Amendment to expand pharmacist prescribing authority rejected after floor debate; bill advances

The West Virginia Senate debated a committee substitute for Senate Bill 526, the pharmacist prescribing authority act, with extended floor discussion about the scope of tests pharmacists may use, emergency dispensing and communication requirements with primary care providers.

Senators described competing goals: expanding timely access to basic diagnostics and treatments at pharmacies, and ensuring safeguards for patient safety and continuity of care.

The senior senator from the seventeenth introduced a strike-and-insert amendment intended to clarify the bill27s language on testing, diagnosis and notification requirements. She said the amendment would "authorize pharmacist to practice the full extent of their education and training and prescribe low risk medication to patients" while ensuring pharmacists administer CLIA-waived tests, complete a medication history and notify the patient27s primary care provider within 72 hours.

The senator from Ohio opposed the amendment, saying "The strike and insert, guts the bill." She said the original committee substitute was narrowly written to allow pharmacists to administer waived tests (for example, flu or COVID), prescribe limited medications guided by those tests, and provide emergency dispensing when a patient cannot obtain a timely refill or during disasters. She warned the amendment would eliminate emergency dispensing authority except for limited cases and impose arbitrary time-limits that would delay care.

Several senators described access barriers that motivated the underlying bill. The senator from Mingo said many constituents lack timely access to doctors or reliable internet for telehealth and would benefit from expanded pharmacy-based testing and treatment.

During debate the senior senator from the seventeenth read an email from the Board of Pharmacy stating the board and its members supported the amendments and that the board would present the proposed language to the Senate.

A roll-call vote was then demanded and sustained on the amendment. The clerk reported 14 yeas, 17 nays, 3 absent; the amendment failed. The presiding officer announced the amendment rejected and the bill will be engrossed and advanced toward third reading in its prior committee-substitute form.

Key points in floor debate included whether pharmacists should be required to administer the CLIA-waived test themselves, the requirement to notify a primary care provider within 72 hours, and the scope of emergency dispensing (including whether epinephrine refills should be permitted without an active prescription).

Votes Roll-call on amendment to committee substitute for Senate Bill 526 (strike-and-insert): 14 yeas, 17 nays, 3 absent; outcome: amendment rejected. Bill advanced for engrossment.