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HB146 INTRODUCED
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HB146
V7DS6LL-1
By Representative Rigsby
RFD: Health
First Read: 13-Jan-26
PFD: 09-Jan-26
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V7DS6LL-1 01/07/2026 JC (L)lg 2026-69
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PFD: 09-Jan-26
SYNOPSIS:
Existing law requires Ivermectin to be dispensed
by a pharmacist only on the prescription of a licensed
physician.
This bill would permit a physician, a physician
assistant, or a certified registered nurse practitioner
to give a pharmacist a standing order to dispense
Ivermectin to individuals without an individual
prescription. The standing order would contain a
protocol providing the pharmacist with guidelines for
providing Ivermectin to individuals who request it.
This bill would prohibit health care providers
and pharmacists from participating in any program or
receiving any benefit that would induce them to
encourage patients or the public to use Ivermectin.
This bill would also prohibit health care
providers qualified to give a standing order and
pharmacists who follow a standing order from being
subject to disciplinary action from the respective
governing licensing board as a result of dispensing
Ivermectin.
A BILL
TO BE ENTITLED
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TO BE ENTITLED
AN ACT
Relating to prescription drugs; to provide for the
dispensing of Ivermectin by a pharmacist without an individual
prescription pursuant to a standing order issued by a
physician, physician assistant, or certified registered nurse
practitioner; and to protect physicians, physician assistants,
certified registered nurse practitioners, and pharmacists from
licensure disciplinary action due to dispensing Ivermectin.
BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:
Section 1. (a) For the purposes of this section, the
following terms have the following meanings:
(1) HEALTH CARE PROVIDER. A physician licensed by the
Medical Licensure Commission pursuant to Article 8, Chapter 24
of Title 34, Code of Alabama 1975; a physician assistant
licensed by the State Board of Medical Examiners pursuant to
Article 7, Chapter 24 of Title 34, Code of Alabama 1975; or a
certified registered nurse practitioner licensed and certified
by the Board of Nursing pursuant to Article 5, Chapter 21 of
Title 34, Code of Alabama 1975.
(2) STANDING ORDER. A prescription order that is not
patient specific.
(b) A pharmacist may dispense Ivermectin without a
prescription to an individual who is 19 years of age or older,
or to an unemancipated individual under 19 years of age upon
written consent of the individual's parent or legal guardian,
pursuant to a standing order that is signed by a health care
provider.
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provider.
(c) The standing order shall include all of the
following:
(1) A risk assessment protocol for use by the
pharmacist to screen an individual who requests Ivermectin and
which includes a plan for treating adverse events.
(2) A standardized information sheet that provides the
following information for the individual who is dispensed
Ivermectin:
a. Indications and contraindications for the use of
Ivermectin.
b. Instructions for using Ivermectin.
c. A statement on the importance of follow-up care and
health care referral information.
(3) A form for the pharmacist to record the completion
of the risk assessment protocol and the dosage dispensed to
the individual.
(d) No health care provider who signs a standing order,
and no pharmacist who dispenses Ivermectin pursuant to a
standing order, shall participate in any program or accept
anything of value that induces the health care provider or
pharmacist to affirmatively commend or endorse the use of
Ivermectin to an individual or the public.
(e)(1) The governing licensing board shall not take
disciplinary action against a health care provider who signs a
standing order for Ivermectin that is based upon a
pharmacist's dispensing of Ivermectin pursuant to that
standing order.
(2) The State Board of Pharmacy shall not take
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(2) The State Board of Pharmacy shall not take
disciplinary action against a pharmacist based upon any of the
following:
a. The pharmacist's failure in good faith to correctly
interpret and follow the standing order upon dispensing
Ivermectin.
b. A defect in the standing order upon which the
pharmacist relies when dispensing Ivermectin.
c. The pharmacist's refusal to dispense Ivermectin upon
the request of an individual, notwithstanding the existence of
a standing order for Ivermectin signed by a health care
provider which covers the pharmacist's employer or practice.
(f) This section shall not constitute standards of, nor
be construed as evidence for, the practice of medicine or the
practice of pharmacy. Nothing in this section shall alter,
amend, or supersede any provision of Section 6-5-333, Code of
Alabama 1975, or the Alabama Medical Liability Act of 1987,
commencing with Section 6-5-540, Code of Alabama 1975, or the
Alabama Medical Liability Act of 1996, commencing with Section
6-5-548, Code of Alabama 1975, or any amendment to any of the
foregoing, or any judicial interpretation of the foregoing.
(g) Nothing in this section shall be construed to limit
the Alabama Medicaid Agency, or any insurer, health
maintenance organization, health care service corporation, or
other third-party payor from determining the scope of its
benefits or services, setting terms for group or individual
insured, subscriber, or enrollee contracts, or negotiating
contracts with licensed providers on reimbursement rates or
other lawful provisions. However, the contract providing
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other lawful provisions. However, the contract providing
coverage to an insured cannot exclude the right to assign
benefits to any provider at the same benefit as paid to a
contract provider.
Section 2. This act shall become effective on October
1, 2026.
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