards, and the division of responsibilities between pharmacists and physicians.