Pharmacists; collaborative agreements, drug therapy.
Summary
HB1582 amends Virginia law governing pharmacist participation in collaborative practice agreements. The bill allows pharmacists and designated alternate pharmacists who are directly involved in patient care to work under collaborative agreements with physicians, osteopathic physicians, podiatrists, physician assistants, advanced practice registered nurses, and certain physician offices to carry out cooperative procedures related to drug therapy, laboratory tests, and medical devices. These agreements are intended to improve patient outcomes for patients who meet the criteria set out in the agreement, and they must stay within the scope of practice of the participating professionals.
The bill also clarifies that patients may opt out of participation in a collaborative procedure, and prescribers may exclude a patient by notifying the pharmacist or documenting the refusal on the prescription. It further permits collaborative agreements to cover implementation, prescribing, modification, continuation, or discontinuation of drug therapy under written or electronic protocols, and it requires that such protocols be clinically accepted or approved by the Boards of Medicine and Pharmacy. The boards must jointly adopt regulations to implement the law and establish a process for reviewing specific protocols when requested.
Impact
HB1582 updates Section 54.1-3300.1 of the Code of Virginia and expands the framework for pharmacist-led drug therapy management under collaborative agreements. It authorizes pharmacists, subject to board authorization and a signed collaborative practice agreement, to prescribe, modify, continue, or discontinue Schedule II through VI controlled substances in accordance with the statute, while preserving existing controlled-substance restrictions except as specifically allowed. The bill also requires pharmacists to submit proof of the agreement to the Board before engaging in controlled-substance prescribing activities under the statute, and it creates disciplinary exposure for pharmacists who act outside the agreement's terms.
Sentiment
The bill appears to have been broadly supported and noncontroversial in the legislature. It advanced through committee and floor votes in both chambers with unanimous or near-unanimous support, including 22-0 in House committee, 96-0 and 97-0 in the House, 15-0 in Senate committee, and 40-0 in the Senate, followed by House agreement to the Senate substitute by 96-0. The voting record suggests strong bipartisan approval of expanding pharmacist collaborative practice authority.
Contention
There is little evidence of substantive opposition in the available record, but the statute itself reflects the main policy guardrails that likely addressed any concerns. The most notable limits are that participation is voluntary for physicians, podiatrists, physician assistants, and advanced practice registered nurses; patients may refuse participation; collaborative agreements are limited to clinically accepted or board-approved protocols; and pharmacists remain subject to disciplinary action if they exceed the agreement. The requirement that pharmacists obtain Board authorization before handling Schedule II through V controlled substances under a collaborative agreement also indicates concern about oversight and patient safety.
Expands the existing law regarding collaborative practice agreements between pharmacists and physicians to allow other healthcare providers to enter into such agreements and removes the definition of “collaborative practice committee.”
Expands the existing law regarding collaborative practice agreements between pharmacists and physicians to allow other healthcare providers to enter into such agreements and removes the definition of “collaborative practice committee.”