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Pharmacist prescriptive-authority draft debated; members delay amendment votes to special session
Summary
The division reviewed LC 25.1386, a draft granting limited prescriptive authority and therapeutic-substitution provisions for pharmacists. Representative Rohrs proposed narrow amendments (limits on therapeutic substitution, exclusions for certain drugs, CGM exclusion, and auto-injector authority) but withdrew a motion to adopt them so stakeholders can testify at the special session.
The Rural Health Transformation division reviewed LC 25.1386 (25.1386.10.00), a draft that would add limited prescriptive authority for pharmacists, create new statutory sections on prescriptive authority and therapeutic substitution, require patient notice and the right to refuse substitutions, and add a provider-notice requirement within 24 hours of dispensing.
Legislative counsel said the draft seeks a middle ground on pharmacist authority: "Some states have wide open full prescriptive authority for pharmacists, and then some states have...taken steps towards more open prescriptive authority. This was trying to find a medium ground." The draft also adjusts CLIA-waived test references and adds pharmacists to a list of professionals exempt from certain clinical-lab licensure provisions.
Representative Rohrs presented a proposed amendment (25.1409.03) that would narrow the scope in several ways: limit pharmacists to prescribing narrowly defined items (for example, prevention of motion sickness rather than treating underlying neurologic causes), remove 'uncomplicated urinary tract infections' without a lab test from this section and address testing under CLIA-waived procedures instead, permit dispensing of disposable blood-glucose testing supplies but exclude continuous glucose monitors (CGMs), add auto-injectors (for patients with documented anaphylaxis) and move toward an exclusion list for therapeutic substitution rather than a broad inclusion list. Rohrs warned that the original therapeutic-substitution language could allow substitution of psychiatric medications for juveniles, which raised concerns.
Members debated procedure: some urged moving drafts forward unchanged to allow full public testimony during the special session and avoid preemptive defeat of amendments; others favored stakeholder negotiation before the special session. Representative Rohrs ultimately withdrew her motion to adopt the amendments to allow additional stakeholder discussion and to revisit changes at the special-session standing committee hearing.
The division recessed to meet again tomorrow; the committee emphasized that the special-session public hearings will provide the formal opportunity for testimony and amendment consideration.
