Pharmacists authorization to initiate, prescribe, administer, and dispense certain drugs for the treatment of opioid use disorder

A bill for an act

relating to health occupations; authorizing pharmacists to initiate, prescribe,

administer, and dispense certain drugs for the treatment of opioid use disorder;

modifying grounds for disciplinary action for pharmacists and pharmacist interns;

amending Minnesota Statutes 2024, sections 151.01, subdivision 27; 151.071,

subdivision 2; 151.37, by adding a subdivision; 152.11, subdivision 2; 152.12, by

adding a subdivision; Minnesota Statutes 2025 Supplement, section 151.01,

subdivision 23.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

Section 1.

Minnesota Statutes 2025 Supplement, section 151.01, subdivision 23, is amended

to read:

Subd. 23.

Practitioner.

"Practitioner" means a licensed doctor of medicine, licensed

doctor of osteopathic medicine duly licensed to practice medicine, licensed doctor of

dentistry, licensed doctor of optometry, licensed podiatrist, licensed veterinarian, licensed

advanced practice registered nurse, licensed certified midwife, or licensed physician assistant.

For purposes of sections
151.15, subdivision 4
;
151.211
, subdivision 3;
151.252, subdivision

3
;
151.37, subdivision 2
, paragraph (b); and
151.461
, "practitioner" also means a dental

therapist authorized to dispense and administer under chapter 150A. For purposes of sections

151.252, subdivision 3
, and
151.461
, "practitioner" also means a pharmacist authorized to

prescribe
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self-administered hormonal contraceptives, nicotine replacement medications, or

opiate antagonists under section
151.37, subdivision 14
, 15, or 16, or authorized to prescribe

drugs to prevent the acquisition of human immunodeficiency virus (HIV) under
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drug therapy

according to subdivision 27 or
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section
151.37
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, subdivision 17
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.

Sec. 2.

Minnesota Statutes 2024, section 151.01, subdivision 27, is amended to read:

Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a

manufacturer or packager of nonprescription drugs or commercially packaged legend drugs

and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance

of safe and effective use of drugs, including ordering and performing laboratory tests that

are waived under the federal Clinical Laboratory Improvement Act of 1988, United States

Code, title 42, section 263a et seq. A pharmacist may collect specimens, interpret results,

notify the patient of results, and refer the patient to other health care providers for follow-up

care and may initiate, modify, or discontinue drug therapy only pursuant to a protocol or

collaborative practice agreement. A pharmacist may delegate the authority to administer

tests under this clause to a pharmacy technician or pharmacy intern. A pharmacy technician

or pharmacy intern may perform tests authorized under this clause if the technician or intern

is working under the direct supervision of a pharmacist;

(4) participation in drug and therapeutic device selection; drug administration for first

dosage and medical emergencies; intramuscular and subcutaneous drug administration under

a prescription drug order; drug regimen reviews; and drug or drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used

to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a
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prescriber
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practitioner
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and the
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prescriber
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practitioner
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is notified

after administration is complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section

151.01, subdivisions 27b
and 27c, and participation in the initiation, management,

modification, administration, and discontinuation of drug therapy is according to the protocol

or collaborative practice agreement between the pharmacist and a dentist, optometrist,

physician, physician assistant, podiatrist, or veterinarian, or an advanced practice registered

nurse authorized to prescribe, dispense, and administer under section
148.235
. Any changes

in drug therapy or medication administration made pursuant to a protocol or collaborative

practice agreement must be documented by the pharmacist in the patient's medical record

or reported by the pharmacist to a practitioner responsible for the patient's care;

(6) initiating, ordering, and administering influenza and COVID-19 or SARS-CoV-2

vaccines authorized or approved by the United States Food and Drug Administration to all

eligible individuals three years of age and older and all other United States Food and Drug

Administration-approved vaccines to patients six years of age and older according to the

federal Advisory Committee on Immunization Practices recommendations. A pharmacist

may delegate the authority to administer vaccines under this clause to a pharmacy technician

or pharmacy intern who has completed training in vaccine administration if:

(i) the pharmacist and the pharmacy technician or pharmacy intern have successfully

completed a program approved by the Accreditation Council for Pharmacy Education

(ACPE) specifically for the administration of immunizations or a program approved by the

board;

(ii) the pharmacist utilizes the Minnesota Immunization Information Connection to

assess the immunization status of individuals prior to the administration of vaccines, except

when administering influenza vaccines to individuals age nine and older;

(iii) the pharmacist reports the administration of the immunization to the Minnesota

Immunization Information Connection;

(iv) if the patient is 18 years of age or younger, the pharmacist, pharmacy technician,

or pharmacy intern informs the patient and any adult caregiver accompanying the patient

of the importance of a well-child visit with a pediatrician or other licensed primary care

provider; and

(v) in the case of a pharmacy technician administering vaccinations while being

supervised by a licensed pharmacist:

(A) the supervision is in-person and must not be done through telehealth as defined

under section
62A.673, subdivision 2
;

(B) the pharmacist is readily and immediately available to the immunizing pharmacy

technician;

(C) the pharmacy technician has a current certificate in basic cardiopulmonary

resuscitation;

(D) the pharmacy technician has completed a minimum of two hours of ACPE-approved,

immunization-related continuing pharmacy education as part of the pharmacy technician's

two-year continuing education schedule; and

(E) the pharmacy technician has completed one of two training programs listed under

Minnesota Rules, part
6800.3850
, subpart 1h, item B;

(7) participation in the initiation, management, modification, and discontinuation of

drug therapy according to a written protocol or collaborative practice agreement between:

(i) one or more pharmacists and one or more dentists, optometrists, physicians, physician

assistants, podiatrists, or veterinarians; or (ii) one or more pharmacists and one or more

physician assistants authorized to prescribe, dispense, and administer under chapter 147A,

or advanced practice registered nurses authorized to prescribe, dispense, and administer

under section
148.235
. Any changes in drug therapy made pursuant to a protocol or

collaborative practice agreement must be documented by the pharmacist in the patient's

medical record or reported by the pharmacist to a practitioner responsible for the patient's

care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and

devices;

(10) offering or performing those acts, services, operations, or transactions necessary

in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of

therapy with opiate antagonists, as defined in section
604A.04, subdivision 1
, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner

designated by the commissioner of health, as allowed under section
151.37
, subdivision 13;

(12) prescribing self-administered hormonal contraceptives; nicotine replacement

medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant

to section
151.37, subdivision 14
, 15, or 16;

(13) participation in the placement of drug monitoring devices according to a prescription,

protocol, or collaborative practice agreement;

(14) prescribing, dispensing, and administering drugs for preventing the acquisition of

human immunodeficiency virus (HIV) if the pharmacist meets the requirements in section

151.37, subdivision 17
;
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and
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(15) ordering, conducting, and interpreting laboratory tests necessary for therapies that

use drugs for preventing the acquisition of HIV, if the pharmacist meets the requirements

in section
151.37, subdivision 17
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.
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; and
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(16) initiating, prescribing, dispensing, and administering drugs for the treatment of

opioid use disorder pursuant to section 151.37, subdivision 18.

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Sec. 3.

Minnesota Statutes 2024, section 151.071, subdivision 2, is amended to read:

Subd. 2.

Grounds for disciplinary action.

The following conduct is prohibited and is

grounds for disciplinary action:

(1) failure to demonstrate the qualifications or satisfy the requirements for a license or

registration contained in this chapter or the rules of the board. The burden of proof is on

the applicant to demonstrate such qualifications or satisfaction of such requirements;

(2) obtaining a license by fraud or by misleading the board in any way during the

application process or obtaining a license by cheating, or attempting to subvert the licensing

examination process. Conduct that subverts or attempts to subvert the licensing examination

process includes, but is not limited to: (i) conduct that violates the security of the examination

materials, such as removing examination materials from the examination room or having

unauthorized possession of any portion of a future, current, or previously administered

licensing examination; (ii) conduct that violates the standard of test administration, such as

communicating with another examinee during administration of the examination, copying

another examinee's answers, permitting another examinee to copy one's answers, or

possessing unauthorized materials; or (iii) impersonating an examinee or permitting an

impersonator to take the examination on one's own behalf;

(3) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist

or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,

conviction of a felony reasonably related to the practice of pharmacy. Conviction as used

in this subdivision includes a conviction of an offense that if committed in this state would

be deemed a felony without regard to its designation elsewhere, or a criminal proceeding

where a finding or verdict of guilt is made or returned but the adjudication of guilt is either

withheld or not entered thereon. The board may delay the issuance of a new license or

registration if the applicant has been charged with a felony until the matter has been

adjudicated;

(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner

or applicant is convicted of a felony reasonably related to the operation of the facility. The

board may delay the issuance of a new license or registration if the owner or applicant has

been charged with a felony until the matter has been adjudicated;

(5) for a controlled substance researcher, conviction of a felony reasonably related to

controlled substances or to the practice of the researcher's profession. The board may delay

the issuance of a registration if the applicant has been charged with a felony until the matter

has been adjudicated;

(6) disciplinary action taken by another state or by one of this state's health licensing

agencies:

(i) revocation, suspension, restriction, limitation, or other disciplinary action against a

license or registration in another state or jurisdiction, failure to report to the board that

charges or allegations regarding the person's license or registration have been brought in

another state or jurisdiction, or having been refused a license or registration by any other

state or jurisdiction. The board may delay the issuance of a new license or registration if an

investigation or disciplinary action is pending in another state or jurisdiction until the

investigation or action has been dismissed or otherwise resolved; and

(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a

license or registration issued by another of this state's health licensing agencies, failure to

report to the board that charges regarding the person's license or registration have been

brought by another of this state's health licensing agencies, or having been refused a license

or registration by another of this state's health licensing agencies. The board may delay the

issuance of a new license or registration if a disciplinary action is pending before another

of this state's health licensing agencies until the action has been dismissed or otherwise

resolved;

(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of

any order of the board, of any of the provisions of this chapter or any rules of the board or

violation of any federal, state, or local law or rule reasonably pertaining to the practice of

pharmacy;

(8) for a facility, other than a pharmacy, licensed by the board, violations of any order

of the board, of any of the provisions of this chapter or the rules of the board or violation

of any federal, state, or local law relating to the operation of the facility;

(9) engaging in any unethical conduct; conduct likely to deceive, defraud, or harm the

public, or demonstrating a willful or careless disregard for the health, welfare, or safety of

a patient; or pharmacy practice that is professionally incompetent, in that it may create

unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of

actual injury need not be established;

(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it

is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy

technician or pharmacist intern if that person is performing duties allowed by this chapter

or the rules of the board;

(11) for an individual licensed or registered by the board, adjudication as mentally ill

or developmentally disabled, or as a chemically dependent person, a person dangerous to

the public, a sexually dangerous person, or a person who has a sexual psychopathic

personality, by a court of competent jurisdiction, within or without this state. Such

adjudication shall automatically suspend a license for the duration thereof unless the board

orders otherwise;

(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified

in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in

board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist

intern or performing duties specifically reserved for pharmacists under this chapter or the

rules of the board;

(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on

duty except as allowed by a variance approved by the board;

(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety

to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type

of material or as a result of any mental or physical condition, including deterioration through

the aging process or loss of motor skills. In the case of registered pharmacy technicians,

pharmacist interns, or controlled substance researchers, the inability to carry out duties

allowed under this chapter or the rules of the board with reasonable skill and safety to

patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type

of material or as a result of any mental or physical condition, including deterioration through

the aging process or loss of motor skills;

(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas

dispenser, or controlled substance researcher, revealing a privileged communication from

or relating to a patient except when otherwise required or permitted by law;

(16) for a pharmacist or pharmacy, improper management of patient records, including

failure to maintain adequate patient records, to comply with a patient's request made pursuant

to sections
144.291
to
144.298
, or to furnish a patient record or report required by law;

(17) fee splitting, including without limitation:

(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,

kickback, or other form of remuneration, directly or indirectly, for the referral of patients;

(ii) referring a patient to any health care provider as defined in sections
144.291
to

144.298
in which the licensee or registrant has a financial or economic interest as defined

in section
144.6521, subdivision 3
, unless the licensee or registrant has disclosed the

licensee's or registrant's financial or economic interest in accordance with section
144.6521
;

and

(iii) any arrangement through which a pharmacy, in which the prescribing practitioner

does not have a significant ownership interest, fills a prescription drug order and the

prescribing practitioner is involved in any manner, directly or indirectly, in setting the price

for the filled prescription that is charged to the patient, the patient's insurer or pharmacy

benefit manager, or other person paying for the prescription or, in the case of veterinary

patients, the price for the filled prescription that is charged to the client or other person

paying for the prescription, except that a veterinarian and a pharmacy may enter into such

an arrangement provided that the client or other person paying for the prescription is notified,

in writing and with each prescription dispensed, about the arrangement, unless such

arrangement involves pharmacy services provided for livestock, poultry, and agricultural

production systems, in which case client notification would not be required;

(18) engaging in abusive or fraudulent billing practices, including violations of the

federal Medicare and Medicaid laws or state medical assistance laws or rules;

(19) engaging in conduct with a patient that is sexual or may reasonably be interpreted

by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning

to a patient;

(20) failure to make reports as required by section
151.072
or to cooperate with an

investigation of the board as required by section
151.074
;

(21) knowingly providing false or misleading information that is directly related to the

care of a patient unless done for an accepted therapeutic purpose such as the dispensing and

administration of a placebo;

(22) aiding suicide or aiding attempted suicide in violation of section
609.215
as

established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation

of section
609.215, subdivision 1
or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction

issued under section
609.215, subdivision 4
;

(iii) a copy of the record of a judgment assessing damages under section
609.215
,

subdivision 5; or

(iv) a finding by the board that the person violated section
609.215, subdivision
1 or 2.

The board must investigate any complaint of a violation of section
609.215
, subdivision 1

or 2;

(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For

a pharmacist intern, pharmacy technician, or controlled substance researcher, performing

duties permitted to such individuals by this chapter or the rules of the board under a lapsed

or nonrenewed registration. For a facility required to be licensed under this chapter, operation

of the facility under a lapsed or nonrenewed license or registration;

(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge

from the health professionals services program for reasons other than the satisfactory

completion of the program;
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and
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(25) for a manufacturer, a violation of section
62J.842
or
62J.845
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.
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; and
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(26) for a pharmacist or pharmacist intern, engaging in conduct that departs from or fails

to conform with accepted standards for health care that would be provided in a similar

setting by a reasonable and prudent pharmacist or pharmacist intern.

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Sec. 4.

Minnesota Statutes 2024, section 151.37, is amended by adding a subdivision to

read:

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Subd. 18.

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Treatment of opioid use disorder.

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(a) A pharmacist is authorized to prescribe,

administer, and dispense legend drugs and controlled substances in Schedules III through

V of section 152.02 to treat opioid use disorder if:

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(1) the pharmacist has determined, based on medically acceptable standards, that treatment

is indicated and necessary; and

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(2) the pharmacist documents in the patient's health record the assessment, treatment,

response, and monitoring activities performed according to an individual treatment plan.

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(b) In order to prescribe a drug described in paragraph (a), the pharmacist must first:

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(1) successfully complete a training program specifically developed for practitioners for

the treatment of substance use disorders, in accordance with United States Code, title 21,

section 823(m); and

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(2) obtain the appropriate federal Drug Enforcement Administration registration number

required for the schedule in which that drug is included, if the drug to be prescribed is a

controlled substance.

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(c) Before dispensing a drug described in paragraph (a) that is prescribed by the

pharmacist, the pharmacist must provide counseling to the patient on the proper use of the

drug, the need for follow-up, and any additional information listed in Minnesota Rules, part

6800.0910, subpart 2, that must be provided during patient counseling.

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(d) A pharmacist is prohibited from delegating the prescribing authority under this

subdivision to any other person. A pharmacist intern registered under section 151.101 may

prepare the prescription, but before the prescription is processed or dispensed, a pharmacist

authorized to prescribe under this subdivision must review, approve, and sign the prescription.

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(e) Nothing in this subdivision prohibits a pharmacist from participating in the initiation,

management, modification, and discontinuation of drug therapy according to a protocol for

opioid use disorder as authorized in this section and section 151.01, subdivision 27.

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(f) Nothing in this subdivision prohibits a pharmacist from dispensing or administering

drugs for the treatment of opioid use disorder in accordance with a valid prescription issued

by another practitioner.

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(g) Nothing in this subdivision prohibits a pharmacist from charging for a service

authorized under this subdivision.

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Sec. 5.

Minnesota Statutes 2024, section 152.11, subdivision 2, is amended to read:

Subd. 2.

Prescription requirements for Schedule III or IV controlled substances.

(a)

Except as provided in paragraph (b), no person may dispense a controlled substance included

in Schedule III or IV of section
152.02
without a prescription issued, as permitted under

subdivision 1, by a doctor of medicine, a doctor of osteopathic medicine licensed to practice

medicine, a doctor of dental surgery, a doctor of dental medicine, a doctor of podiatry, a

doctor of optometry limited to Schedule IV,
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a pharmacist limited to Schedule III or IV and

in accordance with section 151.37,
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or a doctor of veterinary medicine, lawfully licensed to

prescribe in this state or from a practitioner licensed to prescribe controlled substances by

the state in which the prescription is issued, and having a current federal drug enforcement

administration registration number. Such prescription may not be dispensed or refilled

except with the documented consent of the prescriber, and in no event more than six months

after the date on which such prescription was issued and no such prescription may be refilled

more than five times.

(b) This subdivision does not apply to cannabis plants, cannabis flower, cannabis products,

or hemp-derived consumer products sold or transferred in compliance with chapter 342.

Sec. 6.

Minnesota Statutes 2024, section 152.12, is amended by adding a subdivision to

read:

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Subd. 2a.

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Pharmacist.

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A licensed pharmacist, in good faith and in the course of

professional practice only, may prescribe, administer, and dispense a controlled substance

that is included in Schedules III through V of section 152.02 and that the pharmacist is

authorized to prescribe, administer, and dispense under section 151.37, subdivision 18, and

may cause the same to be administered by a pharmacist intern under the direction and

supervision of the pharmacist.

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