An Act to amend and reenact § 54.1-3300.1 of the Code of Virginia, relating to collaborative agreements; practitioners; diagnosis.
HB232 amends Virginia’s collaborative practice agreement law for pharmacists and certain prescribers. The bill expands and clarifies who may enter into collaborative agreements with pharmacists, expressly including physicians, podiatrists, physician assistants, and advanced practice registered nurses involved in direct patient care. It authorizes these agreements to cover cooperative procedures related to drug therapy, laboratory testing, and medical devices, and it allows collaborative agreements to include prescribing, modifying, continuing, or discontinuing drug therapy under written or electronic protocols after a qualifying diagnosis and within the scope of practice of the parties involved.
The bill also adds patient opt-out and prescriber opt-out provisions, allowing a patient to refuse participation and allowing a prescriber to exclude a patient from a collaborative procedure by contacting the pharmacist or documenting the refusal on the prescription. It limits collaborative agreements to conditions with clinically accepted standard-of-care protocols or protocols approved by the Boards of Medicine and Pharmacy, and it directs those boards to jointly adopt regulations to implement the law and review specific protocols when requested. The bill further states that pharmacists acting outside an agreement may face disciplinary action.
HB232 updates § 54.1-3300.1 of the Code of Virginia and broadens the statutory framework for pharmacist-led collaborative care. It expressly permits pharmacists, under approved collaborative agreements, to prescribe, modify, continue, or discontinue Schedule II through VI controlled substances, subject to board rules and, for Schedule II through V drugs, prior submission of the signed agreement and Board authorization. The bill therefore affects pharmacists, physicians, podiatrists, physician assistants, advanced practice registered nurses, and patients participating in collaborative treatment protocols, while reinforcing that no practitioner is required to enter such an agreement.
The available context shows the bill as enacted without recorded committee transcript debate or vote detail, suggesting no documented controversy in the provided materials. The statutory changes indicate a generally supportive policy direction toward expanding team-based care and pharmacist authority within controlled, protocol-based settings. Because the bill became chaptered law, the overall sentiment appears favorable or at least sufficiently unopposed to advance through the legislative process.
The main points of potential contention are the expansion of pharmacist authority into prescribing and managing controlled substances, and the extent to which collaborative agreements may affect physician, APRN, PA, and podiatrist autonomy. The bill addresses this by making participation voluntary for prescribers, allowing patients to opt out, and limiting agreements to standard-of-care or board-approved protocols. Another likely concern is patient safety and oversight, which the bill answers by requiring board regulations, protocol review procedures, and disciplinary consequences for pharmacists who act outside the agreement.